Where have the Covid-19 billions gone?

Kisii County 310 bed capacity Isolation Centre at Kisii Teaching and Referral Hospital. [Sammy Omingo, Standard]

Lack of accountability, corruption and theft of the much needed Personal Protective Equipment (PPE) may be the biggest stumbling blocks in the country’s fight against Covid-19.

These, coupled with inaction by county governments outside the cities of Mombasa and Nairobi in executing the simplest of requirements by the coronavirus task-force, continue to expose many to a disease that is projected to infect more than 41 million Kenyans by 2021.

Kenyans today find themselves between a rock and a hard place. On one hand, the pandemic is spreading through the nation at rates never seen before.

As this goes on, the government is offering little faith in its handling of billions of shillings meant to manage the virus and how it is distributing tonnes of donated PPE to front-line health workers.

This vagueness paints a picture of a free fall in Covid-19 management.

A compilation by The Standard News Desk and data from Treasury shows that almost Sh300 billion, more than Sh200 billion of it in cash from public coffers and donors, may have already been spent on Covid-19 since the confirmation of Kenya’s first case on March 13.

Yet, even with this arsenal at its disposal, the government is still struggling to control the spread of the virus, leading to devastating consequences.

Critical PPE have gone missing from government warehouses as unscrupulous businessmen with connections within government exploit weak regulations and the sense of urgency the country is under to sneak out this equipment and sell it back to the State.

As a direct result of lack of PPE, 526 healthcare workers have been infected with the virus.

Marked 'urgent'

Investigations show that PPE received from donors was often marked ‘urgent’, giving clerical employees at the Government Clearing Agency (GCA) very little time to take the donations through the normal clearance procedures.

“As a result, most of these donations, being marked as government-to-government, never spent time with us. They were often cleared on the same day and moved on to the receiving agency,” a source familiar with the protocol around the Covid-19 donations said.

The GCA is responsible for clearing and forwarding all government imports and exports besides handling sea passages for expatriates.

Our source said all protocols of inspection and mandatory cataloguing were bypassed for PPE, creating a loophole for unscrupulous individuals to steal them.

“Very few people knew how much was brought to the country,” the source said.

Once the donated equipment left airport warehouses, they never reached healthcare workers.

The Standard's trail of investigations into the matter went cold after the Directorate of Criminal Investigations (DDI) took over. To date, there have been no arrests, although more than a dozen persons of interest have recorded statements on the matter.

Our queries to the Ministry of Health Permanent Secretary Susan Mochache were not addressed. Calls went unanswered and messages were not responded to, even as the intended beneficiaries of the donated equipment continue to test positive for the virus.

“There is still a gap with regards to accessibility of PPE,” the Kenya Medical Practitioners and Dentists’ Union Secretary General Chibanzi Mwachonda told The Standard. “This is why most of us are getting infected.”

Kenya National Union of Nurses Secretary General Seth Panyako says despite promises by the government, health workers continue to put their lives at risk as a result of ‘systematic looting’ of donated PPE.

“At the Kenyatta National Hospital (KNH) they ask you to use one mask for 24 hours,” Panyako says. “We are not properly protected. This overuse might be contributing to infections in our ranks.

On July 14, at least 41 nurses at Pumwani Hospital, the largest maternity hospital in the country, tested positive for the virus.

The fight against Covid-19 is an expensive one. The United Nations Economic Commission for Africa estimates that the continent needs Sh10 trillion to tackle the virus across all sectors.

Closer home, billions of shillings have already been committed to the fight. In April, Kenya received Sh5.32 billion from the World Bank.

Under the Project ID P173820, the World Bank loaned Kenya Sh5 billion for the Covid-19 Emergency Response. National Treasury received the money on April 8.

Under seven components, the money loaned to Kenya was supposed to handle the immediate and long-term emergency public health preparedness needs in the country.

The medical supplies and equipment component “aims to improve the availability of supplies and equipment needed to respond to Covid-19, other public health emergencies and, strengthen the capacity of the Ministry of Health to provide timely medical diagnosis for Covid-19 patients.”

Internally, there has been more commitment from Treasury. According to Treasury Cabinet Secretary Ukur Yatani, these commitments by the government led it to forego revenues of up to Sh176 billion to cushion the economy from the effects of the pandemic.

Pending bills

“You have to understand that the first set of interventions wasn’t fiscal,” Yatani told The Standard yesterday. “We had to make sure government paid pending bills, initiated tax refunds as well as revised the VAT downwards.”

But there have been some monetary interventions.

“We have used Sh38 billion to support the health sector. Of this, Sh5 billion has gone to the counties through the Ministry of Health,” says the CS. “Another Sh157 billion has been used to cushion the economy through various programmes like Kazi Mtaani and the ongoing social support.”

The money released to counties by Treasury was meant for two key things.The first was to help every county build a fully functioning 300-bed isolation facility for projected Covid-19 cases.

The proposal to have counties have isolation facilities was made towards the end of January 2019 by a team of Ministry of Health experts tasked with looking into the country’s disease preparedness.

Most of the 44 counties with recorded cases of Covid-19 are struggling to meet the 300-bed isolation unit threshold. This lack of additional bed space has led to the perception that an increase in Covid-19 cases has led to a shortage of hospital bed space countrywide.

There is a catch though.

“We have never had enough beds in our hospitals,” Panyako says. “Anyone getting admitted to KNH even before the pandemic would be forced to wait for a significant amount of time to get a bed. This was the same in private hospitals.”

Panyako argues that the discussion by now should be about lack of bed-space within newly created isolation facilities.

“This can be the only measure of increased bed pressure in our hospitals,” he says.

The billions from Treasury were also meant to increase the salaries of healthcare workers in lieu of the risk they are exposed to while battling Covid-19. This, too, has not been done.

“We have seen distribution of money to counties from the national government, but this has not been paid out yet. Our members have not received their allowances,” Dr Mwachonda says.

As Covid-19 infection rates soar, more needs to be done to secure the lives of the millions of Kenyan taxpayers who have entrusted their lives to the government.