Disturbing reports of patients succumbing to easily preventable deaths is so sickening that one is left scratching the head for answers. Some cases being so bizarre that cynics are even tempted to question the mental status of the health workers and doctors involved.
You stand to wonder whether they lack the skill required for the job they were employed to do or its just ignorance? Is it a case of too much workload, lack of resources or plain apathy?
Emergency care can be defined as the care given in hospitals to patients with serious reversible conditions. It involves triage care where degrees of urgency are assigned to illnesses or conditions in order to decide the order of treatment and subsequent follow up. It encompasses high dependency units, Intensive Care Units, Operating theaters, Post-Anesthesia Caring Units, Kidney Dialysis Units, Burn units, Cardiovascular Units and Stroke Units.
It is safe to say that critical or emergency care services in Kenya have been hampered by economic reversals resulting in low wages, manpower flight to either the private sector or abroad, and the unwillingness of government to fund public hospitals adequately. Wrapped up in this situation is the endemic corruption which unabashedly permeates all sectors of the Kenyan society. The result is an all too familiar harrowing story such as was posted on social media recently by a medical doctor:
“Today just after 4:00 pm, a rogue driver hit a cyclist in Busia. The Mzee had come from buying chicken feed. He sustained serious injuries to the head and sunk into coma. Good Samaritans took him to hospital. The clinicians saw him and declared that they couldn’t help him without a CT scan. No effort to stabilise him, no IV line, no pain killers, nothing. They then threw him, an unconscious man bleeding from the nose and mouth, into the back of the ambulance, with the nurse sitting upfront with the driver, pretentiously referring him to Kisumu for the CT Scan. They murdered him. He barely made it 10km from Busia, of course. They made sure he choked on his own blood… That man is my father-in-law. The next victim will be someone’s mother, sister, brother, father. We do not have medical care in this damned country…”
Rule number one in this business is that you do not move a patient around until they are stable. Maintaining hemo-dynamic stability for say most accident victims before moving them rarely happens. Most times, such patients, who are barely conscious and bleeding profusely, are turned away at ‘small’ government facilities and their minders advised to take them to bigger hospitals. Most never make it.
Other patients in critical condition are neglected for such long periods of time at Casualty that their situation degenerates to a point where their lives cannot be salvaged. We have read cases where medical personnel did not bother to take a set of vital signs on a patient, establish an IV to fluid resuscitation or offer simple comfort care measures as patients await treatment. Moving critically ill patients in ‘ambulances’ that lack trained paramedics and the right equipment is nothing short of murder.