In mid February, a close family member fell seriously ill. Since family has not given permission to say their name/condition, I will keep this brief and a little anonymous. But suffice it to say, the family member has had a few brushes with serious conditions.
The FM (family member) is taken to the nearest hospital, which is not in Nairobi. The Doctors say it is the usual. They don't see anything wrong, but decide to monitor FM. FM deteriorates and goes into crisis- unable to breath. Another FM sends the sick FM on ambulance to Nairobi
Sorry, in* an ambulance. The ill FM has periodically come to Nairobi Hospital for check-ups, so that is the hospital the ambulance guys are sent to. We meet ambulance there as FM is off-loaded straight into emergency. FM is in dire straits. Wouldn't have lasted the night.
Nairobi Hospital put FM on oxygen, look at FM, and declare ICU case. They ask us for 400k on the spot for admission, and a further fundraising to top up that by the next day. Then as we stand there stunned, they declare there's even no room in ICU. We'll have to move FM.
Nairobi Hospital ask us to move FM. They tell us the specialist FM usually sees only sees patients either at Aga Khan or Avenue. They tell us they will make calls to these hospitals to confirm bed space. Two hours later, we are frantic, because they've not made the calls.
All the while, FM is only on oxygen. The Hospital refuses ambulance crew from leaving, telling them they'll have to take their patient back.
Call to Avenue "goes through" eventually. We are instructed to take FM there. FM is hustled back to the ambulance. It is now 1am.
Call to Avenue "goes through" eventually. We are instructed to take FM there. FM is hustled back to the ambulance. It is now 1am.
We rush FM to Avenue. We get there, and are told that Nairobi Hospital did not even give full details of FMs condition, and did not communicate admission protocols to us. We are at a loss, especially when ambulance crew offload FM, try to get ICU intervention but are denied.
Ambulance crew returns FM to ambulance. It is now past 2am. Avenue guys feel pity especially when ambulance crew says, they're running out of oxygen. They ask for 200k for admission to the same ICU they had refused FM admission. We sit in reception and start making calls.
We manage to get 100k on Mpesa. Hospital refuses, says it is too little. We tell them, guys, it is going to 3am. We didn't anticipate he was going to deteriorate to ICU requirement and the people we're calling are asleep. Surely, take this 100k as we wait for guys to wake up?
Mind you, even this 100k is under duress. Imagine being called at 2am and being told by some random relative that they are in hospital, and do you have 20k to send to "jazilia"? In this economy? Who has money lying around waiting for that 3am phone call? Za kupeana tu? No!
FM goes into severe distress as oxygen runs out. We are frantic, making calls to Nairobi East, Nairobi West, Nairobi South, even hospitals I've never known exist. This city is full of private hospitals. Full. All charging an arm and a leg for ICU admission.
Sidebar: customer service in this city SUCKS.
The rude people on the other side of the phone can make you want to weep with frustration. From answering phones with a brusque and ominous "ehhh?" in the middle of the night, like a vampire rising out of a coffin to feed. Terrible.
The rude people on the other side of the phone can make you want to weep with frustration. From answering phones with a brusque and ominous "ehhh?" in the middle of the night, like a vampire rising out of a coffin to feed. Terrible.
Avenue feel pity still. FM is now gagging, in danger of dying at their doorstep. They accept admission with the 100k, and warn us that they will kick FM out by 10am the next day if we don't appear with the balance. It is now approaching 4am. Our nerves are shot.
But we are relieved. FM is wheeled, for the second time, to Avenue's ICU. They will find out FM had an infection (sepsis) that the original hospital failed to find. FYI, at original hospital, they would take FMs blood, give it to a relative to take to a private lab outside...
...the hospital itself for testing. When we asked how this was even possible, they would say "hatuna reagents", and their lab was not functional. Imagine that. Trusting a non-medic civilian to take a sample to a lab far away - is there no danger of compromising the sample?
No wonder they kept saying they couldn't see anything. But they would collect their daily fees. FM is on NHIF, but that covers little in the larger scheme of things.
Anyway. Eventually, after surgery to remove a huge boil that had developed, FM is discharged 3 weeks on, with a bill of 1.3 million. We beg, cry, plead, sell off some assets to get this money.
Twist-because nursing care is sketchy at Avenue, FM contracts pneumonia while admitted
Twist-because nursing care is sketchy at Avenue, FM contracts pneumonia while admitted
No doctor notices this upon discharge. So 6 days later, FM is back in Avenue into ICU, because one lung has collapsed, and the other is very sick. It is wonder FM doesn't die. Oxygen saturation has dropped below 50%. And of course, we're back in Square 1 where money is concerned.
May I say at this point: shout out to the many people who gave, and gave, and gave. Thank you. I wish we didn't have to resort to asking for money from friends when we fall sick, but we asked, and you gave. THANK YOU.
I have left out some information because I have not asked for permission to post full details.
My purpose, as with all such stories, is to highlight the crisis in Healthcare in this country. This kind of thing is unsustainable. It can't work. Many have died when it didn't work.
My purpose, as with all such stories, is to highlight the crisis in Healthcare in this country. This kind of thing is unsustainable. It can't work. Many have died when it didn't work.
And in between, can we talk about the informal economies around healthcare? The many masqueraders? For example, we got a "nurse" to help with home-care for FM's wound, which we had no expertise to do. That wound needed technical care. We got one - who turned out to be a charlatan
The healthcare system, which is so broken, is also filled with con artists who pretend they are nurses, or doctors, or "medics". A large number are not even qualified. They are busy earning a living. Some dropped out of school mid-way, and have "some" expertise. Many don't.
We need to talk about these people, not in a condemnatorial way, but in a nuanced way. Because Homecare is now rampant. It is an alternative to keeping patients in hospitals, filling up beds, for services they can get at home at cheaper costs. In the UK, homecare is part of NHS
Homecare workers may not be fully-trained nurses or doctors, but as part of NHS (which is not in itself perfect in any way, I know), they undergo training and certification. They are like CHVs at sub-County levels within the HIV field for example. But Homecare in this country...
...is not recognised, so it operates like the informal economy around Househelps for example - prone to abuse, as well as vice versa. Househelps, or DMs, can be abused and underpaid. They can also easily harm children, kidnap them, etc. This is how gung-ho the Homecare sector is.
As we continue to talk about Healthcare in this country, and to resist the total privatisation of what must be UHC, we also need to talk about the informal economies around health, because we are all going to need homecare, palliative care, old-age care, etc.
Thank you.
Thank you.
