Whenever Kenyatta National Hospital (KNH) is mentioned, the impression of a well-known international medical facility comes to mind.

With myriad specialised forms of treatment at the national teaching, referral and research hospital, the facility ranks second to none among public hospitals in East and Central Africa. But this does not come without its share of contradictions, with the hospital’s status as a referral facility now merely applying in theory.

Kenyatta National hospital’s imposing building in Nairobi

While KNH was initially meant to primarily offer specialised treatment, this is no longer the case as the hospital has now been literally reduced to a health centre where even patients suffering from minor aliments such as common colds and sore throats seek treatment.

The situation is widely seen as the result of an acute shortage-cum-rundown of lower level public health facilities within Nairobi, leaving KNH and the Mbagathi District Hospital as the only main public facilities offering health services to the region’s ever-swelling population.

KNH Director Richard Leserian Lesiyampe says the hospital is now exceedingly reeling under the weight of out-patients suffering from minor diseases.

“This hospital was ideally meant to be a referral hospital dealing with specialised and complicated cases. There should be a referral system where patients are referred here from district and provincial hospitals. But I am worried that KNH has been reduced to a health centre where we are treating so many ailments that should be handled in health centres and dispensaries,” Mr Lesiyampe told The Standard On Saturday.

Lack of basic facilities

Among the basic ailments he noted are being increasingly treated at the hospital include common colds, tuberculosis, diarrhea, pneumonia, malaria, and diverse types of physical injuries among others. Also of concern is the high number of normal child deliveries taking place at the facility.

“As much as KNH is one of the few health facilities with an intensive care unit, a high dependency unit, theatres, a burns unit, a renal, unit, a heart unit and a new-born unit, let it be known that these are specialised critical care units,” he states.

The director attributes the mess to a failure in the medical system that has seen no major health facilities developed in the past few decades, coupled with a rundown that has seen existing facilities lack drugs and basic diagnostic facilities.

“In Nairobi, there are almost no properly operational health centres. Most of the existing facilities were developed about 30 years ago when the population in the capital city was about 500,000 people. The population has now risen to over five million people with more than 60 per cent of them living in slums and constantly coming here when they fall sick,” Lesiyampe says.

It subsequently comes as no surprise the hospital has, on average, been dealing with 600,000 out-patients and 89,000 in-patients annually. According to official statistics, KNH attended to 550,000 outpatients and 70,000 inpatients last year.

Strained resources

With such a high number of outpatients, Lesiyampe says the hospital’s resources have been highly strained, with aspects such as personnel; equipment and customer care services being the most affected.

The hospital has an estimated staff capacity of 6,000, a total of 1,800 beds and an average length of stay of seven days.

Simon Ithai, the hospital’s chief public relations officer empathises that the hospital has particularly been strained in terms of equipment due to the kind of services it has to offer as opposed to lower level hospitals.

“For instance, almost all patients who come to KNH suffering from head aches have to undergo a scan irrespective of the magnitude.

But if they had gone to a district hospital or a health centre, the nature of the ailment could have been diagnosed through simple examination and medication given, with the patient only referred to KNH if the condition is serious,” he says.

With no imminent master plan to decongest the hospital on the cards, the director says they have taken the high number of non-referred patients as a positive challenge and sought in-house approaches to satisfactorily attend to all patients.

“Most of the nurses here are specialist nurses since our core business remains specialised treatment.

To satisfy the needs of all patients, we have been forced to have nurses work on locum or overtime to ensure service is delivered around the clock,” Lesiyampe says.

To allay the congestion at KNH, he calls for the strengthening of basic medical facilities, particularly within Nairobi.

“There is already a directive from the Ministry of Health that an initiative be rolled out to decongest KNH. We will in the course of the year hold discussions to particularly see how municipal councils can help in this,” he says.

Lesiyampe notes that once the newly-built Mama Lucy Kibaki Hospital in Embakasi is fully operational, it will be a major step in decongesting KNH.

The 112-bed capacity referral hospital, which has ultra-modern wards and equipment such as ultrasound scanners, incubators and mammogram machines, is expected to serve at least two million people in Nairobi’s Eastlands.

By JOE KIARIE, The Standard

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