138 days of silence at Kiambu Hospital

But this eerie calm is not peace. It is abandonment. It is mothers finding clinic doors locked. It is patients waiting five hours for basic treatment. It is the 139th day of a doctors' strike that has turned one of Kenya's key healthcare facilities into a shell of what it once was.

The standoff

Outside the hospital gates on Monday, doctors marched with nearly five months of frustration on their shoulders. Their target: the county government, they say, has failed to address their concerns.

"We have had engagement with the public here, and one declaration we have put forward is that beginning tomorrow, we will be collecting signatures from 10 percent of the residents of Kiambu to petition the parliament, to petition the president to dissolve this county," declared Dr Davji Atellah, Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU). "There is no way we can continue watching people dying."

Governor Kimani Wamatangi, speaking on Sunday during a fundraising drive in Juja town, painted a different picture. "You are hearing so many things out here, that there is a push and pull between doctors and the county. That is just mere politics," he said, insisting there is no health crisis in Kiambu County. He warned critics to "stop playing games with us here."

The governor's denial drew sharp rebuke from the national government. Speaking during the launch of AI-enabled ultra-portable digital X-ray machines and integrated lung health guidelines at the KEMSA headquarters in Nairobi on Monday, Health Cabinet Secretary Aden Duale called on county leaders to take responsibility for healthcare services within their jurisdictions.

"Service delivery is in the counties. So, if some counties don't want to fix their health sector, then you don't blame us. You solve your leadership. And the mortality rate in that county is very high. We have evidence," said Duale. "So when you are a leader, don't live in denial."

As doctors demonstrated, the Council of Governors was meeting with the county's executive committee member for health behind closed doors.

The reality on the ground

Despite county management's insistence that hospitals are "working at full capacity," a recent spot check by the Nation from October 10 reveals otherwise.

Patients endured waits stretching up to five hours for treatment or lab results. One person arrived at 9 am but was only seen by a nurse at noon. Another was forced to return the next day to see any available doctor.

Driven by fear of delayed treatment, patients registered with the Social Health Authority (SHA) are going to a private hospital opposite the Kiambu Level 5. "As long as you are covered by the SHA healthcare plan, you can go there and receive care, instead of sitting here to wait," one patient explained.

A mother with her baby strapped to her back stood outside the closed baby clinic. Her baby was scheduled for a vital weight check.

"It is written in my baby's clinic book that she was supposed to be checked today for weight progress. However, the clinic is closed, and we have not been given any clear instructions on when it should open," she said. "I will come back on Monday, and if my child doesn't get checked, I will go to a private facility because, even though it's just a weight check, it needs to be done consistently on set dates."

The spillover effect

The consequences extend beyond Kiambu's borders. Kenyatta National Hospital (KNH) and Murang'a Level 5 Hospital recently announced they are overwhelmed by surging patient numbers.

KNH Chief Executive Officer Dr Richard Lesiyampe revealed that the industrial action "has led to a sharp rise in the number of very sick patients arriving at the hospital, many in critical condition."

"The maternity department has been hardest hit, with the labour ward and newborn unit handling more than twice their normal capacity," said Dr Lesiyampe. "Sadly, some of the mothers and babies are arriving too late, and a few have had poor health outcomes despite the best efforts of our dedicated medical teams."

"The increased demand for care has also placed immense pressure on essential hospital services such as operating theatres, the blood bank, and diagnostic services. Our staff are working tirelessly around the clock, but resources are stretched to the limit."

Murang'a Level 5 Hospital is now attending to between 1,500 and 2,000 patients daily in their outpatient department and admitting 500. "This is compounded by the influx of patients from elsewhere," their statement read.

Behind the numbers are stories of loss and negligence.

Milca's story

On September 5, 30-year-old Milca Nduta went to Kiambu Level 5 Hospital with high blood pressure. Eight months pregnant, she was admitted for monitoring and treatment.

"I was given some drugs and put on injections, and stayed there for almost the whole month," says Nduta. "All this time, the baby was okay and would move normally. However, two days before delivery, I realised I could no longer feel the baby's movements. I told the medics, but they told me the baby is fine, without doing any tests or conducting an ultrasound. They were all students, and I only saw the doctor on the first day."

On delivery day, she was induced into labour and gave birth to a baby girl. But the baby didn't cry. Nobody showed her to Nduta. The infant was immediately whisked to the nursery.

Four hours later, Nduta was informed that her baby had passed on. "I didn't even get to hold or breastfeed her."

The baby was her thirdborn. Her secondborn had also died from a short illness.

Esther's ordeal

For Esther Wangari, the baby she lost was her second child—a surprise pregnancy after over 10 years. At 40, she was already a week overdue, making it a risky pregnancy.

"All the scans indicated that the baby was fine and presenting normally. The only true challenge was that I was overdue," narrated Wangari. "I went to the hospital with mild labour and was admitted, and they began inducing me. By midnight, labour kicked in, and by 6 a.m., I had dilated to eight centimetres."

The situation turned critical around 8 am when she discovered she was bleeding.

"Even before my waters were manually broken, the bleeding became excessive, requiring a thick pad. Despite the obvious sign of distress, nothing was done. I repeatedly begged the staff to take me to the theatre for a C-section, explaining the intense pain and the alarming bleeding."

The nurses dismissed her pleas. "They told me to relax, that I was simply anxious, and insisted that since I was at eight centimetres, they were waiting for me to reach ten. I pointed out that if I hadn't progressed from eight centimetres between 6 am and 1 pm, it should have been taken as an emergency. They told me to wait and hold on."

By 5 pm, she still hadn't progressed. In desperation, she called a paediatrician friend who arrived immediately and confronted the staff, asking why they were waiting for tragedy when a clear emergency was unfolding.

"Finally, they began prepping me for an emergency C-section. As they prepared the injections, I felt the baby descending rapidly. I shouted that the baby was coming, but they insisted I was just suffering and needed to relax. It wasn't until a staff member glanced over the bed and saw the head that they realised the baby was delivering immediately."

The baby was pulled out, and the force of the extended, obstructed labour caused massive internal damage: tears to the uterus, cervix, and vagina.

"As they began stitching, they realised I was still bleeding severely. They undid the stitches—all three layers—while I was conscious. The re-stitching was excruciating. During this second attempt, they discovered retained placenta tissue and, shockingly, gauze that had been left behind."

The staff refused to place her baby on her chest despite repeated requests.

"When they finally brought her to me, she was crying and soon began frothing due to low blood sugar, which they were slow to treat. It was only two weeks later that I discovered the true reason for their evasiveness: the baby had suffered a broken collarbone during their attempts to pull her out. They had refused to bring her to me to hide the injury. No medical action was taken for the collarbone, only physiotherapy, and they never gave her painkillers for the fracture."

After discharge, Wangari continued to bleed for two months, suffering from oedema and low iron.

"The hospital insisted it was a hormonal issue and gave me countless tablets. Deep down, however, I knew the prolonged bleeding and health problems were all direct consequences of the mismanagement and negligence that occurred during my delivery."

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Additional reporting by Hellen Aura.