the rot in kenya hospital

[Globalcitizen12]

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Stolen from Facebook





Borrowed ..corruption kills my comrades
MY EXPERIENCE AT KENYATTA NATIONAL HOSPITAL
A few years ago at about midnight on a Friday, I got a call from my brother's number. The voice on the other end said he was a policeman and asked if I knew the owner of the phone. In panic I said yes I did.
That was the beginning of a nightmare of a night.
The police officer informed me that they had been called to an accident scene and the owner of the phone was one of the people rushed to Kenyatta National Hospital (KNH).
I quickly grabbed a jacket and the little money I had on me and drove straight to KNH.
Please note, I had never been to the place.
I got to the casualty or ER reception and told them that I was looking for an accident victim who had just been brought in.
The ladies behind the counter did not bother to look at me or reply verbally. One of them just pointed to a mountain of human beings on the floor at a corner.
I almost fainted! I was to look for him amongst people with all sorts of injuries, bleeding onto each other, some writhing in pain and some absolutely motionless.
First and foremost I had no clue what my brother was wearing. How was I to identify him.
So I just shouted out his name.
God was on my side. He was lying a distant way from the pile of human beings on the floor.
He was clearly in a lot of pain and disoriented. He just kept asking me about his friends who were in the same car. I had no clue where they were.
I went back to the counter and asked for a doctor.
The same ladies just pointed a finger to the cashier window. The cashier told me I have to pay 300kes before he can be attended to.
I thought, ok, 300 shillings is not too much, so I paid and went back with the receipt to the nurses station.
Note: all this time no one has attended to him or the guys on the floor.
After what seemed like a lifetime, a fairly young man walked into the nurses station and started giggling with the nurses. I tried to get his attention but he looked at me casually and said be patient, can't you see am talking to beautiful ladies?
I wanted to explode in anger , but figured I still need his help.
He finally turned to my brother and without touching him, just wrote a note and walked away.
I finally figured , it was an X-ray request form.
Surely I have no clue where the X-ray room is, so I ask the nurses, they point me in the direction.
The real drama is yet to start!!!!!!
Shock on me as I find out that I have to physically carry my brother on to the trolley and push it to the X-ray room.
For those who know me, they know the size of some of my bothers . They could be playing for a team in the rugby World Cup.
As I tried lifting this young man he belted out a sound of pain you only get to hear in a horror movie with Dolby surround . No nurse and no orderly bothered to help us.
A stranger who also needed medical attention volunteered to help me carry him. Then I had to cover him with my jacket since he was feeling cold.
Then I get to the X-ray room and the radiologist is not in. I am duly informed that he had gone to nap and they have to call him.
20 minutes later he shows up upset that he was woken up. He asked me for a receipt, and I promptly show him the 300 shilling receipt . He looked at me like I had lost my marbles. I was sent back to the cashiers.
Shock on me as I folk out 3000 shillings and with my receipt I scamper back to the radiology department .
The man looks at me with a straight face and instructs me to carry a 90something kilograms of my brother from the trolley to the X-ray bed and remove his shirt.
For Christ sake I could be causing more harm moving the way I was. ( clipping my arms under his armpits to lift him)
Shouldn't a trained person be doing this?
So the X-ray is taken, I have to trolley him back to ER and come back for the negatives.
10 minutes later, they are ready. I pick them and have to personally look for the doctor.
Woe unto me, doctor is missing so am told he has to be admitted to be seen by ward doctors.
At this point, it crosses my mind to call my other brothers for help. Then I think, that perhaps it's dangerous for them to drive at that hour in panic. (How considerate of me)
Oh! I have to pay 8000 kenya shillings to get him admitted. That the only money remaining in my pockets. So I think , ok! At least he will be in a comfy bed with warm sheets and not a cold metal trolley.
After paying , I push the trolley like I have been working at KNH as an orderly for eons.
His ward is on the 7th floor if I remember , so I head for the lifts. I press the button on the lift and wait. Ten minutes later am still waiting with my patient. Meanwhile I am feeling like an Arab in the arctic wearing nothing but a kanzu.
Then a cleaner came along me and unashamedly told me that the lifts had been cleaned and closed till the next day after the minister on Health's visit. She had to find the place spotless clean.
Wooooiiiiii (in my native language ) , my wig almost flew off.
I begged and begged to use the lift. Apparently if his bosses found out, he'd be fired.
At this point the cold had gotten to my brains and I was talking in tongues.
After much negotiations, he opened the lift and we proceeded to the 7th floor.
There's a reception on the 7th floor where I hand the man behind the desk the file with receipts and an X-ray photo.
Guess what? He tell me, there are no beds!!
Wait a minute!
- I have just paid 8000 bob for a bed. No one down stairs said there are no beds
- I can see very many empty beds from where am standing.
-and where is there another hip of people on the floor clearly in need of urgent medical attention ?
At this point I could not hold back, I almost tore this man with my acrylic nails. I was speaking in tongues.
When a nurse came out to calm me down.
He said without bribing him, we cannot get a bed.
My screams were now waking up patients lucky enough to get a bed. So he had no option but to give us a bed.
Note.
-the ward was half empty
- we had not gotten any medical attention yet, basic first aid or pain killers.
- his friend passed on after many hours of waiting for help.
-I talked to young boy perhaps 10years of age. He had come with a broken leg. A month later they had not put a plaster since he had no money. The leg was now permanently damaged.
- I left KNH in the morning after my bothers came to transfer their bother to another medical facility.

I asked myself, why work at a hospital if you have no passion for the job?

Who is in charge? They obviously have no clue what they are doing.

All these people should be fired and jailed.



https://mobile.twitter.com/HiviSasaMombasa/status/674132884765204480

[Georgesoros]

We have relatives in Kenya so we need to do something about this.

[jakoyo]

As long as our politics will not be issue based and issue driven , Kenyans will continue getting what they deserve.

[Georgesoros]

It can happen to anyone you know.

[bryan275]

Yet Uhuru is spending billions putting up a conference centre.  It's tragic

[RV Pundit]

The last time I was there, there were many families locked up there who had pending bills they couldn't not pay. I think part of the problem is that hospital are underfunded, many patients get treated but can never pay, the nurses and doctors are underpaid, overworked and demoralized.The way forward is to do what Ngilu proposed...National Health Insurance System..that covers everyone. Gov should pay for everyone say 5K to NHIF for compulsory medical insurances...there are maybe 12M households...or well about 20M adults...if everyone get 5K per annum...that is mere 100B...that can be handed to insurance company..to ensure truly free medical care in well funded hospital with well paid and motivated staff.

[mya88]

We have relatives in Kenya so we need to do something about this.

Wow, this is really unacceptable. At this point, I think I should apply to be director of KNH. I thought almost 50% of the population need jobs, why cant they hire workers to transport ppl to procedures in the hospital? If I remember correctly, Jakoyo told us before that there are doctors who cannot get jobs, why aren't the hospital staffed adequately? This is a state hospital, and you have to bribe ppl to get treatment even with a valid receipt? And nurses are a disgrace, where is the basic human decency...ppl piled up in a heap at a corner. I like the idea of everyone buying into some form of insurance so that hospitals can start competing for patients if they really want to get paid. Insurance companies can then hold them accountable for the services they provide. It can be very cheap and should be payable through mpesa so that everyone has a chance.

[Georgesoros]

Pundit. Great idea. How do you get this to become law?
Mya, Kenyan attitude needs to change. Health bosses should be fired for allowing this to happen. Most managers have zero knowledge about managing a healthcare system like kenyatta's. They just show up to control fires and leave behind a worse system after 10 or so years.

[MOON Ki]

Wow, this is really unacceptable. At this point, I think I should apply to be director of KNH. I thought almost 50% of the population need jobs, why cant they hire workers to transport ppl to procedures in the hospital? If I remember correctly, Jakoyo told us before that there are doctors who cannot get jobs, why aren't the hospital staffed adequately? This is a state hospital, and you have to bribe ppl to get treatment even with a valid receipt? And nurses are a disgrace, where is the basic human decency...ppl piled up in a heap at a corner. I like the idea of everyone buying into some form of insurance so that hospitals can start competing for patients if they really want to get paid. Insurance companies can then hold them accountable for the services they provide. It can be very cheap and should be payable through mpesa so that everyone has a chance.

I see little that is "out of the ordinary" in that story; all that seems to be the "norm" for a major public hospital in Kenya.

Many of these places have doctors who are nominally employed to work there.   But much of the time you will find quite a few focusing on their private clinics, using medicines stolen from the hospitals.  (So even when supposedly supplied, the hospitals will not have enough medicines, and patients must buy their own ... from pharmacies run by the doctors' friends or relatives.)

The "insurance option" is an interesting one, and it might help with some solutions.   Still, from what little I have observed, people with insurance will avoid public hospitals like the death-traps they tend to be.  Also, one effect of wider insurance could be a rise in private facilities, which would then draw away more staff from the public ones.   And a large number of people---the most desperate---would still be uninsured, which would leave then at the mercy of increasingly dodgy places.

I think that one thing that could be done right away, even with existing staff, facilities, etc., would be to put serious, capable people in the highest levels of hospital administration.   

[Georgesoros]

Why not hire contractors to run hospitals. Govt pays them to manage. Am sure nobody in the health ministry knows what goes on.
Pundits idea is great but bringing it to legislation is monumental.

[jakoyo]

The current  CEO KNH is a thoroughly clueless woman who cannot construct a full sentence in English. I watched her explain away the brutal murder of patient in KNH. Cringe worthy.

[mya88]

Wow, this is really unacceptable. At this point, I think I should apply to be director of KNH. I thought almost 50% of the population need jobs, why cant they hire workers to transport ppl to procedures in the hospital? If I remember correctly, Jakoyo told us before that there are doctors who cannot get jobs, why aren't the hospital staffed adequately? This is a state hospital, and you have to bribe ppl to get treatment even with a valid receipt? And nurses are a disgrace, where is the basic human decency...ppl piled up in a heap at a corner. I like the idea of everyone buying into some form of insurance so that hospitals can start competing for patients if they really want to get paid. Insurance companies can then hold them accountable for the services they provide. It can be very cheap and should be payable through mpesa so that everyone has a chance.

I see little that is "out of the ordinary" in that story; all that seems to be the "norm" for a major public hospital in Kenya.

Many of these places have doctors who are nominally employed to work there.   But much of the time you will find quite a few focusing on their private clinics, using medicines stolen from the hospitals.  (So even when supposedly supplied, the hospitals will not have enough medicines, and patients must buy their own ... from pharmacies run by the doctors' friends or relatives.)

The "insurance option" is an interesting one, and it might help with some solutions.   Still, from what little I have observed, people with insurance will avoid public hospitals like the death-traps they tend to be.  Also, one effect of wider insurance could be a rise in private facilities, which would then draw away more staff from the public ones.   And a large number of people---the most desperate---would still be uninsured, which would leave then at the mercy of increasingly dodgy places.

I think that one thing that could be done right away, even with existing staff, facilities, etc., would be to put serious, capable people in the highest levels of hospital administration.   

Mooki, the comprehensive insurance option is something to look into. It should be very cheap and cover majority of the people. If the mpesa has revolutionized Kenya and almost replaced banks, it can help revolutionize the health sector.

The success mpesa has had in Kenya is why banks in the west are fighting hard that mpesa never takes off anywhere else (its called a Kenyan experiment). The government can subsidize some of it.

Think about it this way, majority of people do not get sick that often, so only those who need care will visits hospitals. If insurance is paying those hospitals directly, they cannot ask for any money or bribes ab initio

[mya88]

The current  CEO KNH is a thoroughly clueless woman who cannot construct a full sentence in English. I watched her explain away the brutal murder of patient in KNH. Cringe worthy.

Jakoyo, who should I contact for her job???

[Georgesoros]

Mya
Who can sponsor such a bill to become law?

[mya88]

Mya
Who can sponsor such a bill to become law?

Park
I am not sure, I think ministry of health should be a good place to start, by selling the idea to parliament.

[jakoyo]

William Samoei Ruto. If he will agree.

The current  CEO KNH is a thoroughly clueless woman who cannot construct a full sentence in English. I watched her explain away the brutal murder of patient in KNH. Cringe worthy.

Jakoyo, who should I contact for her job???

[MOON Ki]

Mooki, the comprehensive insurance option is something to look into. It should be very cheap and cover majority of the people.

It  actually seems to be the "most recommended option"; what Pundit refers to as "Ngilu's ideas" are actually the product of some hard work by Americans and people they fund.   I was staggered to learn that until USAID stepped in a few years ago, GoK had never bothered to conduct an analysis of out-of-pocket medical expenses by Kenyans.   There has also been significant related work by people at Stanford, Rockefeller Us, etc., and, from what I recall, they all point to the insurance option.     (One interesting report that I downloaded and saved some time ago is , which you can find here: http://www.healthpolicyproject.com/index.cfm?id=KenyaLTFreport )

That approach would go along way in dealing with funding issues.    My main point, however, is that that there are other problems that will not be solved by funding alone and that if these are not solved, then insurance will simply make private care more attractive, with little improvement in the quality of public care.   As long as public hospitals, especially the major ones are run by lazy, incompetent types; as long as doctors employed in places feel they can freely run their own clinics on  the time they are paid for by the taxpayer and with medicines stolen from the taxpayer; ... as long as cleaners know they can bask in the run while filth piles up ... then not much will change.   
Service delivery etc.

By the way, what are your thoughts on something like the NHS?

But under all most of these proposals, the main "insurer" would be the NHIF, essentially just another arm of an incompetent and corrupt  government.   For the kind of results you mention, there would have to be major "culture" changes in government itself.   

(I have seen some proposals that would allow private insurers to be, in essence, paid or subsidized by government, but they seem rather hazy.)

If insurance is paying those hospitals directly, they cannot ask for any money or bribes ab initio.

I don't share that view; I think the problem there is the fundamental moral rot in Kenyan society.  Take a look at the story above, on the bed: would having the Sh. 8000 for the bed already paid for (by insurance, as opposed to the individual) have stopped the person who saw an opportunity to "rake in"?

And one can take that a level up: Let us suppose that with better funding, the doctors get paid a bit more.  (It will not be huge anytime soon.)  Will that really change the fellow who knows he can keep "irregular" working hours or devote himself  to private activities or help himself to medical supplies ...?   
     

[mya88]

Mooki, the comprehensive insurance option is something to look into. It should be very cheap and cover majority of the people.

It  actually seems to be the "most recommended option"; what Pundit refers to as "Ngilu's ideas" are actually the product of some hard work by Americans and people they fund.   I was staggered to learn that until USAID stepped in a few years ago, GoK had never bothered to conduct an analysis of out-of-pocket medical expenses by Kenyans.   There has also been significant related work by people at Stanford, Rockefeller Us, etc., and, from what I recall, they all point to the insurance option.     (One interesting report that I downloaded and saved some time ago is , which you can find here: http://www.healthpolicyproject.com/index.cfm?id=KenyaLTFreport )

That approach would go along way in dealing with funding issues.    My main point, however, is that that there are other problems that will not be solved by funding alone and that if these are not solved, then insurance will simply make private care more attractive, with little improvement in the quality of public care.   As long as public hospitals, especially the major ones are run by lazy, incompetent types; as long as doctors employed in places feel they can freely run their own clinics on  the time they are paid for by the taxpayer and with medicines stolen from the taxpayer; ... as long as cleaners know they can bask in the run while filth piles up ... then not much will change.   
Service delivery etc.

By the way, what are your thoughts on something like the NHS?

But under all most of these proposals, the main "insurer" would be the NHIF, essentially just another arm of an incompetent and corrupt  government.   For the kind of results you mention, there would have to be major "culture" changes in government itself.   

(I have seen some proposals that would allow private insurers to be, in essence, paid or subsidized by government, but they seem rather hazy.)

If insurance is paying those hospitals directly, they cannot ask for any money or bribes ab initio.

I don't share that view; I think the problem there is the fundamental moral rot in Kenyan society.  Take a look at the story above, on the bed: would having the Sh. 8000 for the bed already paid for (by insurance, as opposed to the individual) have stopped the person who saw an opportunity to "rake in"?

And one can take that a level up: Let us suppose that with better funding, the doctors get paid a bit more.  (It will not be huge anytime soon.)  Will that really change the fellow who knows he can keep "irregular" working hours or devote himself  to private activities or help himself to medical supplies ...?   
     

[RV Pundit]

Another idea in addition to National Complusory health Insurance would be the capitation that is now being used by civil services to access medical care and that is being used in free primary schools; basically everyone get to choose a hospital and gov sends certain amount of money every quarter whether you fall sick or not.

There is nothing wrong with our culture...because the same doctors, nurses and staff when they go private or abroad do a good job....but when they are in thoroughly underfunded hospitals...and they are overworked with little pay...they cannot function.

You just need to visit Kenyatta to understand how impossible their situation in...thousands of people filling up every spaces of the wards and the lifts. It like a war zone.

But if you go to private wing of the same KNH..you're likely to be treated well.

[jakoyo]

When you have folks like Bonny Khalwale , the most vocal anti corruption guru ,opening bogus clinics to siphon NHIF funds then you know Kenya is completely fcuked up.