Graft-ridden Homa Bay hospital ‘death trap for its patients’

A gigantic, black metallic gate with a white concrete column welcomes you to the decrepit concrete block that houses the equally run down Homa Bay County Teaching and Referral Hospital.

Only desperation brings patients here, and getting medical care is not guaranteed. 

While the putrid mess of a devolved healthcare sticks out in Homa Bay like a sore thumb, the hospital, like the patients it receives, is struggling to survive. 

To save the situation, a committee of the assembly has recommended the sacking of Health Executive Richard Muga, a former director of medical services at the Ministry of Health.

“An institution that is meant to save lives is on its death bed. Every patient at the hospital is sitting on a time bomb because the hospital contributes to more deaths than other health facilities at the same level,” says North Karachuonyo MCA Paul Wamunga.

The ward representative says the hospital should not be referred to as a training facility. He asks how the institution can train nurses and other medical practitioners with its broken machines.

Students from the nearby Homa Bay campus of the Kenya Medical Training College (KMTC) do their practicals at the institution.

Fact-finding mission

Outside the hospital, private chemists are doing booming business, preying on patients’ desperation. With the hospital unable to provide basic essentials such gloves and syringes, patients must buy them from nearby pharmacies, according to a report from the assembly health committee.

For being attended to by nurses with no gloves, expectant women and newborns are at risk of contracting diseases. Lately, there have been numerous claims of deaths in the maternity wards.

Another indicator of a collapsed system is the number of food kiosks that sell meals to patients. 

“There’s no special diet at the hospital and most children admitted to the wards are malnourished. The condition of the kitchen is also wanting,” says Committee chairperson Joan Ogada.

Two weeks ago, the hospital’s chief executive Lillian Kocholla was suspended after MCAs unanimously adopted a recommendation of the committee, which has also called for the ouster of Prof Muga and other senior officials.

This came on the backdrop of a public uproar and after fact-finding mission by MCAs found that patients are at risk of dying from ailments that can easily be managed by ordinary drugs like paracetamol, but which are in short supply at the hospital.

The facility was also found to be suffering from infrastructural and hygiene challenges as there are no toilets for outpatients.  Nation has established that outpatient toilets were closed and patients told to use toilets in the wards, which are also dirty.

While the hospital charges Sh1,400 per day for each patient admitted to the ward, which is against the County Finance Act 2020, we found that the floors in most buildings are dirty with worn-out and leaking ceilings that are hazardous to patients and health workers.

Exorbitant fees

Ms Ogada told assembly members that inpatients are charged exorbitant fees, including expectant women enrolled in the Linda Mama programme and who should ideally get maternal services free of charge.

At the time of compiling this report, the lab was found to be short of reagents. There were neither blood screening machines nor oxygen for the ICU.  What the committee found was also shocking.

“There were several pieces of equipment at the lab which were dysfunctional and no efforts were made to repair them,” the report said.

“About five pieces of equipment were repossessed by the supplier for non-payment after delivery and the theatre room was not operational.”

Ms Ogada told MCAs that despite the Health department receiving the largest share of the county budget —Sh2 billion annually — the hospital still lacked essential drugs, including painkillers and antibiotics.

There have been graft claims in drug and non-pharmaceutical products procurement.

“One case is where one jerrycan of Jik was supplied at Sh1,560 yet the market cost is Sh400,” the report stated. The committee asked members to bring an impeachment motion against Prof Muga. It wants hospital administrator Immaculate Ojunga suspended over “questionable” academic qualifications.

“[Prof Muga] exhibited incompetence by failing to supervise the management of the hospital and not providing leadership, stewardship, planning, monitoring and evaluation of services and ultimately failing to ensure quality and compliance assurance,” the report stated. 

Leadership wrangles

At the mortuary, the committee found that it had 50 bodies two weeks ago against its capacity of 16.

MCAs want relevant agencies, including the Directorate of Criminal investigation (DCI) and the Ethics and Anti-Corruption Commission (EACC) to investigate some officials in the Health department, said to be intimidating junior medical staff who contributed to the report. 

The document also revealed that there is no clear chain of command, resulting in insubordination where junior officers do not follow instructions from their seniors.

In its recommendations, the Health Committee said the position of the chief executive officer at the hospital established in 2015 should be abolished because it does not exist in law.

Prof Muga did not answer our calls or respond to text messages on the claims levelled against him.

Poor management by top county health officials, said to be engaged in leadership wrangles and corruption at the hospital, which allegedly loses at up to 300 million a year, were cited as some of the issues that have contributed to the reported health crisis.

The report says the hospital management could be engaged in graft as some items used in the facility were bought at exorbitant prices.

On admission, the team established that patients are attended to by medics without protective gear and after at least 48 hours because the staff are few and lack motivation.

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