PRIDE AND PREJUDICE
Every year we have doctors from European countries visiting KNH. Operation smile team of Doctors and Nurses pioneered in this area, until they ran into some disagreement. No one wants to talk about it, there is mention of money being involved. Operation heal the child organized by the round tablers of Nairobi quietly replaced operation smile. This is a local initiative that pays the expenses of two visiting surgeons who perform reconstructive surgeries on needy persons. We also have operation ear drop that aims at restoring hearing function arising from damage to the structures of the middle ear. The orthopedics project deals with hip and knee replacements at a small nominal fee, far below the prevailing market price. The latest addition to the stable is the Kidney transplant project, which introduced new kidney harvesting technology. The team came from Spain, and was willing to transfer new techniques to the local surgeons. A team of nurses and doctors was dispatched to Spain for a familiarization tour.
Junior surgeons participate in these projects enthusiastically, marveling at the skills displayed by the visiting team. Theater nurses are often seen attending lectures given free of charge by the visitors. But our learned consultants keep aloof from these activities, preferring to continue practicing their outdated surgical skills.
I will never forget this little incident that occurred when I was a junior registrar in 1998, just immediately after the bomb blast. The Israeli government donated medical supplies to assist in the treatment of the survivors. Among them was blood and surgical materials of superior value. Everyone had taken the trouble to learn how to use these materials, with the exception of the consultants. So generous was the donation that we were never able to exhaust the supplies immediately, which were left behind by departing Israelis.
I was assisting my senior perform an abdominal surgery, and the consultant asked for a suture so as to approximate some tissues together. The scrub nurse handed over a suture material donated by the Israelis, called POLYDIAXONONE. The fuming surgeon tossed back the suture to the nurse insisting that he wanted a suture made from VICRYL material. It appears that there was a stock out of VICRYL, and the surgeon grudgingly accepted the suture back. Midway the stitching, he paused, doubt written all over him and debated whether to use CHROMIC CUTGUT. WHAT THIS SENIOR Doctor did not know is that POLYDIAXONONE had an absorption rate of 120 days, VICRYL 90 days while CHROMIC CUTGUT only 30 days!
Every year, medical staff get accidentally pricked by used needle, predisposing themselves to contracting highly infectious diseases eg AIDS, hepatitis. As a safety measure, the hospital introduces some of the best practices aimed at curbing needle stick injuries, as practiced in developed centers. Seminars were organized to educate members of staff on the same. Everyone adopted the new techniques, with the exception of the doctors, who could not imagine being taught by a paramedic. Eventually the management intervened and the doctors ate the humble pie.
KNH spent millions of shillings organizing customer care seminars, which our learned consultants avoided like plague
In 2005, the hospital embarked on formulating STANDARD OPERATING PROCEEDURES. To date, the doctors have remained behind schedule, as other paramedical staff have complied to the latter.

The x mass season eventually caught up with Kenyatta national hospital on 24th of December, when the hospital got decorated. Well wishers and visitors came in large numbers to wish the sick ‘merry x mass’. The leading organizations were churches, factories and some cooperate entities. Some individuals brought in gifts too.
Most of the donations went to the children’s wards and the maternity wing of the hospital. Some lucky individuals had their bills paid for by well wishers, while the hospital continued to waive bills of some patients who are not in a position to pay.
However some patients quietly sneaked out of the hospital so as to avoid paying the bills. The hospital is currently detaining some 300 individuals, most of them Jobless, who are having difficulties in paying the medical bills. This includes some mothers in maternity wing, who are forced to sleep on the floor, so as to create space for new arrivals, who are too sick to sleep on the floor. At one time, some 13 mothers attempted to walk out of the hospital with their babies, but were thwarted by the hospitals security personnel. They were advised to be patient as the hospitals’ bureaucracy processed their bills.
One mother will spend a miserable holiday season this Christmas, separated from her baby. She had earlier on absconded from the hospital, over non payment of her bills, leaving the tiny infant in the hospitals’ new born unit. She resurfaced a few months latter to claim the baby. The hospital has managed to trace a baby bearing the same names given by the mother, but are not in a position to verify the identity of the claimant. None of the administrators can vouch for her identity, nor is there any patient who remembers this mother. A DNA test would have helped, but the hospital lacks such a facility. The private sector is charging a leg and a hand for the same. Given that the mother initially sneaked out of the hospital due to non payment of the bills…………, tunaomba serikali iingilie kati mambo haya!!!!!

One of the notable absentees in x mass well wishing list are the politicians. Perhaps, KNH is no one’s constituency…..at least the likes of Raila, Kalonzo, Ruto, et al should have been exempt from this mentality, one could think.
Not that anyone missed them. The last time Kalonzo visited the institution left several staff members with cracked ribs, thanks to his overzealous body guards who have perfected the art of planting bonny elbows in people’s midriffs…….one KNH official quitted the tour prematurely after getting rudely elbowed in her tummy.
A sharp contrast from Raila,s security detail who were courteous to the hospital staff and allowed several workers pose next to him during the photo session.
President Kibaki’s security detail is the most thorough. They visit the venue several hours in advance, identify the concerned officials, choreograph the visit then……viola….here enters the president. Everything proceeds as choreographed. He makes is speech and leaves without engaging in tete-a-tete that often made Mr. Moi’s visits worthwhile. Hata kitu kidogo ya soda hakuna…….bure kabisa kama mafi ya kuku….I think it is the economist in him: no unbudgeted expenditure.
Mr. Raila’s supporters are the most uncouth, even among the educated elite. Take for example Dr. Sulee, a kidney specialist and also Gor mahiah’s team physician. It is not rear to see him sauntering in the hospital’s corridors donning Gor’s colors. Such fanaticism is understandable in the young and misguided, who would rather engage in hero worship than carve a niche for themselves in this modern jungle society.
Dr. Sulee was among the applicants of the vacant post of KNH’s CEO. Thankfully, he was never shortlisted. He is now a walking 6’6” tower of bitterness. During the PM’s last visit, he kept on yapping about how KNH was mismanaging the Nyayo stadium stampede victims. The PM had, on several occasions; to remind him that there is a time for everything… the matter was eventually raised during question time in parliament, and the good slippery professor….Nyoko nyoko parried away the question…he has been in the government long enough to understand its inefficiencies… and his prefects knows it too well…..but there is no harm in sacrificing the reputation of a few professionals just to show the electorate that he is not sleeping on the job…Dr. Sulee is one of the few professionals who failed to keep their heads during the PEV.
Last week, several government hospitals quietly closed down for the festivities and offloaded their patients to KNH. Ambulance after ambulance kept disgorging their cargo at the casualty wing. Most had some vague reasons for referral. The most annoying one being that the doctor was away for Christmas. Most of the patients are the victims of the road traffic accidents that took place as far as nyeri, machakos and nakuru. But KNH’s administration does not seem to mind. They have a budget deficit on their hands, and have opted to raise more money through the user charges. KNH is abdicating its referral status, and is now jostling for the provision of primary health care. Patients no longer need referral letters to get attended at the facility. As a result, the casualty department has recorded an increase of 30% in attendance numbers.
Over christmass, Dr. Kabetu, the acting CEO had to spend time in casualty seeing patients, when only two doctors turned out for duty. The institution has been using part time doctors to attend to patients. But with once a year festivities around, only a very broke doctor would volunteer to work…

Good job with the medileaks , keep them coming.

@tonny. Have just scanned my laptop and found a trojan screen shot stealer.... am finished!

It has been a penniless holiday season for KNH staff. The hospital’s annual budget could not be approved by the outgoing CEO, since he would not be in office to oversee its implementation. The process of selecting a new CEO has been prolonged for reasons best known elsewhere. The hospital barely has enough money, to finance its operations till March this year
Traditionally, all KNH employees’ salaries come from the exchequer. The administrative protocols involved usually cause a degree of delay in the disbursement of funds. To shelter her employees from this irregular disbursement, the management has been paying the employees using the petty cash account, pending reimbursement from the exchequer. The delay in approval of KNH’s budget has thrown the spanner into the considerate works. With shrinking reserves, pressure from creditors, and an ever increasing social responsibility bill accrued from caring of patients who are not economically empowered, the management had to jettison some responsibilities.
This time round, KNH staffers will have to wait for the exchequer to avail the necessary funds. What is not clear is the reason why the December salaries are coming latter than the ministry’s. All GOK employees received their pay before x mass. This has given rise to speculation that the delay might have been engineered so as to cause general unrest among sections of the staff, a trick that was used successfully to dispose Dr. Onguti, and Waweru. But like most conspiracy theories, this does not hold much water. Dr. Kabetu is in acting capacity. He was not shortlisted for the interviews of CEO, and, Dr. Kibosia is now the most favored candidate for the hot seat. However a section of the powers that are to be, are not comfortable with this outcome, wishing that one of their own man had clinched the deal.
As the selection of the next CEO drags on, and as the institution is being starved slowly to its knees, patients in ward 5A continue recovering in a ward without a door. This ward is situated on the fifth florr of the hospital’s tower block, and houses surgical patients. One could imagine that surgical wounds should be protected from infection by all means. The maintenance department has failed to find a replacement. This should go down in the Guinness book of records as the only health institution in the world that has no door!!!!!!!!!!!!. It is now over a month since the door was knocked off its hinges by a trolley being pushed by the laundry man. The initial estimate for replacing the door was estimated at 300,000/=!!!!!!!!!!!!. Another record of sorts for a wooden door. In the meanwhile, dust, flies and thieves are free to enter and exit the ward at their pleasure.

@Murenj..Your inside perspective of KNH is good and very interesting. I only find some of your remarks about some of the consultants very questionable.Without question, most of them are after the dough & their competence leaves alot to be desired. But merely stating on a layman's forum that a consultant postponed seeing a brain tumor patient till the day after, is imho gross misinformation. There are a lot of background medical factors that not all wazurians can adequately analyse. I also believe out of experience that a surg. resident may not always understand the decisions of consultants from other specialised fields.
Otherwise am enjoying your medileaks....

Nice work Murenj! Thanks for the 'KNH-Leaks'
Can someone out there have a separate leak for say KRA..KPA...KACC or some other parastatal.

one may be down, but not out

Murenj is hereby granted the title of Dr.411.