Counties in race to construct buildings for medical equipment

Isaac Wanjala’s 12-year-old son fell during a physical education lesson in school last month. He fractured his collar bone. His distraught father, a resident of Nambale, rushed him to Busia Referral Hospital.

He was given painkillers at the casualty wing and referred to the X-ray department for further medical scans. But the X-ray machine had broken down weeks ago.

“I had travelled 40 kilometres from my village for my son to be given just painkillers. I decided to seek a referral letter to take him to Moi Teaching and Referral Hospital in Eldoret where he was scanned and treated,” Mr Wanjala told the Business Daily.

Mr Wanjala was lucky to have money to travel to Eldoret. In a county ranked by the World Bank as being among the poorest in the country, most patients cannot afford to travel far and they wait in pain for replacement or repair of the diagnostic machines.

Busia is among counties that have not received the medical equipment under the Sh38 billion government leasing deal.

Most patients seeking medical tests have to line up behind a mobile truck donated by AMPATH in partnership with Moi University to be tested. AMPATH is a state-of-the-art, fully automated pathology and diagnostic solution provider.

As the end of a June deadline looms in which the government plans to equip at least two hospitals in every county with 95 modern medical machines, most of the counties lack adequate space to house the equipment.

“One of the greatest problems is that counties do not have infrastructure and unfortunately we do not have money to construct the buildings,’’ said Jack Ranguma, the chairman of the Council of Governors health committee.

Ten counties have received some of the machines while Kiambu, Kisumu and Kakamega have the full set of the equipment.

‘‘The three counties that received the machines were lucky because they had adequate space. Others will take longer to build special buildings or extra wards,’’ Mr Ranguma said.

Bomet Governor Isaac Rutto declined to sign the deal, but the government has equipped Longisa Hospital in his county.

Mr Rutto said he would find other ways of equipping the hospitals. The national government struck a medical equipment leasing deal in February last year.

The funding of the project was entirely being met by the national government and counties were to pay the personnel and buy consumables.

Counties are set to receive X-ray machines, dialysis machines, theatre equipment, incinerators, sterilising units complete with surgical sets and an assorted cancer treatment machines.

All counties were equally allocated Sh95.74 million for the medical equipment, in addition to financing from donors such as Danida and the World Bank for the health facilities, according to the Office of the Controller of Budget report.

Allocation

‘‘This {money} will facilitate easy access to specialised health care services and significantly reduce the distance that Kenyans walk in search of such services,’’ said Treasury.

Mindray Biomedical (China), Philips (Netherlands), General Electric (USA), Bellco SRL (Italy) and Esteem (India) are the suppliers of the equipment.

Five dialysis machines, three dialysis chairs and two dialysis beds and related  equipment were to be provided in each of the 47 counties and two national referral hospitals.

In addition, the 94 county and four national hospitals are to  get modern digital x-ray, ultrasound and other imaging equipment. Level 5 hospitals would get ICU facilities.

But governors say unforeseen challenges will delay the project. Mr Ranguma said it would be difficult to overcome the issue of space owing to lack of funds.

“Let the national government give the counties money to develop the infrastructure if the project is to be implemented smoothly,” he said. Health secretary Cleopa Mailu said the government is working with the counties to ensure the equipment are all in place despite the delay.

‘‘Even if we break ground today, it will take between three to five months to get them completed which might spill to July or even August,” he said when he appeared before the Senate Health Committee.

Some counties have started putting up buildings where none existed while others are expanding health facilities.

In Vihiga, the county government has started putting up the required structures under a Sh26 million hospital upgrade.

A spot check by Business Daily has revealed that Kakamega has built a room to house the intensive unit installations, the renal unit for kidney dialysis machines and the radiology wings for diagnostic machines.

Peninah Mukabane, the county’s health executive committee member, said the new machines have seen the number of referrals to Kisumu and Eldoret remarkably reduced.

Ms Mukabane said the hospital used to pay Sh4,000 for referrals within western Kenya for which the patients are surcharged. Those referred to Nairobi were charged Sh25,000.

“The county has been relieved of the costs of commissioning ambulances to take patients to referral hospitals,’’ she said, adding that the new machines are highly digitalised and would boost diagnosis accuracy.

In Machakos, Governor Alfred Mutua said the county now aims to provide equipment in all level 4 hospitals after the first installation eased the pain for patients who previously had to travel far for treatment.

“We moved fast to install the equipment because proper treatment is the right of every person. Poor management, lethargy and shortage of equipment have led to deaths in many hospitals in our country,” Mr Mutua said.

In Kisumu, a high dependency unit (HDU) and a dialysis wing were set up to house the equipment. The building was funded by the county and donors.

Mr Ranguma said the equipment, which will be expanded to include cancer management devices, have improved lives within a short period.

“But counties needs more cash to train staff who will man the highly technical equipment and also to buy consumables that will be used in the treatment of special conditions,” he said.

Despite the successes of the three counties, many others may take longer than the June 30 deadline to install the equipment.

In the Coast region, Lamu and Tana River are yet to break ground for new the buildings.

Embu Level 5, Thika Level 5 and Nakuru Level 5 hospitals are among the health facilities that acquired complete dialysis units with radiology and magnetic resonance imaging (MRI) equipment.

Kericho Referral Hospital, Isiolo District (Level 4), Nyeri PGH, Murang’a, Naivasha District Hospital, Iten hospital in Elgeyo Marakwet, and Kangundo District Hospital have also been partially equipped.

Council of Governors chairman Peter Munya, however, said the county bosses were reluctant to get the machines because some hospitals already have them and did not require to lease others.

He said there was pressure for the equipment to be taken to Meru Level V Hospital which already has better machines. He accused workers of tampering with expensive machines including a Sh47 million CT scan at Meru Referral Hospital so that those from national government could be taken there.

“We want the machines to be distributed to other facilities like Kanyakine, Nyambene, Mithiane and other hospitals,’’ Mr Munya said.

Implementation

A doctors’ union has said the pace of implementation of the project is worrying and that apart from lack of infrastructure and personnel, some health facilities lack power to run the machines.

Dr Fredrick Oluga, the secretary-general of the Kenya Medical Practitioners Pharmacists and Dentists Union, said as at January this year, only 15 out of the targeted 94 hospitals had received part of the equipment.

Dr Oluga said the government should consider implementing the Mutava Musyimi-taskforce report if it is to succeed in overhauling healthcare and reduce the number of patients seeking services abroad.

“We are happy that hospitals are being equipped, but not with the way the project is being managed. The government should first train experts before going for the machines. Most of them will remain white elephants,” Dr Oluga said.

The Musyimi-led taskforce observed that more than 80 per cent of hospitals in Kenya are poorly staffed, badly equipped and have insufficient infrastructure.

Under the leasing deal, the international companies are responsible for training technicians and biomedical engineers on the handling of the machines.

Dr Oluga cited Marsabit and Embu as some of the counties with MRI and dialysis machines which are lying idle due to lack of experts to operate them.

Additional reporting by Lucas Barasa.