Why Kenyatta National Hospital is not for the faint hearted
By the time we got to the Kenyatta National Referral Hospital, the sedative had worn off and the patient had resumed both violence and gibberish.
It took every ounce of energy for the three people holding him to contain him in the car’s back seat. For their struggles, they picked more bites and scratches whenever the patient wrestled some brief freedom from their grip.
His bouts of aggression were strange considering he was a breathing skeleton, reduced to around 40 kilograms by chronic vomiting and diarrhea.
There is something about seeing a sibling in obvious pain and distress that pricks the heart with pity and impotence. The guilt of not doing enough courses through your veins; you regret that you could not be Ben 10 to deliver him/her from the evil of suffering.
When one after another, tests for suspect diseases turn negative and the patient is rapidly degenerating into a cabbage, it is tempting to give Ambilikile Mwasapile, the (in)famous Loliondo daktari, and other claimants to magical dawa more than casual thoughts.
Even before the patient got out of the car, I had dashed across the open yard outside the Accident and Emergency unit straight to what looked like a triage. Behind a half-open curtain, a nurse was taking vitals for a woman who was groaning loudly. Between pants of panic and impatience, I blurted out my plea: I had a seriously ill and violent patient in the car. Could I please get someone to help me bring him in urgently?
She did not even look at me. I thought she had not heard me so I repeated my request, this time louder but with a conscious effort to sound calm, just in case she had imagined I had strayed from the mental ward. Again, she kept quiet!
I was about to go when she casually directed me to fetch a stretcher and wheel my patient in. I was sure I had not heard her right so I sought her clarification. My question only succeeded in annoying her. In an irate tone she duly reminded me there were many more patients in need of attention, some who were worse off than my relative.
I moved on. By observing what others arriving with new patients were doing, I ended up at the stretchers area. There were a few remaining and certainly, they were not the cornerstone that the builder rejected. Some were missing wheels; others looked like they had survived a bomb blast considering their twisted and sorry state of disrepair.
They were also plainly dirty. In fact, a number of them had raw blood in various stages of congealment apparently from previous patients.
I had heard good stories about KNH’s supposed improvement. There must be a mistake somewhere, I thought. These could not possibly be scenes from the foremost referral hospital in the country!
So I went back, this time to the reception. I found two friendly nurses and after explaining my predicament, in what sounded like well-intentioned advice, one of them told me to pick a provided-for bucket of water and clean the stretcher.
Luckily, we found a better stretcher apparently abandoned by another patient and joined the queue for the triage. As we waited, I began to appreciate that, indeed, there were worse off cases at KNH.
The radiologist had warned us that we would probably have to brave through a long wait before we were attended to, but he had also vouched for KNH as the best placed to unravel my relative’s strange illness.
Other hospitals, he warned, would bleed us dry in trial-and-error tests. Being financially hard-pressed, this advice was particularly welcome.
It was now a few minutes to midnight. Behind us was an accident victim who had been referred from Narok county hospital. Blood was still seeping out of his heavily bandaged head. His right hand and left leg also had heavy bandage. He was semi-conscious.
I would later learn from his younger brother that the victim was driving his Form One son back to school in Bomet when the car rolled several times. His son died on the spot! Behind them was a girl of around 13 or 14 years lying motionless on the stretcher. She had fallen off the balcony on the third floor and had not uttered a word ten hours later.
Immediately in front of us, a man in his early twenties had been involved in a motorcycle accident. His nose and mouth had been ripped off in the crash, and his sister told me he had suffered multiple fractures on the legs too.
A male nurse had helped to literally tether my patient to the stretcher, giving us some much-needed respite. Around 1:00am, we were done with the triage. We then joined a crowded waiting bay for a chance to see a doctor.
At one of the corners, a male patient lay in his briefs, his both legs and hands in casts and virtually his entire head a swathe of bandages. A catheter connected to a dirty bottle tied to the leg of the stretcher and his delirious but funny anecdotes suggested his injuries went beyond the physical.
His name must have been Omondi because he kept on shouting “Mimi Omondi esquire ati niko Kenyatta peke yangu (I, Omondi esquire, I’m all alone at Kenyatta…) Then in vulgar expletives, he would curse his wife for abandoning him and their children for a richer man and for allegedly planning the attack that left him for dead.
Akinyi, who must have been their teenage daughter, was now pregnant and out of school because ‘the mother was out there getting excited about having her beauty praised by an ugly man!”
At 3am, we were called in. The doctor’s ‘room’ was just a jaded bench behind old and dirty curtains. The young doctor asked for the history of the patient’s disease and furiously jotted down notes.
I noticed huge spots of fresh blood on the floor. My face must have betrayed my squeamishness because a nurse standing beside the doctor quickly cut out some tissue paper and dropped it over the largest blood smudge!
We were referred to the laboratory for blood tests. We dutifully joined another queue and waited. Again, we were sandwiched by more dire cases including two young ladies who had allegedly been thrown out of a moving vehicle. One died while still waiting.
At around 4.30am we got the results. The young doctor had since left and the new one advised us to wait for the neurosurgeon. And no, he had no idea how soon we would be seen. In fact, he wasn’t sure if any neurosurgeon would turn up because, well, it was Sunday morning and “doctors, too, have a God!”
We waited and then waited some more.
The Narok and motorcycle accident victims were still waiting too when rays from the Sunday morning sunshine sneaked into the cold waiting bay. When my patient was finally called in at some minutes to 10am, I felt guilty going ahead of the Narok victim, especially.
After a night’s wait, I was finally a lady neurosurgeon surrounded by a battery of nurses. After listening keenly to our explanation, she recommended some tests but warned the earliest we could have it done at KNH was probably after a week due to a long waiting list.
At the waiting bay, another loud wailing suggested yet another patient had given up the struggle while waiting for treatment.
As we left the neurosurgeon wondering what next for our patient, I couldn’t help being saddened by the public health sector. If this is what the best public hospital had to offer, then the sector must be seriously sick!
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