Kenya, like most countries, was caught unprepared to handle the coronavirus pandemic. In an effort to save the situation, the government turned a new wing that was build for maternity services into a 120 bed coronavirus isolation center. In a nutshell, the Nairobi Metropolitan population was robbed off a vital maternity facility.
The coronavirus ushered in a new era of social distancing, lock-down, and curfew which all created an impediment to movement all of which have had a direct impact on health care. Patients with chronic illnesses and live in different geographical locations from where they get medical care are inconvenienced. These patients’ conditions are made worse since their immune systems are compromised. Data from the Ministry of Health indicates that majority of deaths caused by Covid-19 have largely been triggered by pre-existing medical conditions.
The Ministry of Health (MOH) also expressed its concerns regarding declining number of patients visiting hospitals. The MOH Twitter post on May 3 read …..” We have noted that our hospitals are recording abnormally low visitations by the sick. We know we have sick people amongst us, and we urge them to seek medical assistance in our facilities. #KomeshaCorona update @DrMercyHealth “
Disruption in health facilities
The coronavirus has also disrupted business in health facilities. Most of them have to strategise on how to cope with the situation. “Hospital budgets have increased so much. The costs of some drugs have tripled and some are out of stock,” said Thomas Ndolo, the administrator of Shalom Community Hospital in Machakos County. He also added that Single-use mask that used to cost Kshs 300 for a packet of 50 pieces now costs Kshs. 5000.
While the costs have increased, hospitals cannot raise their costs of treatment anyhow. This is due to long-term contracts they have with private insurance companies and the National Hospital Insurance Fund (NHIF) who are their major partners in the provision of affordable health care.
A spot check by RoGGKenya on several private hospitals in the city revealed that the number of patients visiting has drastically reduced. Madina hospital, a thirty-bed capacity facility situated in a densely populated area of Eastleigh in Nairobi, had only one inpatient on the day of the visit.
“The hospital relies heavily on business people in the area and Covid-19 has messed up their businesses hence their ability to pay for health decreased,”said Cleophas Langat , the hospital administrator.
Other health providers like laboratories have also been negatively affected. Dr Martha Mwangi, a consultant pathologist based at Fortis Towers in Upper Hill said “we’re at our bare minimum since most of our patients come from Kenyatta National Hospital which is experiencing reduced numbers of patients.
A visit to Lancet Pathologists Parklands revealed the same story of less number of patients. Mr Aggrey Buleti, a pathologist at the facility said that a big percentage of their work currently is Covid-19 tests.
“Lancet is one of the lucky private facilities allowed by the government to test for the virus. Otherwise , we would also be suffering,” The others other facilities testing for the virus are Aga Khan University Hospital and Nairobi Hospital.
In Homabay , where one coronavirus case has been reported , the number of visiting patients has reduced from approximately 250 to 100 per day.
Coronavirus forced major hospitals like the Nairobi Hospital to close down their satellite clinics in fear of spread of the virus. The move was to eliminate the chances of of infected patients visiting the satellite facilities which were inadequately prepared.
Speaking to the media,the hospital’s Chief Executive Officer Dr Allan Pamba said that the hospital had also established a 100 plus bed capacity residence for healthcare staff who may be required to stay at the main hospital to manage the disease.
According to Health Sector Human Resources Strategy 2014-2018, the top five causes of outpatient morbidity in Kenya are Malaria, Diseases of the Respiratory System (including pneumonia), Skin Diseases, diarrhea and accidents accounting to 70 percent of total causes of morbidity.
Coronavirus has brought in unexpected era of curfew, social distancing and hampered movement. This means people suffering from such conditions cannot easily seek timely treatment largely due to government directives and also fear of contracting the dreaded virus.
Why the fear?
According Thomas Ndolo of Shalom Community Hospital, some patients refuse to be admitted and that poses a legal issue in Kenya. He further said that without inpatients, hospitals will be forced to scale down its manpower.
People who spoke to RoGGKenya gave various reasons as to why they are keeping off hospitals. Some said that they fear mingling with asymptomatic coronavirus patients.
Others said that they don’t want to risk being confined to quarantine and footing the bills. “If my temperature is taken and I’m suspected to be positive, I will be taken to forced quarantine which I cant afford,” said Faraji Mulwa.
The poor living conditions at the quarantine and isolation centers is also a common reason among Kenyans.
Health experts have raised fears that people are self medicating at home. “People still get sick yet they avoid hospitals.This can only mean that they are self medicating or buying over-the-counter medicine,” said Dr Lukoye Atwoli.
Blood banks are also running dry because there’s no constant supply of fresh blood. Schools have been the sure source of fresh blood and with the closure and restricted movement , the national blood banks have a challenge.
What journalist should do:
1.Find out the effects of Covid-19 to private health providers.
2.Talk to the management of various health facilities in regards to support they get from the government.
3. Find out if Covid19 is being given too much priority as compared to other illnesses.
4. Find out how the government is incorporating other health providers in getting solution to the pandemic in terms of treatment and management.
5. Visit the public hospitals and monitor the number of patients they have been receiving since the coronavirus landed in Kenya.
By Vitalis Rugie