A sick health system, with doctors who gloss over patients

By Emeka-Mayaka Gekara

Everlyn Namukhula should be alive today, looking after her children. But the woman who gave birth to quintuples in March died a month later. 

After she gave birth to quintuplets at the Kakamega County Referral Hospital on March 12, she was transferred to the Moi Teaching and Referral Hospital Eldoret three days later after two of her children developed breathing complications – needing to undergo what is known as zipap in medical terms, which is the improvement of oxygen circulation in their bodies. They later died.

Their mother who made warm national headlines, died a few weeks later. The 28-year-old had four other children. An autopsy showed she had succumbed to a condition known as peripartum cardiomyopathy – weakened heart muscles.

According to the American Heart Association, peripartum cardiomyopathy is an uncommon form of heart failure that happens during the last month of pregnancy or up to five months after giving birth. It has no known cause.

It is a condition in which the heart chambers enlarge and the muscle weakens, causing a decrease in the percentage of blood ejected from the left ventricle of the heart with each contraction. That leads to less blood flow as the heart is no longer able to meet the demands of the body’s organs for oxygen, affecting the lungs, liver, and other body systems.

Dr Benson Macharia, a pathologist at the Moi hospital, explained that the condition occurs to all mothers and is not always fatal, but her case was exceptional because of multiple births. Doctors, upon examination, discovered her heart was slightly swollen.

Another doctor, Wilson Aruasa, said Namukhula died as she was being taken to the ICU. According to Aruasa, the mother had an enlarged heart with fluids around it. Her lungs were full of fluids.

She had been put on treatment to control the possibility of a blood clot in her veins, because she had delivered through a caesarean section.

Namukhula’s death shook the country and sparked debate about her handling at the Eldoret-based hospital. An argument was made that the fact that such a “special mother” would die in such circumstances is a disturbing indictment of the impotency and aloofness of our medical system.  

One would have hoped that because the birth of quintuplets is rare, the medical fraternity would have summoned its best talent and tools to look after the woman and her children. 

A Nairobi-based pathologist who spoke the Nairobi Law Monthly in confidence so as not to antagonize her colleagues described Namukhula’s death as “an act of both negligence and incompetence.”

“Her death has put a stain on our health system. Given the multiple births, the doctors should have reviewed the patient thoroughly to access possible risks. It sounds like they threw caution into the wind,” she said.

But Dr Allan Kimani, another city-based physician defends his colleagues, arguing that the condition was uncommon and the multiple births could have posed a challenge to medics anywhere. According to him, the symptoms of the conditions can be severe but largely unnoticeable. He, however, admits the mother should been exposed to extra care.

Significantly, Namukhula’s death turned a spotlight on First Lady Margaret Kenyatta’s Beyond Zero campaign. According to its founding statement, the campaign was inspired by the realisation and knowledge that maternal and children deaths are preventable. 

Launched in 2014, the campaign has been raising funds ostensibly to supporting initiatives geared towards preventing mothers from dying while giving birth.   

One would have expected that Namukhula plight would have been an important rallying call for the Beyond Zero crusade but it was not to be.

Her transfer from Kakamega Referral Hospital to Eldoret also points to inadequacies in most county referral hospitals, mostly attributable to poor management, inertia, lack of cash or theft.

This explains why county government bosses, mainly governors, fly to Nairobi for treatment, running away from health institutions they preside over.

Corruption unto death

From another angle, let’s consider the case of the Sh800 million container mobile clinics which have been rusting in Mombasa for four years because they are entangled in a scandal. They were meant to improve health services in counties, including maternal health, child care and emergencies in Kisumu, Nairobi, Murang’a, Uasin Gishu, Elgeyo-Marakwet, Kericho, Nakuru, Nandi and Makueni.

Health Principal Secretary Susan Mochache last month told Parliament that the ministry will need about Sh336 million per annum to run the clinics. Transportation to various sites around the country and medical supplies are expected to cost Sh330 million. And to operationalise them, the government will need to build toilets in them and get connection to water and electricity, besides needing waiting bays. 

Kenya Revenue Authority filings reveal that Estama Investments, the firm contracted to bring in the medical equipment, bought each of the 100 clinics at Sh1.4 million and sold them to the government at Sh10 million each. 

According to the contract, Estama was meant to supply, install, commission and hand over the 100 clinics at a cost of Sh1 billion. But an audit later showed that the ministry paid Sh800 million for the clinics before all these processes were complete, in contravention of the contractual agreement.

No government official has been brought to account for the scandal. Meanwhile, Kenyans continue pay with their lives for government’s immorality.

Seven children are motherless today because a system failed them. It is incredulous that those in charge of it have got nothing to say about it.