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Unmasked: Hard truths State faces over protective gear

By Daniel Wesangula and Allan Mungai | April 11th 2020 at 00:00:00 GMT +0300

Workers from New Dawn company in Kikuyu, Kiambu county prepare a mass production of surgical face masks. [John Muchucha]

A month after the announcement of the first novel coronavirus case in the country, Kenyans are still grappling with how best to keep themselves safe.

Apart from conducting tests and issuing an array of directives, little else has been done by the government for a majority of poor and vulnerable Kenyans.

A series of directives from Health Cabinet Secretary Mutahi Kagwe may cause more harm than good during these difficult times. On Tuesday, the CS decreed that it was mandatory for Kenyans to wear face masks whenever they use public transport or go into public spaces such as supermarkets.

The Kagwe directive came on the back of a Special Issue Gazzette notice that made it mandatory to wear a mask in public and prescribed a fine of up to Sh20,000 or a six-month imprisonment for breaking that law.

But in a country that did not have a vibrant mask manufacturing industry before the coronavirus hit, millions of Kenyans have found themselves without an item that has almost become a pass for venturing outside your house.

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Both President Uhuru Kenyatta and Mr Kagwe insist that the country’s stockpile of masks and personal protective equipment are enough to satisfy local demand with local manufacturing plugging the deficit.

Hard questions

“Fortunately for us, we don’t have to import them anymore, were are making them locally now. We are now able to manufacture personal protective equipment and therefore to assure all health workers that they are now secure going forward. A factory in Kitui is manufacturing 25,000 masks per day,” Kagwe said on Saturday. 

“We do not approve anything until the doctors themselves say it is good quality,” he added.?

Now, consumer protection agencies and nurses unions are asking hard questions: where exactly should Kenyans get these masks that now determine whether one can access public transportation or supermarkets?

Critically too, the quality of masks being used by healthcare workers has come into question, endangering a critical group instrumental in the war against Covid-19. This, as entrepreneurial Kenyans make all manner of masks, some which are ineffective.

The response from the government has been simple enough. Each to his own. Get creative. We are working on it.

“It is critically necessary that every Kenyan wears a face mask while in public spaces. Everyone must make the effort to get a mask to protect themselves and others as we endeavour to provide them,” Kagwe said in a briefing.

Like most things in government, even prior to the Covid-19 epidemic, timelines remain fluid. A week before this statement, Kagwe and his Industrialisation counterpart Betty Maina announced, again from the steps of Afya House, that they had engaged several manufacturers who were, at that particular moment already producing face masks and other relevant Personal Protective Equipment (PPE) necessary for the corona war.

Following this announcement, Eldoret-based Rivatex East Africa declared they were in the running for mass production of face masks.

“As a textile facility, we have embarked on the production of face masks. Everything is running smoothly and we expect to produce enough to help in the fight against this pandemic,” Rivatex Managing Director Thomas Kipkurgat said in a March 31 interview, during which he also said the firm would make 8,400 face masks a day over a 24-hour production cycle.

“Each tailor can produce up to 120 face masks a day. We have a dedicated unit where our staff are working 24 hours on rotation,” said Kipkurgat.

Weeks since his announcement, the ideally close to 60,000 masks were yet to be released, let alone reach the public. Even nurses, critical to the fight against the virus, were still dealing with shortages in the various hospitals.

Enquiries to the Eldoret plant on the number of masks and protective suits completed were met by a brief answer.

“Let me check out and get back,” Kipkurgat said when contacted by Saturday Standard.

Responding to questions on Thursday on the protection of nurses and doctors, Kagwe again revised his initial timeline from availing PPEs to front line staff from “as soon as possible” to a more tangible future.

“On the issue of the PPEs, we will not be needy. Nobody will be lacking in the next two weeks. We have an additional 10,000 kits this week. In the next two weeks, we will roll out about 200,000 kits,” the CS said.

The nurses’ union says all they have from the government are promises.

“There is no improvement. All we have are promises from various manufacturers. We have not even received one mask, let alone a whole PPE kit. There is nothing like that,” Kenya National Union of Nurses Secretary General Seth Panyakoo told Saturday Standard.

Kitui County Textile Centre (KICOTEC), a county-owned textile factory is one of the establishments also making PPEs and face masks.

“The challenge has been that we never really thought we could make these things locally,” Kitui Governor Charity Ngilu told Saturday Standard. 

Ngilu says the factory only got the Kenya Bureau of Standards (Kebs) Certification on Friday April 3, close to a week after the public announcement by the President that Kitui would be one of those making the PPEs.

“We are looking at producing some 30,000 pieces per day,” Ngilu said.

But, none of these are yet to be publicly distributed, apart from what she calls ‘low quality’ masks to boda boda operators in her county.

“The high quality masks will be reserved for those in the medical profession.”

There have been other ideas as well put forth by the President, all aimed at making the lives of Kenyans better during this crisis. Most of these, the economic interventions that were to be effective on April 1. are yet to reach the man on the ground.

Cushioning measures

Whereas the impact of the disease on the economy has been immediate, the cushioning measures are taking more time. To date, commodity prices in shops are still holding firm, no noticeable reductions from the pre-corona prices.

The Consumer Federation of Kenya (Cofek) said the ongoing outbreak should not be an excuse for government quality control agencies to look the other way.

“Government has a duty to ensure proper quality of goods are in the market. Existence of Covid-19 does not amount to waiver of the law that the likes of Kebs and Anti-Counterfeit Authority (ACA) are supposed to enforce,” said Cofek Secretary General Stephen Mutoro.

“We urge Kebs and ACA to deploy their surveillance officers on the streets of Nairobi and Mombasa to curb the fraud being experienced.”

“We have standards that have been clearly articulated by the Ministry and the Kenya Bureau of Standards for medical masks. The only place where we do not have standards is in the place of cloth masks…but it is better to deploy even the cloth mask to protect our people,” said Dr Patrick Amoth, Director Genreal.

Healthcare workers on the frontline have been forced to come up with quick solutions in a bid to first protect themselves from the virus, then those they are attending to.

The doctor’s union, Kenya Medical Practitioners and Dentists Union (KMPDU) has set up a fund asking the public to contribute to it for the procurement of PPE for their members on the frontline.

But it is not only doctors that are worried about scarce protective face masks. Since Monday, despite the difficulty of acquiring the recommended three-layer medical masks, increasing numbers of people have worn protective masks but of various kinds, from cloth masks fashioned out of kitenge to dust masks, all of which cannot filter fine respiratory droplets that spread the virus.

Following the gazettement of the Covid-19 Restriction of Movement of Persons and Related Measures, retail outlets have said they will not allow anyone without a masks into their shops.

But the prices charged by distributors have been wildly varying. 

On Tuesday, former National Assembly Deputy Speaker Farah Maalim was shocked to discover that the price of a pack of 50 pieces disposable surgical masks had increased seven-fold.

“I earlier bought it at Sh1,000 but it isnow retailing at Sh7,500 a pack,” Mr Maalim said, asking Kagwe to protect Kenyans from profiteers.

However, the Ministry of Health expects that the price will fall to as low as Sh20 for a single mask when local production ramps up.

The government now says manufactures have assured it of their capacity to produce up to 60 million masks for immediate distribution.

“Garment manufacturers have enough materials in stock that can produce up to 60 million masks which can be distributed immediately,” CS Maina said earlier in the week.

“We are not saying that people should sit around and wait for masks to come to them, you now have the freedom to make them as cheaply as possible provided they are following the laid guidelines,” Kagwe has said. 

A joint Kebs and Ministry of Health statement advised the public to leave the surgical masks and N95 respirators to frontline healthcare workers and patients owing to their limited supply. So far, things remain touch and go. And outside Nairobi, the epicenter of the disease, availability of protective equipment still remains a distant hope.

Elgeyo Marakwet County Executive Committee Member for Finance Isaac Kamar has said funds, testing kits and PPEs from donors have not been delivered to the county yet, raising questions on preparedness of counties in treating Covid-19 patients and taming the spread of the virus.

Mr Kamar called for immediate release of funds from The National Treasury to fight the pandemic, saying counties such as Elgeyo Marakwet which receive little allocations are cash strapped and are likely to be overwhelmed in case of a Covid-19 worst scenario cases.

“We have learnt that there are funds and equipment from donors and we were hoping that the support would trickle down to the counties,” he said.

Critical gear

Clinical officers around the country say they too bear the brunt of the shortages.

“We will withdraw our services from counties that will not provide our members with PPE,” George Gibore, the secretary General Kenya Union of Clinical Officers, said. “Ninety per cent of the respondents have only received gloves. Only 57 per cent of them have received masks.”

As the government assures the public that they will access the critical protective gear soon amid the coronavirus spread, demand for the same in Europe and America, which have a higher disease load have increased significantly, starving African countries of access as a result.

Outside China, few other countries are able to manufacture enough masks to satisfy their demand.

The result has been stiff competition for the masks coming from China and which are in short supply due to logistical challenges.

For instance, although the details were unclear, Kenya has been accused of stealing masks intended for Germany. The US has been reluctant to permit a mask manufacturer from supplying Canada and France and Germany are both reported to be accusing the US of diverting their supplies.

Face Masks Coronavirus Kenya Health CS Mutahi Kagwe
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