By Mary Mwendwa
Dressed in a pale white free dress with a plate of rice and meat , eating her meal slowly in a ward that is full to capacity , lies Sharon Mutheu, who lost her baby two days ago due to a ruptured uterus.
We greet her and she responds with a heavy voice that seems to indicate she has been crying. Her eyes are puffy and she looks weak. Ambience of infants crying and other women murmuring in low tones fill the air.
The midwife on duty, dressed in a greenish transparent attire who seems to be very busy rushes to Sharon’s bed to help in explaining her case. Immediately he disappears leaving us with other doctors as he has to attend to a patient urgently.
This is a scene you will experience at St. Mary’s Mission Hospital in Nairobi, here the maternity ward is stretched to full capacity since the six weeks’ doctors’ strike .
A corridor with patients at the Maternity wing at the St.Mary’s Hospital.The facility has been struggling with high numbers since the nationwide doctors strike started.
One of the patients at the maternity ward was Mutheu. She started experiencing labour pains at 3am, but since it was still dark, she waited till the day breaks. “Since it was still dark, l feared going to Pumwani where l attended clinic due to insecurity in our area,” she narrates.
At around 7am, as she prepared to go to Pumwani, a neighbour informed her that doctors are on strike and no one was at the facility. It was closed. Mutheu explains: “I did not no where else l could go, so l decided to stay indoors and see if l would have a safe delivery just with the help of a female neighbour.”
Unfortunately for Mutheu, the wish of safe delivery out of healthy facility didn’t go as anticipated. Four hours later, she started having difficulties. The womb raptured. It was at this moment that the female neighbour-who knew nothing about delivery-realized there was indeed a problem sought for intervention.
The neighbour then called Kibera MSF France clinic asking them to come immediately and help Mutheu. Mutheu says at that point she still in Eastleigh, going through the worst moment of her life. Seeing that was taking time to respond, the neighbour helped her into a vehicle to MSF clinic, in Kibera. On arrival, the clinic quickly put her in an ambulance and and took her to St. Marys Mission Hospital.
“When I arrived here I was received well and treated, however due to the prolonged labor I lost my baby boy,” explains Mutheu amid sobs and tears going down her chicks.
She resumes her talk with intervals of tears rolling down her cheeks.
“It was because of the strike that I lost my baby, I had no doctor to help me on time.”
According to Dr. Wycliffe Kimani Ngaruiya, Pediatrician and Deputy Medical Director at St.Marys Mission Hospital, Sharon’s case is very unfortunate, “She is just among the many patients who suffer the effects of prolonged labor which leads to a ruptured womb.”
“We had to save her life by transfusing seven units of blood , she lost her baby.This is a very sad story ,if a quick intervention was not done, Sharon would not have lost her baby.”He regrets.
Similarly, Linet Kimathi , a mother of two cuddling her baby girl says, “After giving birth, I was allocated a bed on the corridors of the hospital,” Ms kimathi who lives from Laini Saba , Kibera narrates how she found the hospital full, “The corridors too were already filled and my bed had to be squeezed between others. I thank God l got assisted and delivered well.”
Ms. Kimathi recalls some years back when she delivered her first baby, “Things were not the way they are now , the situation was not like this when she gave birth to her first born , I gave birth three years ago at this facility and we were just few .”
Dr. Kimani continues to say how the doctors strike has put a heavy burden on maternal health in general. For example the Obstetric department records indicate on Friday, January 6, 102 mothers delivered. “On any normal day, the facility handles 20-30 deliveries. “With strike on, the least we get is 60 deliveries in 24 hours.”
The number of cesarean section deliveries has increased .
On normal days cesarean deliveries ranged from 6-10.With on going strike, they operate up to 30 cases. Dr. Kimani confirms it is a challenge because mothers stay in labor pains for too long without knowing where to go and only rush to facility when complications arise.
St. Mary’s Mission Hospital has not been always like this as the hospital serves the urban poor , many from the nearby Kibera. Trouble started after doctors went on strike.
A walk through all departments showed an overstretched facility with patients being attended to on the corridors and several winding queues of out-patients waiting for treatment.
“Our wards are full to capacity, most of the time patients who go to hospitals like Kenyatta National Hospital, Pumwani and Mama Lucy are now coming here. Here, hospital wards were designed to accommodate 280 patients. Today we have over 450 patients,” Says Dr. Bryann Nyangeri, Managing Director.
Dr. Nyangeri confirms how they’re receiving patients from as far as Kajiado, Kiambu, Nakuru and Machakos. Something he says has put on strain on the staff who now have burn out . “On average we used to see at least 1000 patients per day. But now the number has doubled to almost 2000. Our personnel here work for very long shifts and those on leave were recalled”
“Despite the high number of patients across all departments; obstetrics, pediatricians, medical and surgery, the facility has done its best to admit and care for any patient comes.”
Dr. Nyangeri says they anticipated high influx of patients following the impending strike and prepared for them. “It involved recruiting additional staff, requested staff not to go for both December holidays and leave, and purchased extra commodities/medical supplies,” He explained.
The nationwide doctors strike , has paralyzed services in public health facilities.
Two months down the line, doctors are demanding a 300 percent pay increase from the Ministry of Health and improvement of the 2013 Collective Bargaining Agreement (CBA ) that has turned controversial.
Dr. Kimani narrates how the pediatric receives premature babies who are at high risk of mortality from other affected facilities.
“Mothers arrive here carrying babies without accompanying ambulance or warmth in a risky way, our unit has a capacity of 20-30 babies which has since increased to over 60.
“We have resorted to Kangaroo mother care, for skin-to-skin mother care as an incubator for babies weighing over 1.5 kg and who had high chances of survival. Those with less than 1.5 kg were put four in an incubator,” he said regretting that there were several mortalities due to processes in which they were being transferred or carried to the facility.
Stephen Nyaga Njeru, hospital Administrator,”The high number of patients has put a strain on our facility. Normally, we purchase our medical supplies on monthly basis but this time we have done it three times .”
Patients who initially attended Kenyatta, Mama Lucy and Pumwani don’t pay because it is free. They are also not paying and the hospital shoulders the problem. In fact, the hospital pays for patients who required imaging services that the hospital does not offer like CT-scan.
Njeru is now asking both the national and county governments to help finance the facilities so as to care for big number of patients. He says: “I know there is some form of funding that comes with this kind of scenario so we are telling the stakeholders to intervene.” The hospital also grapples with how ambulances bring in patients and dump them there without proper handing over and documentation.
“We are left with many questions who to contact just in case something happens,” Says Dr. Nyangeri as policy does not allow them turn away patients hence overcrowding. “Since they did not want to put any patient on the floor, they ordered extra beds from outside and put them in the corridors,” adding “The strike has been a test of staff resilience and institutional responsiveness towards the health needs of patients we serve.”
The strike has hit the already ailing health sector which is struggling with many challenges ranging from low funding , poor infrastructure , under staffing among other issues. According to Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) reports, Kenya currently has 6,306 doctors registered with only 4,756 in active practice. With this kind of scenario coupled with the strike, patients who rely on public health facilities will suffer most.
