Why patients abandoned by family have turned KNH wards into their home

Michael MusyokI, brought to the hospital in February 2024. [Rosa Agutu, Standard] Some were brought in unconscious by Good Samaritans; others walked in alone, writhing in pain. With no memory, no identification and no loved one nearby, just patients in search of care. In some cases, they are brought in by family members who never return. They arrived expecting a short hospital stay. Years later, the corridors of the hospital have now become their home. This is the story of 34-year-old Peter Muchiri, 37-year-old Michael Musyoka and Eunice Nasirombe, patients who now call Kenyatta National Hospital (KNH) their second home. In August 2018, Muchiri, then 27 years old, began coughing, and with every cough came blood from his mouth and nose. For the past seven years, the corridors of Ward 7D at KNH have been his constant companion. Dressed in a green hospital gown layered over his clothes, Peter slowly takes a walk before sitting down, breathing heavily. Even as he speaks, it's clear he is struggling to breathe. "My neighbours came for me, and I was rushed to Mbagathi Hospital. After a week, I was still coughing up blood. They referred me to KNH, where I was told my lungs had an infection," he recalls. Peter also opens up about his family situation. "My parents are dead, I have one brother, my elder brother. We weren't living together. I lived in Majengo, and he lived in Dandora. He knows I am here. He's been called, but he's never come. He is not interested," he says Life in the hospital, Peter says, is not for the faint-hearted. And after nearly eight years inside, he admits he has forgotten what life outside even feels like. "It's not easy, but I have to accept it. You just come to understand the challenges of living in a hospital. I can't go back home-I need the oxygen machine. I'm praying for a place I can stay that can support it," says Peter. Vumilia Mashauri, the Team Leader of Nursing at Ward 7D, knows his case all too well. The ward handles patients with chronic lung infections, and Muchiri is its longest-staying resident. "He suffered lung damage due to infection and is now oxygen-dependent. Such patients can be integrated back into their families if the family is willing to take them in," she explains. "But he also needs an oxygen concentrator to ensure a continuous supply at home." Before a patient is discharged, the hospital assesses where they will go. In Peter's case, reliable electricity is crucial, as the oxygen concentrator requires uninterrupted power. "If you're living in the slums, it becomes very difficult to operate the machine because of power issues. Then there's the cost of the equipment itself. For Peter, there are no relatives willing to help. That's why we don't know how to discharge him. He is oxygen-dependent and can only survive here, where the oxygen supply is guaranteed," says Mashauri. The price of an oxygen concentrator ranges between Sh70,000-Sh100,000. Still in Ward 7D, we meet Michael Musyoki, who is wheeled in for the interview due to a spinal injury. He wears a rosary around his neck and another on his wrist. He later tells us he prays the rosary daily, believing God will ease his suffering. Though his speech is affected, he communicates clearly. "I need support because I can't walk on my own. When I was at home, I couldn't speak or hear well, but now I feel better. I have a mother and three sisters. It's been a while since they last visited me," he says. "I'd love to go back home, but there's no one to care for me like they do here. Diapers are expensive, and I use them regularly," adds Michael. Mashauri explains that Musyoki was admitted in February 2024, brought in by his mother and sister. When the family stopped visiting, the hospital tried reaching out without success. Further inquiries revealed that financial hardship at home may be the reason."We took Michael's history when he arrived and found he was living in a single room with his mother and two sisters," says Mashauri. "That living arrangement was already problematic." Everyone in the household depends on casual work to survive, making it difficult to care for Michael, who cannot be left alone. At Ward 4C, the neurosurgery unit that handles head injuries, we meet Eunice Nasirombe. A nurse wheels her out of the ward; she's wearing a hospital green gown, lying on a bed with a plate of food beside her. She gently lifts her head to take a bite. "There's some improvement, at least now she can feed herself," the nurse says. Jeremiah Ouma Ayiro, the nursing team leader at Ward 4C, explains that Eunice was admitted to KNH on December 2, 2024, with an intracranial haemorrhage caused by hypertension. She underwent surgery and was later moved to the ICU, where she remained until February this year. June this year is when she started feeding normally," says Ayiro. Eunice was cleared for discharge, but no one came to take her home. The only reachable relatives were her son and uncle, neither of whom was willing to collect her. Grace Njiru, Senior Nursing Officer at Ward 4C, says the team continues to provide Eunice with essential care-feeding, bathing, and changing her. "She's still under treatment for hypertension. About three-quarters of our patients are bedridden, so we offer full-time care. We also involve a physiotherapist and a counsellor. Eunice has been with us for quite a while," Njiru says. According to Phillis Murithii, a medical social worker at KNH, part of their service charter requires that all admitted patients be seen by a social worker within 48 hours."We are expected to assess each patient within 48 hours-find out who they are, where they come from, and whether they have any family or friends visiting them," says Phillis Murithii, a medical social worker at KNH. But what happens when a patient is unable to speak or has no identification? "We have a system where, together with the National Registration Bureau, we take the patient's fingerprints if they lack a national ID. Once we receive results, we can trace where they're from and begin contact tracing," she explains. If that fails, they turn to social media and other networks. While some cases are successful, others lead to dead ends. "If we can't reach any relatives, we conclude the person is alone. That's when we start looking for long-term care options," Murithii adds. "We partner with religious groups, private institutions and well-wishers. Once the paperwork and bills are processed through KNH, we help place them in a suitable institution."

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