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Pumwani cries to be delivered from deep rot

Evelyn Makena @evemake_g

Intensely busy best describes Pumwani Maternity hospital on any typical day. Expectant mothers constantly stream in as others leave the facility with infants bundled in their arms while the members of staff move around with some sense of urgency.

Looking at the busy facility, one gets a sense that it’s business as usual for the largest maternity referral hospital in East and Central Africa. But that’s far from the truth.

Behind the façade of normalcy, the hospital reels under the weight of huge systemic inadequacies that hinder access to good quality of maternal health. The ongoing incident of 11 dead babies found in the facility on Monday has only served to expose the system’s weak links.

With an average of 60-80 births every day, Pumwani Hospital delivers more babies daily than in any other hospital in the country.

Amid the pressures of attending to numerous mothers and infants daily, the hospital struggles with staff shortage. The hospital with a bed capacity of 415 — 265 for adults and 150 bed cots is served by five gynecologists, 160 nurses, 12 medical officers and three clinical officers.

Since it is a referral hospital, the hospital often receives mothers with severe complications such as obstructed labour, sepsis and ruptured uterus,” said Mahat Jimale Chief officer Health Services, Nairobi County. 

Inevitably there are consequences for this. Understaffing in the hospital means that they are not able to attend to all mothers on time, ultimately leading to complications and in some cases death.

The discovery of 11 bodies of babies within the facility, which has become an issue of contention, reveals yet another systemic inadequacy in the running of the facility. The hospital constructed in the 1920s does not have a morgue. 

“In case of death, corpses are put in a designated room, like was the case with the 11 babies. The bodies are then collected on three days that’s Monday, Wednesday and Friday and ferried to City Mortuary,” said Vesca Kangogo, the acting County Executive Committee member for Health, Nairobi county, alluding to the fact that there was no foul play, in the case of the 11 babies discovered at Pumwani on Monday.

However, the lack of a mortuary at the facility revealed a quiet scandal in management of Pumwani Hospital. According to Thuranira Kaugiria, Secretary, Kenya Medical Practitioners and Dentists Union (KMPDU), Nairobi Branch budgetary allocations towards the construction of a mortuary at Pumwani were made on two occasions but the money was squandered.

During the past county government, about Sh23 million was set aside to build a mortuary. An additional estimated Sh8 million budgetary allocation was made in the past financial year for the same purpose. Yet there is no mortuary,” said Thuranira.

According to Mahat,  out of the 11 dead babies found in the hospital whose deaths occurred between September 12 and 17, the cause of death for four of the babies was attributed to advanced obstructed labour and protracted labour.

The two complications are associated with failure to slow response while attending to the mothers due to the staff being overstretched. Despite receiving many cases that require caesarian section, the hospital also suffers shortages in terms of facilities. The facility has only one operational theatre which serves one patient at a time.

According to KMPDU chairman Samuel Oroko, the hospital lacked capacity to attend to all the mothers it receives due to limited facilities. On some days the hospital receives up-to 50 cases of emergency caesarian section.

“One caesarian section takes an hour to complete. That means that if the hospital operates to capacity they can only manage 24 cases per day,” he said.

The other mothers who miss out of the operations risk developing complications including ruptured uterus and stillborn births.

The quality of service at the hospital has also suffered a blow owing to poor hygiene conditions. A spot check by People Daily revealed that the incinerator where the medical waste is burnt has not been in operation since April.

According to hospital staff who sought anonymity, the operations of the incinerator had stalled because of lack of fuel, which is supposed to be provided by the county government of Nairobi.

Heaps of medical waste lie in the open unattended posing great risk of spreading diseases. The hospital had instead resorted to fencing the area with iron sheets to avoid spillage of the waste.

“It’s a big risk to even those that bring the waste here. We work with no gumboots and other safety gear posing a risk to ourselves and patients within this facility,” said an attendant.

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Poresed mi, occuptur rest, omnimus experiorro dis ut quo volore, quis maximinus.

Nem que sum quuntemquae audipsa vita sum, aut eario. Itaeste dolore, ut audaerf erumqui beatem abor adis unt que porempos quam facia quatem rendusdae. Itas num esectium corecabores num erunt volecera nia volupta turibea quatem eosam int pos ium ne cuptaepudis es eles consecus.

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