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Scandal of biggest hospital without crucial equipment

 Kenyatta National Hospital suspended CEO Lily Koros when she appeared before the National Assembly Health Committee at Continental house on March 15, 2018. [Photo by Boniface Okendo/Standard]

If you have been scheduled for a heart surgery at Kenyatta National Hospital, you must wait for a heart and lung machine to be borrowed from a private institution before the procedure can be performed.

And the biggest referral hospital in East and Central Africa can no longer perform some surgeries due to lack of crucial equipment, and instead refers patients to private hospitals.

It is shocking that KNH does not have a heart and lung machine, critical in life-saving heart operations.

The machine costs Sh30 million. KNH performs an average 1,200 heart surgeries per year.

A heart surgery costs between Sh120, 000 and Sh600,000, using the heart and lung machine. Charges depend on the nature of treatment.

Lung machine

The heart and lung machine at KNH has not been working for months. The machine takes over functions of the heart and the lungs, with sufficient safety to sustain life while the heart is stopped or opened for surgery.

The findings are in a report by the National Assembly Health Committee that probed a recent incident where a brain surgery was carried out on the wrong patient at KNH.

Plastic surgeons at KNH have sometimes had to manually harvest and transplant skin on patients requiring grafting. The only skin grafting machine at KNH broke down in 2015. It was taken to the US for repair, but has never been brought back.

The skin grafting machine, according to the report, was a donation by well-wishers. KNH has not replaced it. Experts say manual harvesting and grafting of skin is painful and takes time to heal compared to when a machine is used.

And the hospital has not had a functional Magnetic Resonance Imaging (MRI) for one year now. Patients are referred to lower cadre hospitals, an irony for a facility that is meant to be last resort for patients.

The report shows how dysfunctional the facility is, hamstrung by lack of equipment and a stretched workforce. KNH’s burns unit is one of the most affected.

It is not clear why KNH was left out of Jubilee government’s Sh38 billion Medical Leasing Equipment Scheme meant to ensure each county has modern equipment for specialised treatment.

In the past one year, patients at KNH have not accessed MRI services after the machine broke down and was declared unserviceable. An MRI machine costs Sh200 million.

A patient in need of MRI head scan has to part with between Sh23, 000 and 24,000 to get the services in private hospitals. However, when KNH’s scanner was operational, a patient paid Sh16, 000.

The machine, with a lifespan of seven years, has been in use since 2005. This has made the machine become technically obsolete in 2016. Last year, it emerged the machine could not work anymore after losing helium, used to cool it.

The report says a new MRI machine is expected in June. However, until then, about 18,000 accidents victims, making up a quarter of the annual inpatients, are being referred to Nairobi West Hospital for the crucial scans.

“It has become impossible for doctors to conduct scans hence, the patients are being referred to private hospitals where the costs are high,” says the committee report.

The hospital is also said to have one laparoscopy, a diagnostic equipment used to observe organs in the abdomen. The machine is in theatre six. Ideally, KNH should have four of such machines.

“This is after operating without one for six months. Procurement of two more machines has been slow,” the report says.

Treatment machine

Last year, Kenya’s oldest cancer treatment machine at the KNH was finally retired. The Cobalt 60 radiotherapy machine was bought in 1983 and was meant to work for 15 years and be retired in 1998.

KNH continued using it, beyond its lifespan, until last year when it was replaced.

The committee, led by Murang’a Woman Rep Sabina Chege, however, absolved the hospital from blame.

“The budget allocation to KNH has always been below what is required. These budgetary challenges, to some extent, contribute to the deplorable state of some of the critical equipment, medical facilities as well as human resource inadequacies in this national referral institution,” the report reads.

In the past four years, KNH has been receiving an increased allocation which hit Sh9.1 billion in 2017-2018. The facility also makes Sh4.5 billion on average every year from the services it offers.

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