What One Catholic Mission Hospital in Kenya is Doing to Weather COVID-19 Storm

A majority of patients who consistently seek medication at the facility are those suffering from chronic non-communicable diseases including diabetes, arthritis and cancer. Some of them have become increasingly defaulters in their treatment, according to the Cleric of Kakamega diocese.

“Our patients who have chronic illnesses that require constant check-up are no longer attending their clinics. Some of them are brought to us when it is too late and they die along the way or at the hospital emergency section. I am sad to report that we have lost a number of our patients when their death could have been avoided,” Fr. Columban shared.

He added, “Though the deaths are not very alarming, the trend is worrying and something needs to be done urgently. People with chronic illnesses should be encouraged to stick to their medication.”

The hospital, which has a bed capacity of 255 patients used to admit up to 200 patients before the outbreak of the coronavirus. Today, the highest number of patients it has admitted since Kenya recorded its first COVID-19 case on March 12 is 70.

With this reduced number of patients, the highest number of occupants in a single ward is three. The three patients are in turn attended to by 12 nurses who take day and night shifts, a situation that Fr. Columban says beats logic.

“It doesn’t make sense having three patients being attended to by 13 nurses. These are the things that forced us to send some of our clinical officers, nurses and other contracted staff members on unpaid leave until things start to look up for us,” he explained.

The hospital has been paying some 402 workers including 262 staff on payroll and 62 contracted cleaners and security personnel. The rest are people in the field including community health officers who are given incentives by the hospital.

Three months ago, when the health facility started performing poorly in terms of revenues, Fr. Columban convened the hospital board, which decided to keep all staff around for three months.

“We deliberated on our performance and agreed to have everyone around for three months even though there was very little work to be done. But recently, we decided that we couldn’t do it anymore and send some 40 employees on unpaid leave,” he said, adding that those on unpaid leave will be taken back once normalcy returns in the operations of the hospital.

Out of the 40 staff sent home on unpaid leave, the neediest cases have been identified and continue to remit services at the hospital on pro-rata basis, meaning that they do not have a salary but are paid according to the number of hours they work.

“There are those who went ahead to submit their resignation letter but those who are willing to continue working with us on pro-rata terms still have an engagement with the hospital,” the Priest clarified.

The woes at St. Mary’s Mumias Mission Hospital, however, did not start with the outbreak of the virus. According to the Hospital Administrator, the hospital was already struggling towards the end of 2019 when National Health Insurance Fund (NHIF), which settles hospital bills for its clients, stopped processing claims for the hospital.

“NHIF promised to give us the funds beginning of January this year but when they finally responded, they gave us very little,” Fr. Columban disclosed, adding that receiving the raw end of the deal from the health insurer marked the beginning of hurdles at the hospital.

Additionally, NHIF pulled out of elective procedures when Kenya reported its first COVID-19 case, leaving the hospital’s two surgical wards with a negligible number of patients. The decision by NHIF to pull out of these procedures has, however, been replicated across many other hospitals in Kenya.

Also top on the hospital’s list of concerns is the high number of needy cases in Mumias who rely on the Mission hospital that does not exist to make profits.

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“Many households in Mumias were left very poor at the collapse of Mumias Sugar Factory, which employed many people in this region. Many lost their jobs. Others had to get rid of their sugarcane and are now in deep need,” says Fr. Columban.

Many Mumias residents rely on NHIF capitation remitted in three-month quotas to the hospital. This is very little, according to the Kenyan-born priest.

“NHIF gives KES.300.00 (US$3.00) per card, which translates to KES.100.00 (US$1.00) every month. Some of the patients who rely on NHIF have chronic illnesses and they get medication of over KES.2,000 (US$20.00) a month. This is way too much compared to what we get from the health fund,” he says, adding that the hospital’s catchment area has over 3,000 patients with chronic illnesses who visit the hospital at least once a month.

Additionally, the hospital is grappling with lack of facilities including Personal Protective Equipment (PPEs) for its staff.

Kenya’s health ministry has allocated KES.3.9 billion (US$39 million) to fight COVID-19. The money was set aside for the hiring of health workers, purchase of PPEs for frontline health workers in the fight against the virus and testing and treating of 100,000 people.

Most of the resources targeted the country’s level 5 hospitals across different countries. Mission hospitals, which make part of the country’s private sector have been exempted from these benefits, a situation that Fr. Columban considers unfair.

He explains, “The dichotomy between the public and private sector is very hurting especially during such times as these when we are all facing the pandemic. Whatever aid that is given by the government should cut across all sectors because the patients that come to our mission hospitals are taxpayers, just like everyone else.”

The Mission Hospital in the Catholic Diocese of Kakamega is one of the hundreds of health facilities run by the Catholic Church in Kenya. Through the Catholic Health Commission of Kenya, the Catholic Church runs about 30 percent of all healthcare facilities in the East African nation.  

According to the report by the Commission that operates under the Kenya Conference of Catholic Bishops (KCCB), the Catholic Church in Kenya has an expansive network of health facilities, which consist of 448 health units including 54 hospitals, 83 health centers and 311 Dispensaries and more than 46 Community Based Health and Orphaned and Vulnerable Children (OVC) Programs. 

In the Arid and Semi-Arid Areas of Kenya, the Catholic Church has and manages mobile clinics for nomadic communities; these are difficult areas that other organizations, including the Government, have not been able to reach in order to provide health services.