Hospital seeks court help to kick out ICU patient over Sh3.8m bill

General view of Aga Khan University Hospital, Nairobi, September 2022. [Elvis Ogina, Standard] For two months now, a patient who we will call Jane for ethical purposes, has been fighting to stay alive. At the age of 18, she has seen the worst; battling the jaws of death with the help of doctors and God. The Form Four student ought to be in class today. However, she has been confined in an Intensive Care Unit (ICU) bed since February this year. Jane has been in two hospitals now. She was initially at Kenyatta University Teaching Referral and Research Hospital (KUTRRH). This was before she was admitted at the Aga Khan University Hospital. The reason why she was moved from KUTRRH to Aga Khan was not explained in court papers exclusively seen by The Standard. However, from the look of things, Aga Khan Hospital does not want anything to do with her. Simply put, it wants the court to force her guardian to transfer her to another hospital as soon as possible. Alternatively, the private institution wants orders from the court allowing it to take her to Kenyatta National Hospital, or a nursing home. At the bottom of this unfortunate situation is growing tension over money. Aga Khan Hospital has stated that bills are shooting high and Jane's mother cannot afford to pay. When she was brought to Aga Khan, doctors found that Tuberculosis Meningoencephalitis (TBM) had knocked down Jane's system. Our research on what TBM is reveals that at least a third of the world's population gets TB. From the lot, about 10 per cent get clinical disease. Medical journals indicate that TB is likely to cause meningitis, which is said to be the culprit behind chronic cases. Jane is among at least 10 million persons who have or are suffering from the disease. The disease enters the body through inhaling infected droplets. As it advances from day one to nine months, its victim will show signs including headache, vomiting, photophobia, and fever. Jane was admitted in Aga Khan Hospital on February 11, 2024. Papers filed in court by Aga Khan indicate that she was brought into the facility as a self-referral from KUTRRH, where she was initially admitted and was being treated for TBM. Doctors at the Accident and Emergency Unit at Aga Khan saw that Jane needed emergency care and she was moved to the ICU. Doctors tried to control her seizures with anti-epileptics after which she was intubated. Her mother was listed as a next of kin, while her grandfather was named as her guarantor. The hospital has now sued the two. In its case, Aha Khan claimed that on February 29, 2024, its clinical team held a meeting with the girl's mother and relatives and informed them that the student would require a long period to recover. In the meantime, the hospital in its case before High Court Judge Chacha Mwita, said that upon assessing the mother's ability to pay, it decided to foot the bill through its welfare fund. As of May 14, 2024, Jane's medical bill had shot to Sh24 million. Part of the bill, Sh6.7 million was paid by a well-wisher while the hospital paid Sh13.5 million. It then left her mother to raise Sh3.8 million. However, Jane's mother was unable to pay the balance, Aga Khan stated. Initially, the hospital said that it had mooted to have the girl taken home to be treated there or at a nursing home by March 11, 2024. However, according to Doctor James Mwangi, a nursing home in Ngong, Trinity Care Nursing Home, had agreed to take in the girl. At the time she was to be transferred, Mwangi narrated that her condition changed and the plan aborted. However, Mwangi said that the girl's mother has also declined to consent to have her transferred from Aga Khan's critical care unit. According to the doctor, the girl can get the services she is getting in either a public health institution or a nursing home. "I know the patient does require continuous medical treatment and such treatment is available at subsidised costs in public health facilities like KNH," Mwangi explained. Official documents do not indicate whether Jane or her parents have insurance cover. Perhaps if the National Health Insurance Fund (NHIF) would have continued the Sh4.5 billion schools' insurance scheme EduAfya, Jane's sorry state of affairs would have been different. NHIF ended the programme in January this year. When EduAfya was operational, it offered comprehensive medical insurance coverage for students in public secondary schools registered with the National Educational Management Information System (Nemis). NHIF data indicates that in 2019 alone, some 606,893 students sought medical treatment through the programme. In the meantime, Kenya Kwanza's pet project Social Health Insurance Fund (Shif) does not have such a scheme in place. Aga Khan's lawyer said the subsidised costs in public hospitals will enable Jane continue with treatment. "Unless this matter is heard urgently and on priority, the petitioner's constitutionally guaranteed right to property and provision of services to other members of the public shall be jeopardised," he argued. As Jane continues to fight for her life from the jaws of death, her fate now lies in the court's wisdom. Her mother and grandfather are helpless.

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