Agony of road crash victims as facility grapples with scarce staff

Patients lie along corridors of Jaramogi Oginga Odinga Teaching and Referral Hospital casualty and trauma center. [Harold Odhiambo,Standard]

It takes about two hours before a patient in urgent need of help is attended to.

Largest referral hospital in Nyanza also lacks specialised doctors.

A man writhes in pain on a stretcher as blood oozes from his left leg at the casualty and trauma centre at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH).

He sobs quietly as a nurse intern passes by. A few metres from where the patient lies, three other patients are also lying on three beds placed at the casualty and trauma centre of the region's largest referral facility.

It takes about two hours before the patient is attended to by a nurse who bandages his injured foot and places him on a bench along the corridor before walking away.

But the patient is not alone. Along the corridors of the trauma centre, two other accident survivors brought by in an ambulance lie on two beds along the corridor. They haven't been attended to yet.

One of the patients - a male, groans in pain while holding his left hip.

Like the first patient, it takes more than three hours for the medics at the facility to turn their attention to him.

This is the experience most road accident victims go through as delays in providing emergency response, lack of enough specialised doctors, and slow response by medics worsen emergency response.

A three-week investigation by The Standard unearthed the woes that patients who require emergency treatment go through at the casualty and trauma centre at JOOTRH.

At the JOOTRH trauma center, interviews with patients, relatives as well as health workers established the horrors patients go through as the long waiting times worsen their conditions.

Fredrick Owino, a boda boda operator who survived a horrific road accident in December last year is among those who claim delays in responding to his medical emergency placed his life at a risk.

Owino was taken to the facility by well-wishers after he was involved in a hit-and-run accident. He suffered a broken leg and cuts on his thighs.

"I was hit by a pickup truck that fled after the incident but some people rushed me to the hospital," he says.

Despite the extreme pain he was experiencing, he claims he was only attended to the next day after the nurses who were available stopped his bleeding.

"It was a terrible experience. I was all alone and slept in a corridor at the facility," he says.

Interviews with medics at the centre established that the lack of enough medics and support staff was partly to blame for the slow response.

Maureen Nanjala, a relative of a patient who was also involved in a road accident in Maseno said that they spent more than five hours at the facility before her brother was taken through a chest and head x-ray.

"It was traumatising. All the nurses told us to wait before they could attend to us," she explains.

A nurse who asked not to be named said that in most cases they always strive to administer emergency medical care to the patients but admitted that they only focus on severely injured patients.

"We always try to give severely injured patients priority or patients who require resuscitation but there are days we are overwhelmed," said the nurse.

The nurse says the facility also doesn't have specialised doctors.

"All patients are seen by the general doctor who is sometimes overwhelmed. Accidents require a specialised response so that patients can get the right treatment as soon as they arrive," said the nurse.

Her comments were echoed by Kenya Medical Practitioners and Dentist Union (KMPDU) chairman for Nyanza Dr Onyango Ndonga who admitted that delays in providing emergency care to road accident victims put their lives at a risk.

"We should have accident and emergency trained nurses and doctors who are always ready to respond to road crash emergencies at all times. The specialists are the ones who should see the patients and know where they should be sent for various types of injuries," said Ndonga.

According to Ndonga, the situation is worsened by the lack of equipment and the necessary infrastructure. At the facility, some patients wait for even three months to undergo surgery.

"At times you will find that there are no bandages or other equipment and we have to send the relatives of the victims to go and buy before they can be assisted," said the medic.

The facility conducts an average of three orthopedic surgeries in a day. This means that patients who require emergency surgery have to wait longer because of backlog.

Ndonga claims that the situation worsens when some of the staff are on leave.

"It is true the delays are worsening the state of patients and can result to even the death of patients who could be saved if the response is prompt," he states.

He said they have already petitioned the county government to fast-track the employment of additional health workers to help cover all the critical areas and improve services.

"We should have accident and emergency trained nurses and doctors who are always ready to respond to emergencies. Kisumu should employ about 100 more specialists and more than 200 medical workers," he said.

Although health facilities in the region have been working to help improve trauma care, medics believe that increasing the number of staff as well as modernising equipment is vital for responding to emergencies.

According to health CEC Dr Gregory Ganda, the facility is overstretched because of too many referrals but denied patients are kept waiting before being attended to.

Ganda said that the facility operates five theatres and has been working to ensure that critically injured patients are responded to promptly.