The untold toll of protests on healthcare system
Well-wishers carry an injured protester during anti-Finance Bill demonstrations along Cardinal Otunga Street, Nairobi on June 20, 2024
What you need to know:
- Some protesters walked up to the aid station at Jamia Mosque for treatment.
- Others were unconscious and unable to recall the names or contacts of their loved ones
At 1.30pm on a gloomy Thursday last week, an ambulance screeched into the parking lot of Jamia Mosque in Nairobi, an unusual scene for a place that typically exudes tranquillity.
That day, the mosque served as a makeshift aid station, bustling with the urgency of a hospital's triage unit. The air was thick with tension and the faint odour of antiseptic, a chemical substance used to disinfect and prevent infections on wounds, cuts and abrasions.
In one corner, a trio of health workers checked the vitals of a young woman who had just regained consciousness. Nearby, a pair bandaged a young woman’s arm, her face etched with pain.
Just a few feet away, 23-year-old David Murage sat on a chair, his wounds from a tear gas canister being cleaned. The arrival of an ambulance was met with a flurry of activity.
A team on standby rushed to unload a new patient while another quickly assembled the required medical supplies. Within minutes, the young man was stabilised and he was ready to be transported to a larger facility for further treatment. The health workers settled for Mbagathi Hospital, about seven kilometres away from the mosque.
Jeremy, who identified himself only by his first name, was one of the thousands of protesters, who had taken to the streets to voice their dissent against the controversial proposed Finance Bill 2024. He is in his 20s— a Generation Z. That morning, he had left his home feeling invincible, but by afternoon, he lay on a stretcher, nursing a knee injury.
“I came out to protest like so many others because we feel our rights are being violated and there are many things that are not right in our country,” Jeremy explained, wincing as he adjusted his position. “We were running for safety when a teargas canister hit my knee and it has led to this, me being here.”
The chaos, the screaming and the stampede of feet running in every direction had been overwhelming and resulted in many getting injured. As the ambulance wove through the crowded streets of furious protesters, Jeremy lay still, his mind racing with thoughts and fears. “I hope it's not too bad. I just want to get treatment and go home,” he murmured, his voice a blend of hope and anxiety.
Jeremy, only identified by his first name, injured his knee during last week’s protests when a police officer threw a teargas canister towards him. He was taken to Mbagathi Hospital for further treatment.
Healthy Nation was part of the crew aboard the ambulance, determined to experience firsthand the health impacts of the protests. After witnessing the protest from the frontlines and seeing the panic and physical injuries amid the crowds, the scene inside the ambulance epitomised one of the aftermaths of protests—pain. Equipped with the bare minimum—just a stretcher and a few essential medical tools—it was a moving lifeline in the chaos.
In recent years, Kenya has witnessed many protests, each with its health ramifications. For instance, the recent doctors’ strike dealt a particularly harsh blow to the country’s healthcare system. Hospitals were left understaffed and many patients, some with critical conditions, were left in distress, unable to receive the medical attention they required.
The effects of these systemic issues were palpable aboard the ambulance, where the constant ringing of Gordon Nyongesa’s phone echoed the urgency of the situation. As a registered nurse, he was juggling multiple emergencies.
“An injury, a gunshot, a protester who has fainted...it's a nonstop barrage of calls,” Gordon sighed, coordinating care over one of the two hotline numbers that had been shared with the protesters.
“Where are you? Do you have someone with you that we can talk to if we can’t reach you on the phone?” He would ask, each conversation a lifeline, ensuring health workers reached those in need. When it was not a serious medical condition that needed a review, he would guide them on what to do. “Take some water… sit down for some minutes.”
On arrival at Mbagathi Hospital, the team quickly transferred Jeremy from the ambulance stretcher to a hospital gurney and left him under the care of health workers who would offer him the specialised care he required. Time was of the essence, and the team quickly prepared to head out again.
There were many more cases to handle, and the scarcity of ambulances made every moment critical. At the health facilities where critical patients were being referred to, it meant stretching their medical supplies and staff to save lives.
As we drove back to the makeshift aid station at Jamia Mosque, the health workers reviewed their protocols and prepared for the next emergency. This time, a young man sustained a gunshot wound and he had already been taken to a nearby health facility for first aid but needed a transfer to a facility that could handle his situation.
Each case was a race against time, a balancing act between providing immediate care and transporting patients to facilities where they could receive more comprehensive treatment.
Back at Jamia Mosque, the scene was a beehive of activity. Volunteers provided primary health care, while others offered emotional support to the distressed. Among them was Kiige Wamaguru, a medical student at the University of Nairobi who had come to help. He moved from one person to the next, offering calming words and reassurance. Whenever an ambulance pulled up, he would dash over to help.
“I am volunteering in basic first aid and first response. I believe that people are out here fighting for a good cause and that is why I am here today,” he said.
The irony in the chaos was striking: the very doctors who had only just ended their strike last month and the clinical officers who were still on strike were now the ones offering medical services to the injured.
These healthcare professionals, who had been protesting for better pay and working conditions, found themselves back on the frontlines of protests, this time saving lives. Some like Nyongesa are yet to secure employment.
“After what happened on the first day of the protests, we decided to come together and offer medical support,” said Dr Austin Omondi.
Through the social media platform X, he connected with Dr Salim Ishmael and they rallied other healthcare workers to join them to offer free medical care to anyone injured during the protests.
Within hours, different experts, from nurses and paramedics to specialists, were offering their support.
The initiative is called Medics for Kenya and it has the backing of the Kenya Medical Practitioners Pharmacists and Dentists Union. Some contributed monetarily, while others brought in medical supplies.
By afternoon, medical volunteers were still streaming in to help amid a shortage of medical supplies attributed to the high demand for primary care. At one point the health workers on ground had to turn to social media, requesting well-wishers to donate medical supplies as they had run out.
“We began this yesterday and are doing it out of pocket and with the support of well-wishers. We just put our numbers out there and urged those who will get hurt, whether police officers or Kenyans, to come here. We have at least 100 medics here and around 2,000 in different parts of the country. We also have 17 stations and ambulances in Nairobi and Kisumu,” he said.
By the end of the day, the team had attended to more than 200 patients and referred at least 50 to neighbouring health facilities. “Then there are tens to whom we offered medical advice on the phone,” added Dr Ishmael.
Stephen Ogada, another picketer, was among those who benefited from the services offered in the vicinity.
“I came to town for demonstrations just like my peers. I am here to seek medical services because I got injured when a teargas canister was thrown towards us and it left one of my legs and hands injured. For a moment there, I thought I was gone but my friend called the hotline and brought me here to get help. My wounds have been cleaned and bandaged. I have also been given some painkillers,” he said.
Unaware of the chaos, another victim found herself in the thick of the protests. On an errand in the city centre, the woman, seemingly in her 50s, and in a lot of pain for a lengthy chat, said she had no idea about the day’s demonstrations when a sudden scramble for safety sent her sprawling. A searing pain shot through her knee as she landed on the ground.
Thankfully, the health workers t the makeshift aid station were quick to respond. They bandaged her injury and offered her a quiet corner to relax.
While many protesters like her walked up to the aid station for treatment, others were in such a severe condition that they were unconscious and unable to recall the names or contacts of their loved ones. They had suffered serious injuries, including gunshot wounds requiring immediate and intensive care.
According to Dr Salim, the health workers had already treated four cases of gunshot wounds in Nairobi alone.
These individuals represent just a few of the faces behind the health toll inflicted by protests, but some don't live to tell the story.
Already, Amnesty Kenya, a human rights organisation, reported a fatality from Thursday’s demonstrations. The doctors at the medical facility where the death occurred confirmed that it was a gunshot wound.
They said the patient arrived having already succumbed to extensive bleeding. One more protester has also been confirmed dead having sustained injuries from a teargas canister on his private parts.
To put the public health impact of protests into perspective, a 2017 analysis published in the British Medical Journal examined health-related complications from protest injuries.
The study found that 15 per cent of those injured in protests sustained permanent disabilities and three per cent of the injured died. Of the 2,135 injuries in those who survived, 71 per cent were severe, predominantly affecting their extremities.
“The rubber bullets are commonly used in crowd-control settings. We find that these projectiles have caused significant morbidity and mortality during the past 27 years, much of it from penetrative injuries and head, neck and torso trauma,” read part of the study.
Experts say the effects of teargas and water cannons and chemicals designed to irritate the eyes and respiratory system, can be devastating, especially in enclosed spaces. Commonly used in Kenya during protests, these substances can cause injuries ranging from chemical burns to permanent vision loss.
Nation Media Group journalist Maureen Mureithi (centre) is assisted by colleagues after she was injured while covering the protests in Nairobi on June 18, 2024.
Experts note that when teargas is deployed, the particles irritate your mucous membranes, affecting your eyes, nose, throat and mouth. If inhaled in significant amounts, it can also impact your lungs and skin. For adults, especially those with pre-existing conditions like asthma or chronic obstructive pulmonary disease, this can trigger an asthma exacerbation which can be fatal.
In yet another study published in 2021, more than 2,000 individuals who had participated in civil unrest and were exposed to teargas revealed significant physical and mental health effects, with some symptoms persisting for days or even weeks. Many of those affected were compelled to seek medical treatment.
Notably, the study revealed that more than half of the menstruating participants experienced disruptions to their menstrual cycles following exposure to teargas.
The overwhelming majority of participants — 93.8 per cent — reported physical or psychological symptoms such as burning eyes, blurred vision, shortness of breath, a choking sensation, rashes, burns, nausea, cramping and dizziness.
“What we are witnessing now are the immediate effects like dizziness, burns and fractures. However, from these protests, some individuals will suffer long-term injuries, mobility issues and mental health impacts such as post-traumatic stress disorder and anxiety disorders,” explained Dr Omondi.
