The curse of inadequate equipment in hospitals

By Paul Wafula

Mildred (not her real name), a medical professional, watched in horror as a mother and her unborn son died under her watch three years ago because there was no ambulance to transport the pregnant woman to a provincial hospital.

“The sad bit was that there was nothing the doctor on duty, the midwife or I could do,” she recalls. “Everything that could go wrong went terribly wrong that night. It felt like I was killing them myself. I was so guilty and desperate.”

“A minor operation would have seen the patient safely deliver. But what I have never got over in the experience is the fact that I had to face the waiting friends and relatives to break the news that we couldn’t save her because we lacked the necessary tools.”

For a start, the hospital had no theatre. She says the incident was her first shock as she began her career in the medical industry. She always wanted to save lives. That was her motivation as she sat through the torturous lessons at Mumias-based St Mary’s School of Clinical Medicine and Surgery, where she earned her diploma in clinical medicine. Now she was disillusioned.

Grim reality

The incident happened at Kisumu’s Chulaimbo Hospital where she had been posted. It was in August 2010 when she first came face to face with the reality of how a poorly funded national health system has reduced medical practitioners to mere spectators. Medics watch patients die in their hands.

“She was brought at about 10pm. The lady had already been given some local herbs to quicken her delivery,” Mildred goes on.

“We realised the baby was in a breech presentation. This is when a baby comes out of the canal with its feet first instead of the head,” she goes on.

“There was a doctor and even a qualified midwife among the nurses. But we were helpless. We needed a theatre for the operation,” she says. The pregnant mother was screaming in pain. But the doctor did what was to be done, refer the case to the Nyanza Provincial General Hospital. This is when the system got nastier.

The ambulance had no fuel. That was not all. A Good Samaritan volunteered a car to take her, but there was also no driver in sight. “We knew she would die if nothing happened. Nothing happened. And she died. Then her son followed. The two died under our watch,” Mildred adds.

“This was the first time I cried in front of the patients and her relatives. Doctors, nurses and clinical officers are not supposed to cry. If they do, their tears must not be seen. But I had not been prepared for this,” she said. For the past two years, she has seen this incident repeat itself more than a dozen times in the two stations she has served in western Kenya. There was a time she wanted to quit. “What is the point? It is made worse by patients who are increasingly getting too demanding without the knowledge of what capacity the doctor has. Their training, what they can do and what they cannot do,” she adds. But now she has developed a thick skin.

Small gods

Mildred even thinks that it is normal. Her story is so familiar among the medical professionals, who she says are expected to perform ‘miracles’ or are seen as small gods.

“Once a patient arrives in hospital and sees a doctor, they know their problems are over. How wrong they are,” says Janet, not her real name, a health officer at Kakamega County’s Malava District Hospital who last month saw a 12-year-old die. “It was late last month. The boy had Meningitis. His case was both lack of the necessary equipment and arrival to hospital too late to allow medics do any meaningful treatment. This is not rare. We literally counted his last 15minutes,” she adds as she pleads with me not to use her real name because she would easily be picked out.

“The medical industry is just like the military, if you fall out with your bosses, who most of the time happen to be your supervisor, then forget about a license,” a registrar who is in Nairobi from Kilifi to sit his exams told Standard in an interview. He sums up the health situation in the country as ‘pathetic’. 

These are just a tip of the iceberg. In sourcing for this story, we heard tales of cases where doctors were forced to go into theatre without enough blood, some operated on their patients in darkness or with the help of a torch, some have gone ahead and taken on cases without protective gear. It common for hospitals to run out of critical supplies like gloves, syringes, anesthesia and drugs.

There is a familiar case where the oxygen tank ran out on a doctor doing a Caesarean section on a lady who had been struggling to conceive for ten years. Result, a dead mother, twins, and a doctor hit by serious post-theatre distress. “But who cares about the plight of doctors,” Janet adds.

Kenya has literally ignored all the stress signs in the medical industry. It has been cutting its spending on health as a percentage of the total budget for the past five years in a trend that is gradually grind