Sick, untreated and unsafe: The plight of KNH patients

The Standard investigation has uncovered a dire shortage of critical blood test reagents, essential drugs, and nutritious food for patients, problems compounded by alarming security lapses at Kenyatta National Hospital (KNH), the largest referral hospital in East and Central Africa. 

According to multiple senior insiders, these failures are directly linked to a National Treasury directive that has starved the hospital of operational funds and placed the lives of hundreds of patients in grave danger by compromising the quality of healthcare. This, despite the medical facility collecting Sh40 million to Sh60 million daily from patients and being owed, according to government figures, approximately Sh1.58 billion by the Social Health Authority (SHA).   

Founded in 1901, the 1,800-bed Level 6 facility represents the final hope for thousands of Kenyans seeking specialised treatment. Its core function is an accurate diagnosis, which stands paralysed with sources confirming that more than 300 blood samples remain untested due to a lack of lab reagents. Reagents are specific chemical substances added to a blood sample to trigger a detectable reaction. This is used to detect specific antigens or antibodies, thus ensuring accuracy in determining diseases. 

The companies that supply reagents to KNH have not been paid, and without these tests, doctors are flying blind, treating symptoms rather than accurately diagnosing sickness. 

“This is a referral hospital. So we don’t assume anything; we give them the best treatment, and this starts with a blood culture,” explained a senior doctor, who spoke on condition of anonymity. “Other hospitals might have been treating a bacterial infection instead of malaria, so Kenyatta will do a full blood test. Now, the problem is that anyone who comes in can’t get treatment because we don’t have reagents.” 

The implications are severe for patients. “Those who can’t afford to seek private labs for these tests will probably die without being treated,” the source added. “Doctors can’t treat what they don’t know.” 

The crisis extends beyond the laboratory. Last week, patients missed meals entirely after the hospital’s food supplies ran dry, forcing relatives to step in. A spot check revealed that at the moment, patients are primarily served with ndengu (green grams), ugali and cabbage. 

“It’s such a shameful situation where the CEO personally has to go on his knees pleading with suppliers,” our source within the finance department said. “You can’t blame the suppliers, though. They supply items, hoping to be paid. Those supplying meat, beans, and other nutritious cereals have not been paid.” 

“Imagine patients being fed on white porridge for breakfast. It has little nutritional value apart from energy. We are giving people medicine but not feeding them; so, they get sicker,” a nurse lamented. 

Insiders point to a single policy change as the source of the hospital’s financial problems. Historically, KNH, which collects between Sh40 million and Sh60 million daily from patients, used these funds to pay suppliers directly. However, a recent directive from the National Treasury under President William Ruto’s administration now requires all hospital revenue to be deposited into a single government paybill account number. 

“The money to pay suppliers is there, but since it all goes to the Treasury, and the Treasury doesn’t remit it back to KNH in a timely fashion, the hospital will continue struggling,” a senior hospital manager explained. The Treasury’s failure to disburse funds has left KNH unable to service its debts to critical suppliers, triggering the shortages in food, reagents, and drugs. As of August 2025, KNH owed Sh2.39 billion in supplier debts. A senior manager at the facility said the buck stops with the SHA. “Our hospital is on the brink of collapse. If SHA worked as touted, we wouldn’t be in this situation.” 

SHA owes the hospital billions, reported by RUPHA (Rural & Urban Private Hospitals Association) in September this year, as approximately Sh1.58 billion. 

In the Financial Year 2023/24, KNH was allocated  Sh21.6 billion, with an additional Sh1.1 billion proposed for renovations. 

Patients are sitting ducks 

Other than the medical crisis, security at the facility is virtually nonexistent, putting patients and staff at physical risk. Despite two murders occurring in the hospital this year, the Standard reporter, wearing a lab coat, easily accessed seven entry points at midnight without a challenge. Four were entirely unmanned. 

Simply wearing a white lab coat granted unrestricted access to all levels of the hospital. The entrances easily accessed without being asked to present a staff identification badge include the University of Nairobi entrance, the TB Clinic entrance, the Casualty entrance, the entrance behind the police post, and the Clinic 18 entrance.   

“A few weeks ago, a member of staff lost their car in the staff parking. The staff parking is heavily secured, but a thief came in, disabled the car, and drove away,” a source said. 

The lax environment has instilled fear, particularly among female staff working night shifts, who now walk in groups for safety. Security has shown little improvement since the arrest of a murder suspect earlier this year. This year, within a span of five months, two patients have been murdered in the same hospital block. Kennedy Kalombotole was linked to the murders and is in police custody. 

The investigation uncovered another layer of neglect affecting contracted cleaners. The company Kamtix, which holds cleaning contracts for both KNH and the private Nairobi Hospital, provides different working conditions. At Nairobi Hospital, The Standard confirmed that cleaners are equipped with protective gloves, masks, and adequate footwear. 

Health hazard 

In contrast, at KNH, young men and women working the night shift clean labs, wards, and isolation areas without any protective gear—no gloves, masks, or proper boots, with most of them wearing open rubber footwear popularly called “crocs”.  Their exposed hands and feet put them at direct risk of harmful bacteria, viruses, and pathogens, turning a vital job into a health hazard.  

Mohammed Ibrahim, the chief executive officer at Kamtix Cleaning Service, the company contracted by Kenyatta National Hospital, however, says his staff are well protected: “ We give them uniforms and proper protective gear.” 

He, however, added that sometimes his employees, who are young, refuse to wear protective clothing. “You know some of these Gen Z even refuse to wear gumboots or staff badges but I know we provide enough protective gear to the cleaners.” 

Efforts to reach the cabinet secretary for Health, Aden Duale and Kenyatta National Hospital CEO Dr Richard Lesiyampe bore no fruit as both didn’t respond to communication and inquiries from The Standard. Social Health Authority chief executive officer Mercy Mwangangi failed to respond to queries from The Standard. 

“KNH is owed Sh5.58 billion. MTRH owes Sh2.5 billion. Mathare Hospital owes Sh150 million. The government, through the Social Health Authority in the last two years, has accumulated more debt than NHIF did in six years,” says Dr Simon Kigondu, the President of the Kenya Medical Association. 

He says that because of the failure by the SHA to pay, the health CS has started creating sideshows to cover the government’s failure. 

“The CS is telling the public that doctors are not coming in to work, that’s why services are not available. It’s simply because most hospitals are turning away SHA patients. And anyway, health is a devolved function; what interest does the CS have in doctors working for county hospitals? Is he an HR manager? That’s a diversionary tactic,” fumes Dr Kigondu.