Poor management puts Health Sector in Baringo on its ICU

By Mercy Kahenda | Saturday, Sep 1st 2018 at 08:40
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A medic at the ICU unit in Kabarnet hospital on August 24, 2018. [Kipsang Joseph, Standard]

Sickening.

That is the exact word that can describe the state of the biggest hospital in Baringo County.

And the story of Nancy Chewochei Lotule, an accident victim who was rushed to the hospital on August 3 paints even a grimmer picture.

Lotule, recalls her sister, was rushed to Kabarnet County Hospital with multiple injuries and was put on oxygen. When the first cylinder of oxygen ran out, the doctors asked for a second one. It was brought, but it was empty. They asked for a full one, and it was brought, but there was bigger problem: They could not turn on the gas.

When her relatives were advised to rush her to the Moi Teaching and Referral Hospital at 5pm, an ambulance provided had a leaking fuel tank. Another ambulance was brought at 6 am but it had a normal hospital stretcher, did not have an oxygen cylinder and its siren was not working, forcing the driver to hoot all the way to Eldoret.

Sleepy nurse

The patient arrived at the referral hospital at 9am, but the 24-year-old died at 10am while waiting to be admitted.

“Had she received services on time at Kabarnet, she would not have died. My sister would not have died if she was placed in a well-equipped ICU unit and attended to on time,” Lotule says.

On a visit to the facility on Saturday morning, one nurse struggles to attend to 20 patients at the casualty section.

Just a few steps into the casualty area, there are visible traces of blood along the corridor; used cotton wool, gloves and syringes contaminated with blood litter the floor in one of the wards.

At around 8am, another sleepy nurse emerges from the nursing room. She slowly heads to a nearby room to wash her face before attending to patients.

Kabarnet County Hospital, which attends to approximately 800 out-patients is manned by nine doctors, over 90 nurses and 14 clinical officers.

Hassan Kibet is among those who have been patiently waiting the entire night to have his younger brother with stomach complications attended to.

Kibet keeps knocking on doors at the casualty, hoping to get help, and luckily, at 8.30am, a nurse known to him arrives. He follows her to dressing room and pleads with her to attend to his brother. She administers antibiotics and directs them to the pharmacy. However, they are forced to leave the facility after they find the pharmacy locked.

Only one nurse

“You cannot receive emergency services at this hospital unless you are known to a health worker,” he tells The Saturday Standard.

At the hospital’s Intensive Care Unit (ICU) this reporter found two patients in acute pain. Alfadine Kendagor is taking care of her ailing mother, Talaa Chebii. She covers her with light blankets and sheets but they do not seem to keep her warm.

“I brought these blankets from home, and even though my mother is feeling cold, I do not have money to purchase more to keep her warm. I was shocked to learn that the facility does not provide bedding for patients,” Kendagor says.

Chebii, who has a fresh wound on her leg had earlier been admitted with acute pneumonia. The unit, manned by a Cuban ICU specialist has contracted only one nurse. She handles patients single-handedly. She is overwhelmed, and keeps checking oxygen cylinders and ventilators as she monitors patients. The ICU lacks crucial equipment like ventilators that help in breathing. Patients who require specialised care use oxygen cylinders.

According to a medic who works at the hospital, piping of oxygen has been done, connecting to ICU, wards and theatre but it is not being used, simply because there is no oxygen plant.

There is no main monitor to observe operations of each patient at the facility. Each bed is connected with a monitor that requires a medic to keep walking from one patient to another for observation. Further, there is also shortage of personnel. For instance there are only two nurses who went to Australia for an induction course on ICU operation. For a functioning facility, a trained ICU specialist nurse is required, including other medics like lung specialist, an anaesthetist, a neurosurgeon and critical care nutritionist, says a source.

In the wards, somepatients have been waiting for weeks to be attended to. Faith Chepkoech, has been lying on the hospital bed for one month. After giving birth on July 24, she was discharged but returned after four days when she developed complications.

She says the gynaecologist recommended she undergoes magnetic resonance imaging (MRI) scan, but has only been offered painkillers. She has been discharged but cannot leave because of accumulated hospital bill of Sh21,000.

“I have been discharged, but I am still unwell. I cannot understand why I have not been checked and treated,” she says.

The CT scan at the facility has not been operating for two weeks and needs to be serviced.

Not functioning

“Patients are sent for CT scan either in Nakuru or Eldoret because our machine is not functioning,” says an employee who requested for anonymity.

The radiology unit has also not been spared. It does not have radiography doctors, and the hospital management has to send images to a consultant doctor based in Eldoret via email. Results according to a source, are sent after approximately 12 hours.

Interestingly, Chief Officer Health Dr Gideon Toromo and Hospital Superintendent Dr Stephen Kalya do not agree on what really ails the hospital.

While Dr Toromo blames shortage of funds for the lack of blankets and linen, the Superintendent denies such a problem exists. “The hospital is supposed to receive bedding, though the allocation delay might have contributed to the shortage,” Dr Toromo says.

Dr Kalya, however, says that the facility has enough linen. “All patients are provided with linen on admission. Some patients, however, choose to buy their own blankets,” Kalya says. 

He acknowledges that the ICU is not fully operational due to lack of an oxygen plant and requires funds for its construction to be complete.

He adds that the Cuban doctors deployed at the facility are yet to be fully deployed. “One of the Cuban doctors is based at the ICU, with another reviewing general cases like tuberculosis and malaria.”

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