Covid-19: Death of Homa Bay nurse raises questions, exposes shortfalls

It was a short marriage.

That is what Stephen Okal Oketch says following the death of his wife - a nurse from Homa Bay County who had the coronavirus and who had just given birth to their first child.

Theatre nurse Marian Awuor Adumbo from Rachuonyo South died on Sunday, two weeks after giving birth to a healthy baby, while on oxygen support.

Awuor, 32, and Mr Okal got married in a ceremony last December at Jabali Country Resort. They had been married for exactly seven months.

She was born on July 24, the same date as that of her first born child’s birth.

Mr Okal, the fifth born in a family of nine, was beside himself with grief when the Nation visited their home at Nyandang’e village in Kasipul division on Monday.

He said his wife booked a cake a month ago to celebrate their child’s birth as well as her birthday but her admission to hospital prevented this

“I will collect the cake after her burial, which is scheduled for Friday, and celebrate with the rest of the family,” said the 33-year-old, whose birthday is on July 22.

DEFICIENCIES

Awuor’s death has exposed deficiencies in county hospitals when it comes to handling Covid-19 patients as it emerged she was moved to Kisii County Teaching and Referral Hospital because of lack of specialists in her home county.

Earlier, the National Nurses Association of Kenya (NNAK) claimed the patient had not been reviewed by any specialist since her admission at KTRH yet she needed intensive care.

The nurse contracted the coronavirus at 33 weeks of pregnancy and gave birth normally.

She was found infected on July 20 and had symptoms including difficulty breathing, a cough and chills, but she had also tested negative three times.

“She was first tested at Rachuonyo South hospital but her results were negative. At Kisii Teaching and Referral Hospital, she tested positive on July 20 then we insisted on another test which we both took. The results were negative. After giving birth, she and our son were tested and the results were negative. A final test on Sunday brought negative results,” Mr Okal said.

Kisii County Public Health Director Richard Onkware said one of Awuor’s lungs collapsed due to the virus and that this was what caused her death.

NEGLECT CLAIMS

Awuor’s family said her condition worsened last Friday.

Mr Okal and his father, Barack Oketch Amwata, have faulted the KTRH, saying medics neglected her when they learned she was infected.

“Doctors and nurses at KTRH are on a go-slow because they have not received their salaries. Our patient was left unattended from Friday last week with our newborn left to feed on air,” Mr Okal claimed, adding he was devastated when he visited his wife but found her in an abandoned ward.

Mr Amwata said that getting information from the facility was an uphill task.

“Nobody was willing to attend to her. We were not even informed of her transfer from ICU to the Covid-19 isolation facility.”

Mr Amwata further said they were not officially informed that Awuor had tested positive and were updated by a nurse who saw them in agony.

“We met the official incharge of KTRH, Dr Enoch Ondari, only two days ago. Before that, it was very difficult to get information from the hospital that is supposed to be a referral facility,” said Mr Amwata.

He asked the government to investigate the case.

“I do not want any other person to undergo what we have been subjected to. Patients deserve care and their kin deserve to be treated with dignity,” he said, adding counselling would have helped.

County Health executive Sarah Omache denied the reports of neglect at the Kisii facility.

EULOGIES

Awuor had been a theatre nurse for almost a year. Rachuonyo was her first posting and she had worked there in different departments since 2014.

Her boss, Dr Stephen Okello, said she loved her job.

“I am a surgeon. We worked together in the theatre. She loved her job and attended to her patients with passion,” he said, adding they would help the family with burial plans.

Following Awuor’s death, Mr Okal moved their son to Jaramogi Oginga Odinga hospital in Kisumu.

“He is still in the incubator. This is for feeding purposes  …  he is being fed via pipes,” he said, adding his wife left him a “wonderful gift”.

The child weighed 1.7 kilograms at birth and 1.85 kilograms at the time of being transferred from KTRH.

“My wife was headed for the theatre for delivery through a cesarean section but she insisted on delivering the normal way,” Mr Okal said, describing her as a loving, hardworking, intelligent and development-conscious woman.

“Even while expectant, she attended to emergencies at the Rachuonyo theatre,” said the trader based in Oyugis town.

MEDICS’ PROTEST

Earlier on Monday, health workers in Homa Bay downed their tools accusing the county of exposing them to the virus by failing to hire specialists for the ICU and other departments.

Kevin Osuri, Nyanza chair of the Kenya Medical Practitioners and Dentists Union (KMPDU) and the county’s KMPDU Liaison Officer Amos Dulo said it does not have staff to handle critical cases.

“We have not heard a statement from the government about the death of our colleague. We are working in dangerous environments and are declaring Homa Bay a hostile place to work,” Dr Osuri said.

Dr Dulo said an ICU at the county referral hospital was not operational because of the lack of specialised medics.

The Homa Bay health department said it was waiting for a medical report from the Kisii hospital to ascertain the cause of Awuor’s death.

The Kenya National Union of Nurses (Knun) asked the county to provide nurses with enough personal protective equipment (PPEs) to minimise their chances of getting infected.

Secretary George Bola said medical workers at public hospitals were grappling with a shortage of PPEs.

"The government has provided us with PPEs but they are not enough. We ask for more to protect ourselves and our loved ones," he said.