The sorry state of Siaya's health sector

Siaya governor James Orengo when he visited Bondo sub-county hospital last Monday. [Isaiah Gwengi, Standard] When it was upgraded to a level four hospital more than a decade ago and with the health functions devolved, residents of West Yimbo in Bondo sub-county expected that health needs would be well catered for. However, Got-Agulu, the only referral facility that serves more than 28, 000 residents from five sub-locations, including three islands is a mere shell and is grossly understaffed, ill-equipped and perennially lacks essential drugs. Mary Achieng, a resident of Ulowa village has used the facility for more than one decade, with minimal improvement in infrastructure. "Having been upgraded, we expected that everything else would have improved but nothing much is happening," said Achieng. Children are forced to share a ward with women. Whenever it rains, accessing the hospital from the main road is also difficult. Patients say that in some instances, they are sent home to buy syringes, drugs and even cotton wool to dress wounds. According to the Kenya Medical and Practitioners and Dentists Board which is in charge of the classification of medical facilities in the country, a level four hospital should be able to handle an emergency, general and specialized operations. The facility should also have the capacity to manage medical, surgical, paediatric and gynaecological in-patients, radiology services, renal dialysis, tuberculosis management and mortuary and autopsy services. While the requirements also indicate that such a facility should have a 150- bed capacity for inpatients with 30 beds each for male, female, paediatric, antenatal and postnatal wards, Got-Agulu falls short of these. A staff privy to the happenings at the hospital said the conditions were discouraging. "The hospital has enough space for expansion but it is yet to meet the specifications of a level four hospital," said the staff. The least number of clinical officers that Got-Agulu should employ is 195 specialists with 76 special nurses, 4 pharmacists, 2 clinical Pharmacists and 8 pharmaceutical technologists. With no specialists, 18 beds for in-patients and two delivery beds in the labour ward, the hospital which is yet to have a mortuary and x-ray facility has a long way to go. It is against this backdrop that governor James Orengo has embarked on a mission to resuscitate the county's ailing health systems. Orengo, who has visited Siaya County Referral Hospital and Bondo sub-county hospital, came face to face with the challenges. He promised to address them. In Mageta Island, Monicah Atieno, a mother of five took a tiresome and dangerous journey across the waters of Lake Victoria to deliver her fifth born child in a health facility. Here, Mageta Health Centre is the only public health facility for more than 10,000 residents on the entire island. However, it also lacks basic health equipment. Most patients are forced to make dangerous journeys even in the middle of the night through the lake to access hospitals on the mainland. "I was referred to Bondo Sub-County hospital since I had a delivery complication. I was to be at the hospital at 9am to be examined by a doctor," Atieno tells The Standard. Atieno, who boarded the 6am boat from Mageta Island to Usenge beach, was delivered in the boat just as they were about to dock. "With the help of women who were aboard the boat, I successfully delivered my baby girl," she says adding that she was taken back to the island where she was examined and allowed to go home. Atieno is among the many women in the county's islands, who despite the government's free maternity care, have to contend with long distances and inadequate facilities to access health services. According to Millicent Anyango, a Community Health Volunteer (CHV) on the island, the number of mothers who are giving birth at home has gone down. "Our challenge as CHVs is lack of proper means of mobility. We would like the county government to consider getting us bicycles or motorbikes to enable us to reach as many women as possible," said Anyango. Bondo MP Gideon Ochanda says the county government needs to upgrade most of these rural health facilities in order to minimize medical referral cases. "There is need for the new administration to find ways of managing basic health problems," he says. Constant electricity power interruptions and water shortages have been another greatest challenge in the county's health sector with most of the health facilities unable to stock drugs that require refrigeration. In his manifesto, the governor promised to ensure that all stalled health projects are completed and made fully operational. Orengo, who is banking on the swearing-in of the Siaya Members of the County Assembly who will then pass the supplementary budget to fix the gaps in the health system, said his administration is also going to empower all the CHVs to offer basic care to children and pregnant women. "Once the assembly starts its operations, they will be able to prepare a supplementary budget to enable us to address the critical areas in our health facilities," said Orengo. The governor also announced that his administration plans to elevate the Siaya County Referral Hospital from level five to a satellite hospital under Jaramogi Oginga Odinga Teaching and Referral hospital. He also revealed that they are going to address the shortage of specialists so that the locals could access quality healthcare. "We also want to address the welfare of health workers in the county to ensure a dedicated workforce and improved services and a clear promotional structure based on their terms of service," he said.

The sorry state of Siaya's health sector

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