Medics battle fear of Covid, poverty on the frontline

“‘How much are we required to pay? Bill ni pesa ngapi?’ That’s all she wanted to know, and I am sure that, apart from the infection, the psychological burden of paying the bills led to her quick death,” says one of her doctor friends who sought anonymity because she is not the family’s spokesperson.

A dedicated professional, Dr Njoroge was the first Equity Leadership Programme (ELP) doctor and one of the founders of Equity Afia Health Network.

She is one of the dozens of doctors and other front-line workers who have succumbed to Covid-19.

Until her death, she had risen through the ranks to become the deputy medical superintendent and consultant physician at Thika Level Five Hospital.

She left behind two sons aged 11 and nine.

“We are seeking comfort in the knowledge that Jacqueline has left behind a legacy of self-determination, love for mankind and was a role model for our scholars as well as young professionals in our country,” says Dr James Mwangi, Equity Group Managing Director.

Unknown to her, as thoughts about mounting costs troubled her soul in the ICU, the medical fraternity had fund-raised about Sh1.2 million to clear her hospital bill.

Rising Covid-19 infections and deaths among the medics have been blamed on rising patient traffic amid lack of protective gear.

Already, 2,352 healthcare workers have tested positive for the virus — 1,177 men and 1,175 women.

The cumulative fatality among healthcare workers is 30, according to data from the Health ministry.

National Nurses Association of Kenya (NNAK) president Alfred Obengo and Kenya National Union of Nurses deputy secretary-general Maurice Opetu said health facilities are overwhelmed, with just a few personnel left to attend to patients using substandard personal protective equipment (PPE).

“We will definitely succumb to the virus if we are to continue working in such conditions,” Mr Opetu said.

Lack of protective gear

Healthcare workers in several counties have downed their tools to protest against the lack of protective gear.

The Ministry of Health has given the Kenya Medical Supplies Authority (Kemsa) the green light to issue PPEs that have been lying idle at its warehouse for eight months now.

“When you are infected, you need to cough up money for treatment. There has been no risk allowance for the past five months, yet we are attending to Covid-19 patients; no life insurance yet we are dying and leaving our loved ones with nothing,” Mr Opetu said.

“We have for the past few months doubted the quality of the locally produced masks. And even with the quality issues, the supply is erratic,” he added.

WHO Regional Director for Africa Matshidiso Moeti said during a WHO Africa press conference that inadequate PPEs and weak prevention and control measures have raised the health workers’ risks.

“Risks may also arise because of heavy workloads which result in fatigue, burnout and possibly not fully applying the standard operating procedures,” Dr Moeti said.

“One infection among health workers is one too many,” said Dr Moeti. “Doctors, nurses and other health professionals are our mothers, brothers and sisters. They are helping save lives endangered by Covid-19. We must make sure they have the equipment, skills and information they need to keep themselves, their patients and colleagues safe.”

Healthcare workers have had no option but to fund-raise for their infected colleagues.

With the government and insurers such as the National Hospital Insurance Fund (NHIF) declining to foot Covid-19 treatment bills, some patients who could have been saved are dying of the virus.

Fear of heavy medical bills and other Covid-19 costs has kept many Kenyans away from seeking treatment.

“When you are unwell, and you know very well that you don’t have the money to clear the bills, why would you take yourself to a hospital? Most of them are dying at home,” said Kenya National Union of Nurses deputy secretary-general Maurice Opetu. 

Kenyans seem to be on their own, with the government only preaching precautionary measures without providing protective gear or financial help.

Given that the front-line heroes are struggling to get admitted to high-end hospitals where they work, where does this leave the ordinary Kenyan who lives on less than a dollar per day?

Medics who have died

Mr Opetu told the Nation that a nurse who had difficulty breathing died after the management of a private hospital in Kisumu refused to admit her without a down-payment of Sh100,000. The facility did not accept insurance cards.

After 30 minutes of pleading in vain, she succumbed on her way to Jaramogi Oginga Odinga Teaching and Referral Hospital.

“The government has literally abandoned us. It is saddening,” said Mr Opetu.

“You might think doctors are rich people. Wait until you see some of their payslips. They survive on loans and if the insurance cannot take care of their bills, then definitely they are left to die,” he said.

Some of the medics who have died include University of Nairobi periodontal surgeon and lecturer Hudson Alumera, pharmacist Faith Kanjiru Mbuba, plastic and reconstructive surgeon Ashraf Emarah and bariatric, general and laparoscopic surgeon Vladimir Shchukin.

Others are Hudson Inyangala, a specialist in public health focusing on HIV/AIDS, maternal, neonatal and child health and family planning/reproductive health (FP/RH), nutrition and WASH programming, orthopaedic surgeon Daniel Alushula, paediatrician Robert Ayisi, obstetrician and gynaecologist Doreen Lugaliki and internal medicine specialist Ndambuki Mboloi.

“Every morning when I leave my house for work, I am a very worried Kenyan. I don’t know whether I will contract the virus when I am on duty and I am not sure whether the protective equipment I am putting on can protect me. In case I get infected, I have to foot my bills all by myself and in case I die, there is nothing to leave behind for my family,” says Esther Atieno, a nurse at Kisumu County Hospital. 

“Who will take care of the patients when hospitals beds are full with doctors? The government has to wake up and take the health workers’ issues seriously,” says Ms Atieno.

Risk allowances

Since July, the government has not paid risk allowances as directed by President Uhuru Kenyatta. It paid the allowances only once.

The allowances ranged between Sh5,000 and Sh20,000 for different cadres of health workers including doctors, nurses, laboratory technicians and were to be paid for three months from April 1.

The health-care workers are also worried that the government does not want to insure them.

“Today when I die, that is it. If I fall ill as I risk my life to attend to Kenyans, I will use all my savings to clear my hospital bills, leaving nothing behind for my family. Why is it so difficult for the government to give life insurance to health-care workers,” Kenya Union of Clinical Officers secretary-general George Gibore said.

“If we are heroes as they claim, why are they not afraid of losing us? A precious gift is always kept. We should be their priority,” Mr Gibore said.

The medical fraternity yesterday convened a Special National Advisory Council meeting to deliberate on the welfare of the front-line medics as the union recorded a loss of four members to the virus in just 24 hours.

“Today is a dark day for the medical fraternity. The death of four of colleagues in the last 24 hours is devastating news to the profession,” said Dr Chibanzi Mwachonda, acting secretary-general.

Data from unions shows that about 800 doctors, 320 clinical officers and 600 nurses have so far been infected, 15 nurses and six doctors have died while others are admitted to intensive care units in various hospitals.