Health minister encounters sickly Mathari hospital

micha came face to face with the sorry state that is the Mathari National Teaching and Referral Hospital (MNTRH), one of the country’s four Level 6 health facilities.

Congestion, regular critical medicine stockouts, understaffing, unsustainable infrastructure, long patient queues and a growing number of recovered mental health patients who have been neglected by their communities, define the state of disrepair at the facility.

According to hospital records, as of Monday evening, there were 151 extra patients in the male wards, and the hospital management confirmed that they were sleeping on the mattresses on the floor.
“We have, however, made arrangements for the extra patients to sleep on the mattresses, as we wait for a solution from the Ministry,” said Dr Julius Ogato, the hospital’s Chief Executive Officer, admitting that the facility’s aging infrastructure is completely running out of space.

And while this congestion is an eyesore for the hospital administration, about 209 mental health patients who have recovered are yet to be picked by their families or communities where they come from.
“We have patients who have recovered, unfortunately though they are still here; because the families or communities where they come from are not willing to have them back, even as we try to find ways through county administrative officers to repatriate them,” he added.

This was confirmed by female patients who requested the CS to contact their guardians, because they have refused to come for them. “I have recovered, and I want to leave this place, but every time I call my guardian to come for me, they disconnect my call,” one female patient told the CS.

Nakhumicha promised to follow up on the matter. “So as an immediate action, we are taking their contacts and I will, personally reach out to have their people come and pick those who have recovered,” she said, emphasising that these people need to get home, even as she was made to understand there are some whose families were not aware.

However, after admitting the issue was more of a social one that required a multi-sectoral approach, Nakhumicha promised she will contact her Social Protection counterpart, to have a special holding place for them as they await collection.

“We must do something as a country to be able to have a place where those who have now recovered to be assisted to stay there as they wait until their communities or families can accept them back,” the CS said after an impromptu, but routine visit to the hospital.

On Monday, she launched a national health facility census, through which the Ministry can pick out gaps that result in systemic shortcomings in health service delivery, and the visit to the mental health facility is well within this programme that targets 15, 000 health facilities. She intends to discuss this with the governors today at the ongoing Devolution Conference in Eldoret.

“We want to work together with the institution to create awareness on mental health,” she said, when approached by the hospital to find a way through devolution to have facilities similar to Mathari decentralised to the counties.

During a closed-door meeting with the hospital management and staff, the CS learnt the mental health issue is a big challenge in the country, and this is compounded more by the fact that Mathare is the only national referral hospital that offers mental health.

“So as I attend the Devolution conference in Eldoret, I am going to have a conversation with governors to see how then do we get these services at the County Level, so that we can reduce the congestion that’s here,” she said, disclosing that they had reached a consensus with the Hospital management and Board through the Ministry’s Mental Health Programme to capacity Build officers at the counties to be able to take care of patients who have mental issues.

The impromptu visit also revealed such dire constraints as patients in their hundreds slept on the floor, waiting hours for medication, and lamentations from management on some units such as forensic being in almost total disrepair.

The facility is also understaffed. It currently needs more than 20 Psychiatrists, and a doubling of staff at its pharmacy outlet to handle the more than 1500 clients who visit every day.

To decongest the hospital, the leadership called for mental health campuses to re-open in all 47 counties.
The facility also does not accept the National Health Insurance Fund (NHIF) cards for outpatients hindering their access to care.“I am 65 years old,” said John Kabaka Ikenga, “I have contributed to NHIF all my working life and when I come here am told they can’t fund my medications?” Ikenga wondered in question to the CS.

The CS promised to take up the matter with colleagues at the cabinet. “They only give us low cost medication here and we are asked to go buy the expensive ones outside the facility, why is that?” wondered Nancy Wairimu who had brought in her 23 year old son for check up.

“That is a KEMSA issue and I will take it up with them after this visit,” answered the CS.

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