A hospital’s split personality and the many unanswered questions

The entrance if The Nairobi Hospital.

Photo credit: File | Nation Media Group

What you need to know:

  • Its medical expertise and backup is impressive and I give special credit to its nurses and galaxy of physicians.
  • It has had, and continues to have, a series of governance issues which drag down its reputation.
  • The hospital is a company limited by guarantee and, therefore, owned by around 2,600 paid-up members.

Nairobi Hospital is one of the premier medical institutions in the country and, indeed, in the region. I do not just say this because I have been on its board of management on and off for near on 10 years but also as one who has had two in-patient experiences there this year.

Its medical expertise and backup is impressive and I give special credit to its nurses and galaxy of physicians. It is not just a hospital per se; its bank of medical expertise and experience generates and radiates well outside its perimeters. It is pricey and bureaucratic and I agree that needs to be worked on.

But Nairobi Hospital suffers from a split personality: It has had, and continues to have, a series of governance issues which drag down its reputation. Some of these areas have been addressed or are being tackled. Just under a year ago, the old board of management was dissolved by members who, last month, replaced the interim team.

The hospital is a company limited by guarantee and, therefore, owned by around 2,600 paid-up members, each a stakeholder and a voting one at that. Its surpluses are ploughed back rather than taken out as profits.

Some areas needing metaphorical surgery identified during audits have been tackled. But there are several aspects of the governance side which are of notable concern.

First is the Nairobi Hospital/UN Covid Hospital, which is under construction at the old nursing school across the road from the main hospital. The hospital tender committee initially recommended China Wu Yi due to its much stronger technical capability but the board’s Finance Committee, chaired by Vice-Chair Chris Bichage, advised a different methodology with the curious recommendation of Quest Civil Engineers Ltd, owned by a husband-and-wife couple, Messers Yuehua Bai and Ella Quia. The project was to take five weeks but we are in Week 12.

The Finance Committee has also recently requested a variation in costs. The project has so far cost in excess of Sh59.5 million. But the big question is why it picked this company.

The sad irony is, we did not have a Covid hospital when we urgently needed it.

Now to another. Natconsult, represented by an Engineer Ndegwa, was given two contracts relating to the technical audit of the hospital. Can the hospital’s chairman, Mr Irungu Ndirangu, confirm that there is no conflict of interest there? Let us go to Grant Thornton. Could Mr Michael Chomba confirm, or deny, that he copies in the chairman of the Nairobi Hospital board on all his correspondence? If so, why? And is that good and transparent corporate practice?

Towards the end of March, Mr Ndirangu forwarded to the management a report by Opticom (K) Ltd entitled “Nairobi Hospital Physical Security Assessment Report and Proposal” requesting them to review and possibly action it. The proposal for Sh118 million was to replace the security systems at the hospital, much of which were working perfectly.

Management responded that there were much more pressing priorities. Opticom subsequently won a restricted tender for the UN hospital valued at Sh31.5 million. The UN interrogated the proposal and only approved Sh21million worth of it. Why?

Management have been inundated with requests from some board members to look at certain proffered contracts. An example was from Earstar (EA) Ltd with an accompanying note indicating a director highly placed on the board was recommending them.

I cannot talk about the departure of former CEO, Dr Allan Pamba, as the matter is in court but could the chair and vice-chair explain why Mr Hesbone Githiaka, former COO, was not confirmed at the end of his probation? Ditto Ms Dorcas Kiai, former HR director, who left prematurely and Dr Aysha Edwards, former Acting Director of Medical Services and Research, who recently quit in a huff.

The chairman and vice-chairman owe the members, board and staff a full and explicit explanation on these issues. And, of course, there is the way in which the chair handled the Pamba case only for the board to find out some, maybe not all, the details later.


Mr Shaw is a public policy and economic analyst. [email protected].