Got to be wet lease, county gaaabana dont have personnel to run the ambulances.

It cannot be inclusive of fuel, emergency drugs, maintenance, drivers or EMT personnel because there is an unknown variable in the number of trips or emergency cases they will handle in a day.

Thika might refer 20 patients to KNH each day, Embu might refer 10, Murang'a 2. Also, Thika might refer 2 cardiac patients who need extensive resuscitation and expensive blood thinners while Murang'a will refer a stable playful child who has swallowed a coin lodged in the airway for ENT care.

I'm sure the Red Cross contract says the minimum per month is 600k, but in case of other expenses over and above that amount, those will be surcharged in a separate invoice. That amount may rise to millions.

Either way, more than half of the critically ill patients referred to KNH and other tertiary institutions pass on either on the way or within 24 hours of admission. So, what's the cost-benefit?

Also, due to an "increase" in specialised personnel, cases that would otherwise have been referred or seen as emergencies can be handled locally e.g. a gunshot injury to the chest or abdomen can be handled by resident surgeons. The surgeon would otherwise have to explain to MoH why he would refer such a case to KNH while he possesses the skills to manage it.

Most Level 4, 5 and 6 hospitals have 1 to 4 ambulances already that are supplied by NHIF. A level 5 hospital such as Thika has never had a shortage of an ambulance to ferry critical patients to KNH. And most private hospitals have to have an ambulance as part of acquiring the status of a nursing home, maternity home or hospital. Aren't these adequate?

This deal is not right. Just an avenue to eat.

and two trained paramedics