Agony as Mombasa medics battle Covid-19 without health insurance

When Dr Biabu Adam fell sick, she was sure that her National Hospital Insurance Fund (NHIF) comprehensive cover would settle all her bills.

She had been diagnosed with a condition that required her admission to hospital. On June 30, she was admitted to a private hospital in Mombasa.

After undergoing a life-saving operation, the medic, who works at Tudor sub-county hospital, was, however, shocked when she was slapped with a bill of Sh190,000.

“I had been diagnosed with a medical condition that necessitated an urgent caesarean section. I am concerned as the NHIF cover has not been renewed and I am not in a financial position to cater for the payments,” Dr Adam said in a letter addressed to the county chief health officer, Dr Khadija Shikely in July.

She had to pay cash due to the expiry of the NHIF medical cover and is now seeking a refund from the county. 

The lack of a medical cover following a stalemate between the Mombasa County Government and the NHIF has left more than 100 Covid-19 frontline health workers in distress.

“The doctor thought her NHIF would cover the treatment, only for us to realise the county has not been remitting funds for our medical insurance. We have now been forced to help her clear the hospital medical through harambee.

"This is so heartbreaking, especially since we are frontline health workers battling this pandemic,” said Dr Niko Gichana, the Coast Kenya Medical Practitioners, Pharmacists and Dentists Union deputy secretary general.

Currently, 78 health workers in Mombasa have contracted the virus.

Governor Hassan Joho blamed the NHIF for demanding a Sh142 million premium upfront.

The county, however, said it had made arrangements with the Coast General Teaching and Referral Hospital and its satellite facilities to offer medical care to all county health workers free of charge.

“We have tried to fix the challenges since we got in, but we had huge amounts of remittances of the statutory deductions that were not met by the municipal council to the tune of billions of shillings, which we have been able to clear,” said the governor.

The governor, who was being questioned by the Senate Ad-Hoc Committee on Covid-19 at his office, however, assured the frontline health workers that his administration would address the challenge.

“We hold dear the welfare of our staff but we are struggling with the economic decline due to the effects of the pandemic. We strive to ensure we pay our health staff every 10th of every month. July salaries have been paid, we are finalising August payment,” said Ms Mariam Mbaruk, the county executive in charge of Finance.

Ms Mbaruk said the county had engaged financial institutions to pay salaries.

“Our county revenue collections are very low due to the effects of the pandemic. NHIF covered up to June but they refused to renew our covers unless we pay Sh142 million upfront. It is difficult when we are not collecting revenue but immediately we receive funding we will pay,” she added.

Dr Gichana urged the county to address the matter especially because of the pandemic.

The union official said members have been paying when seeking medical services since June 30.

“With the current economic conditions and delayed salaries, members seeking medical services have had a hard time financing their medical costs. Statutory Deductions effected from payslips but not remitted to their respective institutions has led to members being blacklisted for defaulting on bank loans, insurance premiums, cooperatives, saving schemes and pensions,” Dr Gichana told the Senate Ad-Hoc Committee on Covid-19.

However, committee chairperson Sylvia Kasanga stressed the importance of addressing the challenges affecting the frontline healthcare workers.

“We have had these complaints on the hurdles the health workers go through during the pandemic, kindly address their concerns,” said Ms Kasanga.

The county executive in charge of Health, Ms Hazel Koitaba, said the county had so far received Sh68 million from the national government.