Mathari mental health patients sleeping on floor, sharing beds

Lawmakers have expressed concerns over the deplorable state of Mathari National Hospital following revelations that mental health patients were forced to sleep on the floor while others shared beds.

The National Assembly Public Accounts Committee yesterday heard that 60 patients had also been abandoned at the facility, while 120 had recovered but were yet to be collected by their next of kin, further straining the already meagre resources at the facility.

This came to light during the committee’s sitting, where Principal Secretary for the State Department of Medical Services Ouma Oluga appeared to answer questions raised by the Office of the Auditor General for the financial year ended June 30, 2024.

In her report, Auditor General Nancy Gathungu had highlighted that there are inadequate beds at the hospital, leading to a humanitarian crisis.

She detailed that despite Sh12.6 million having been allocated for renovations of the hospital for the year under review, a review of the daily inpatient attendances indicated the number of inpatients exceeded the 653 available beds, resulting in patients being kept on the floor or sharing beds for a period of 26 days, thereby raising the risk of cross-infection.

“This was contrary to Article 43 (1) (a) of the Constitution of Kenya 2010, which states that, ‘Every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. In the circumstances, management was in breach of the law,” reads the report.

This elicited disquiet from the House team, which sought to understand why, years since its inception, the facility had not been expanded to accommodate more patients and improve the standard of care.

“Why not come up with another facility to replicate Mathari? What happens when eventually it is full and can no longer accommodate any more mental health patients?” posed the Committee chairperson, Tindi Mwale.

Vice Chairperson Amina Udgoon said that the deplorable condition had also been observed in other medical facilities, accusing the state department of negligence.

“You are killing people who have nothing through negligence. Mothers across the country are finding it very hard because they carry a pregnancy for nine months, but the baby dies due to negligence at the facilities or from being asked to share beds. A colleague recently lost their baby. The situation is bad,” she stated.

Turkana Central MP Joseph Emathe decried the lack of sufficient capacity to handle patients, especially across referral hospitals in the country, noting that patients have repeatedly failed to access treatment due to a lack of beds in hospitals.

But in his response, PS Oluga explained that the lack of adequate beds at Mathari hospital in the hospital was attributed to various issues including a high number of abandoned patients who have recuperated but are yet to be picked by their next of Kin and the fact that a large number of unknown mentally-ill patients who were brought to the hospital by well-wishers and taken in for treatment but they have not regained their cognitive functions/insight to remember where they come from.

He also told of a constrained repatriation budget. A repatriation exercise has to be accompanied by Security Personnel, Nurses, a psychologist, a Social Worker and a Driver, further constraining the Hospital Human Resource.

“There is a high number of patients who have been treated and are well, but are unable to settle their medical bills and are therefore held at the Hospital awaiting the decision of the Hospital's Waiver Committee. Government policy that no patient seeking mental health care should be turned away from accessing healthcare from a public health facility has also led to crowding of patients at the hospital wards,” submitted Oluga.

Adding, “The hospital undertook to expand two wards, but currently we are not able to operationalise the wards due to a lack of enough staff to man the wards.

 To address this challenge, the PS proposed that all mentally ill patients be registered as indigents under the SHA to allow discharges on time, as 70 per cent of discharges who are well are patients who have no capacity to pay hospital bills.

“The management proposes that all abandoned patients be put under the State Department for Social Protection. This will enable these abandoned patients to have access to shelter and food under various social protection services and homes. Further, the Department for Social Protection has the capacity to take these patients through Community Empowerment Programmes wherein the abandoned patients can, in the long run, be empowered to be socially and economically productive and self-independent,” he told the House team.

Lawrence Nderi, the Acting Chief Executive Officer of Mathari National Teaching and Referral Hospital, told the MPs that the main challenge facing the hospital was a lack of infrastructure, given that the facility was established in 1910 but has never been upgraded.

“We have nowhere to take the patients. Most of the Counties do not have mental units, but we are talking with the Governors to ensure they establish such units so we can transfer the patients downwards. There are also efforts to expand Mathari hospital so that it can accommodate more patients,” said Nderi.