Day or night our surgeries are safe, say KNH doctors

Health Cabinet Secretary Cleopa Mailu (left) when he visited twins who were recently separated at Kenyatta National Hospital.

Doctors at the Kenyatta National Hospital (KNH) have assured women of safe C-section surgeries.

Kenyatta, the largest referral hospital in the region, attends to the highest number of emergency caesarean deliveries in the country.

On average, records show that 10 to 20 emergency caesarean deliveries are conducted every day, distributed between day and night.

However, there have been reports of work overload at the hospital, frequent worker burnouts, and delays in scheduled surgeries.

Recent demands by striking health workers, some from KNH, have included rational working hours, employment of more doctors, and a humane working environment.

An earlier survey among health workers at KNH by top psychiatrists in Kenya found staff burnout levels to be among the highest in the world.

The global average, the survey led by consultant psychiatrist Donald Kokonya said, was 66 per cent but at KNH, it was 97 per cent.

The single biggest cause of burnout among the workers was reported to be a poor working environment characterised by too many patients and inadequate facilities.

“It is a miracle they are still working without serious consequences,” the survey, which also involved leading psychiatrist David Ndetei, concluded.

Now, a team of senior consultant gynaecologists at KNH says despite the huge work load, surgeries and particularly caesarean sections, meet high standards and are safe.

The team of Dr Anching’a Arnold Makori, Prof Bill Onjua Oyieke, Prof Patrick Muia Ndavi, Dr J. Wanyoike Gichuhi, and Dr B. Kihara tells of high numbers of caesarean sections done at the hospital, especially at night.

The spike, they say, comes about when scheduled operations are delayed and in most instances turn into emergencies at night. The doctors found that women scheduled for normal caesarean operations are more likely to turn into emergency cases at night than during the day.

“This was attributed to patients scheduled for elective surgeries missing theatre during the day and developing complaints at night.”

Elsewhere, they said nighttime surgeries had been reported to be less safe due to sleep-related staff errors.

“We wanted to find out whether this was the case at KNH and advise on staffing and shift management,” says the study published on Saturday in the East African Medical Journal.

The team recruited 240 patients undergoing emergency caesarean surgeries at the hospital. One half of the group was operated on at night and the other one during the day.

“We found no significant difference in outcomes between caesarean sections done during the day compared to those done at night,” the doctors concluded.

However the doctors agree that caesarean surgeries at the facility are less than ideal. They say of 1,435 deliveries during the two-month study period, 574 or 41 per cent were through caesarean section. This, they say, is higher than the national average.

“These high caesarean rates have led to high cost of health care, increased workload, and challenges in ensuring improved quality of care.”

They say it takes a full hour in Kenya, from when a decision for an emergency caesarean is made to performing the operation, while the recommend time is 30 minutes.