Intensive care units in hospitals an investor’s dream
Photo/ Laban Walloga
A newly born baby on an ICU incubating machine at the Coast General hospital. Few hospitals in the country have the facilities and yet the need is escalating in both cities and rural areas.
Trauma is increasingly becoming the leading cause of fatalities in our country. Whether from the roads, work-related accidents or assault.
Whenever a mass accident – like the many fires across the country – happens, the strain on intensive care facilities comes to the fore. The ‘waiting’ lists are long and patients often succumb while awaiting these services.
Kenyatta National Hospital’s CEO, Richard Lesiyampe attests to this as the referral hospital is the most affected, receiving most tragedy victims.
Given Nairobi’s population, there should be at least 500 ICU beds. This is because cities register high crime rates. However rural facilities also need ICU care for chronic and debilitating conditions.
The local distribution for this service is such that it is only offered in level 6 facilities (referral hospitals) and a few well-funded private facilities.
The result is a cumulative number of less than 200 beds nationwide. In addition, almost all are in the top-tier facilities (in fees charged) meaning no places exist for the lower and mid-tier clients.
What emerges is a ‘conspiracy’ to limit these intensive care beds to a wealthy few.
A friend recently expressed her exasperation at not being able to get a bed for her patient.
The reality of the matter is that intensive care comes with many challenges, not least of which is the cost. With hourly blood works and other monitoring procedures the expense is enormous.
The dedicated specialised staff required to monitor each person per shift and correct any deterioration of function means hefty wage bills.
Legal hurdles also exist and such beds are issued on a “first-come-first-served basis”.
In this case a patient on such a bed is bonded to it unless he/she or the relatives agree to take her off or if they succumb.
Our culture which isn’t fond of Do Not Resuscitate orders (DNRs) means that few will accept a doctor’s opinion on the patient’s prognosis. The courtroom saga a few years ago pitting a local hospital and relatives of a patient is an example.
Sadly you don’t usually transfer or refer these patients as any time lost on the road is aggravating the condition and you cannot guarantee having that bed on arrival.
Our referral system is not the best and these critical patients endure hundreds of kilometres in harrowing conditions; often without monitors in the ambulances. The statistical chances of survival are greatly lowered with every mile travelled.
The distribution is centred mainly around the city with less than five peripheral facilities offering ICU services.
Of these, only two public facilities with less than 30 beds are operational. This clustering goes against the statistics which shows equal, if not skewed need especially towards peripheral areas.
This said, there is room for those willing to venture into this arena. It is hugely underserved and a huge demand exists. As someone with interest in intensive care medicine, if I were to choose a medical enterprise to invest in, it would be a Neuro-trauma ICU.
If ever comatose and admitted, I would like to be sure I succumbed, not because the facility didn’t have the resources but because I was too far gone.
Amazing recoveries have occurred; one being a man who woke up after a 19-year coma. Everyone deserves a chance to fight for their life.
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