How Nyanza Covid-19 crisis sucked all the air out of Kakamega County

“My mother can’t breathe, we need help,” a 28-year-old woman we will call her Nekesa helplessly screamed from the entrance to Kakamega County General Hospital last week.

All Nekesa, born and bred in Kakamega, wanted was for the elderly woman to get treatment that nowadays, due to coronavirus pandemic, includes huge amounts of medical oxygen.

The ailing woman, who nurses said portrayed all signs and symptoms of the virus, was gasping for air. A series of tests confirmed the following day that she had the virus.

“After stabilising her they told us to go elsewhere because they did not have enough oxygen,” Nekesa said.

“We spent the whole night in the casualty ward hoping to get some oxygen but we were sent away and when you are told there is no oxygen, just start running around hoping and praying to find it.”

Crisis

Eight nurses working at the hospital’s Covid-19 casualty and isolation units all confirmed that this has been the situation for many weeks.

“We are really overwhelmed, especially after the surge in Kisumu. Our Intensive Care Unit can hold only 20 patients, who need huge amounts of oxygen and now that patients keep coming from there, our supply is very limited,” a nurse, who sought anonymity, explained.

“We only have like two oxygen sources and then in the isolation unit we have the oxygen system fitted to the wall. This means at any given point they can all run out. We get our gas cylinders from HewaTele in Siaya and their system broke down a few weeks ago, which made things more difficult,” a second nurse said.

Medics also revealed that many caregivers who find it difficult to get oxygen for Covid-19 patients opt to take them back home and pray God shows mercy.

“A patient told me she was taking her dad who tested positive for Covid-19 back home because they could not afford to run around in search of oxygen. I felt so bad,” said a doctor.

“You see people have been playing politics with a very serious health situation around here, saying ‘tuko na plant, tuko na plant’, and that is where the problem is.”

The hospital gets a minimum of three or four cases, the doctor said, and because they have nowhere else to go, most of them linger in the casualty area and medics cannot touch them because there are not enough PPE.

Medics in isolation wards, the doctor said, have PPE but not their colleagues in the casualty area.

Oxygen plant

Speaking to the Nation in an exclusive interview, Martin Nandwa, a biomedical engineer at the hospital, acknowledged that a lot of oxygen is needed at the hospital because of rising Covid-19 cases and referrals from Nyanza counties.

“We have a lot of patients coming in and most of them have very low saturation levels that need a very high-flow supply of oxygen to them,” he said.

The facility’s ICU has six beds for Covid-19 patients and they were filled, with all patients on oxygen, he said.

Mr Nandwa explained that though the hospital’s oxygen plant was running, a lot more oxygen was needed.

“Sometimes we procure more oxygen from HewaTele in Siaya because we have an oxygen plant that has a production capacity of 300 litres per minute and Covid-19 patients who come here need 20 litres per minute per patient,” he said.

The plant, he said, also serves non-Covid-19 units, such as theatres and the new-borns unit, and with a need of above 500 litres of oxygen per minute, it is overstretched.

The current patients consume much more oxygen compared with previous cases, he said.

“Right now as we speak we have realised most of the patients in need of ICU care are coming from the Nyanza region. They are the group that are consuming much more oxygen and without it we will lose them. We are basically part of what Nyanza is experiencing,” he said.

Speaking to the Nation, hospital administrator, Dr Titus Mumia, said the quality of oxygen is the most important factor.

“We are reducing the number of admissions for Covid-19 patients to help the patients we already have. If you expected me to admit 10, I will admit half of them to help that number benefit from what we have,” he said.

“Hospitals are not dealing with Covid-19 patients alone. We cannot close down our hospital to handle Covid patients alone, because we also have other normal patients who need to be attended to. If a Covid patient can consume 60 litres of oxygen per minute alone, what about the other non-Covid patients?”

Testing Kits

Nation investigations on Tuesday revealed that Covid-19 testing kits being used by the Kakamega county hospital will expire on July 3.

Responding to this revelation, Dr Mumia said the hospital will use all the kits supplied by the national government before the deadline, and if they cannot use them all, they plan to donate what is left over to other counties that can use of them before they expire.

“We will not let them go to waste, that I can assure you. It would be very bad and I will talk to the officer in charge because I’m not aware of what you have just told me,” he said.

A high-ranking official at the Ministry of Health, however, told the Nation that they had not received any communication from Kakamega County about expiring Covid-19 testing kits.  

“We at the ministry have kits. They are there, but to the best of my knowledge I have not seen any requisition from them,” the official said.

The Nation reached out to Kakamega Governor Wycliffe Oparanya by phone, leaving text messages and speaking to his press team, but he did not respond.

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