We did our best to save Baby Travis - Thika hospital
Thika Level Five Hospital did its best to attend to Baby Travis Maina — who was referred there with a fork jembe lodged in his head — but the lack of proper equipment and competence, and the delicate nature of treatment meant they could only do so much, a Senate committee heard on Tuesday.
He looked joyful, was playful and okay, and even with a fork jembe in his head, Baby Travis did not deserve to die.
Those were the words of Kiambu Governor Kimani Wamatangi when he appeared before the Senate Committee on Health investigating the circumstances of the death of Baby Travis.
Appearing before the committee led by Uasin Gishu Governor Jackson Mandago, Mr Wamatangi said doctors at Thika Level 5 Hospital did their best to save the life of the two-year-old.
Mr Wamatangi said Thika Level 5 hospital, where the baby was taken, does not have facilities required to deal with emergencies as delicate as Travis’ injury.
“Whereas Thika Level 5 has the capacity to provide a wide range of surgical and other specialised services, it does not have the requisite capacity to comprehensively manage the injury that Master Travis Maina had,” Mr Wamatangi said.
Neurosurgical trauma unit
“Management of a treatment that requires penetrating brain injury requires a comprehensive neurosurgical trauma unit, which Thika Level 5 does not have,” he added.
Mr Wamatangi said the proper facilities are at Level Six hospitals and the county will do everything possible to get them.
The governor also decried the county having 95 of its best doctors away on study leave, but still on the county payroll.
“These are issues that we are going to have serious discussions on. There is need for serious reforms in our medical facilities,” Mr Wamatangi said.
The governor said a team of nine doctors, including Dr Mustafa, Dr Lilian Musonye in the theatre, Dr Wanjiru Karimi, Dr Philip Mulingwa, Dr Alice Wachuka, fully cooperated and attended to the baby until his transfer to Kenyatta National Hospital (KNH).
Dr Wanjiru Karimi, a consultant in the surgical department who, together with the team, made a decision to refer Baby Travis to KNH, yesterday told the committee that even with timely intervention, something would have been lost.
“You can imagine having a fork inside the brain, if we were to remove it immediately, then there was going to be haemorrhage at the brain and it would have even crashed, so I cannot pin point blame to anybody over the incident,” Dr Karimi told the committee.
Statements filed in the committee by the senior nurse at Thika Level 5 Hospital, Mercy Wachuka, indicate that Baby Travis arrived at the hospital on October 10, at 3:15 and five minutes later, was referred to the nurse in charge to seek a waiver since the family did not have money to pay for the X-ray and CT scan of the head.
Waiver was granted immediately
“A waiver was granted immediately and an X-ray of the skull and CT scan of the head were done. The management of the patient continued in casualty until a decision for referral was concluded,” Ms Wachuka says in her statement.
A report by a Dr Njoroge, a radiologist based at the hospital, of the CT scan done on the head of Baby Travis shows that there were two prongs of the fork jembe penetrating into the left parietal lobe of the brain with the posterior one extending to about 4.25cm into the brain matter, and the anterior one 1.58cm deep in the brain.
Dr Njoroge says in his report that there was no intracranial haemorrhage, and the posterior fossa structures, pons, brain stem, optic nerves and globes were all normal.
If Thika Level 5 hospital were to fully attend to Baby Travis, the head of surgical unit at the Thika hospital, Dr Philip Mulingwa, says in his surgical management report, that the hospital would need a neurosurgical trauma team, which includes a neurosurgeon, neuro-anaesthesiologist and a neuro-perioperative nurses.
In addition, the hospital would need a neurosurgical operating theatre room with the right equipment and supplies and postoperative neurosurgical ICU care.
According to Dr Mulingwa, the only neurosurgical care at Thika Level 5 hospital can only handle extra axial (brain) conditions, which include soft tissue injuries, depressed skull fracture and extradural and subdural haematoma.
The committee said it will invite the management of KNH, whose doctors have been accused of delaying to attend to the baby, to appear before it next.
Last week, Ms Judith Muthoni, Baby Travis’ mother, told the committee that they arrived at KNH at 6.30pm on October 10, but were not attended to until the following day at 1pm when the baby was taken to the theatre, where he died.