15 August 2013

Kenya: Police Promise Emergency Services Overhaul


Following the failures of the emergency services to combat the fire at the Nairobi airport last week, the police have promised to revamp the struggling NDOC. Will it be a success?

Shortly after 5am Wednesday 7 August, smoke began to appear near the immigration desks at Nairobi's Jomo Kenyatta International Airport (JKIA). As fire spread and claimed the arrivals hall of East Africa's busiest international airport, it took a further two hours for all emergency services to arrive.

But their response was disheartening and lacked basic standards of professionalism. Fire brigade units operated independently, without a coherent strategy or any central command. In an interview with Think Africa Press, one fire chief spoke of one crew trying to bring a building fire under control with tactics meant for airplane fires. Others are said simply to have used individual buckets to help out, while some reports allege that police officers and airport workers opted to loot the shops.

Following a sustained and widespread backlash against this mismanagement of services, news today emerged that the police are to take a central role in the coordination of emergency help. They have also assumed control of the struggling National Disaster Operations Centre (NDOC).

In a message to the press, David Kimaiyo, Inspector General of the National Police Service explained:

"I have created a new unit, National Disaster Management Centre (NDMC). The officer in-charge will be coordinating and liaising with police, military, ambulance providers, fire marshals and other service providers in times of emergencies to ensure proper management of issues during disasters."

Few will doubt the need for this reshuffle - Kenya faces disasters from massive seasonal floods to road carnage that kills over 8400 per year - but it remains unclear how far-reaching these reforms will be, or if they will be backed up with the financial assistance to make a lasting difference.

As Yusuf Nyakinda, operations manager of emergency services for the Kenyan Red Cross (KRC) reminds us: "As Kenyans we are very good, we come together, we do many papers and vigorous things, but then it is not implemented until something happens again. We've done it many times before."

Opening the lines of communication

"Our preparations are nil," said Selina Kibogy, CEO of St. John Ambulance, one of Kenya's leading providers of emergency medical services. "It is very uncomfortable being a citizen here. There really isn't much in terms of emergency [services]."

So where could the police help out? The status quo may be bleak, as there are no standardised training programmes but the role of communications - all facets and interactions of the victims and authorities - could be overhauled relatively inexpensively.

According to Nyakinda, one of the core issues is that there has thus far been no single communication system; the police and the KRC have often worked side by side at the same incident, but with different information.

"If I'm the incident commander," says Nyakinda of the Kenya Red Cross, "and I hand the control over to, let's say, the police, that means the command structure in place changes very fast, which brings confusion."

For those in need, reporting an emergency brings up similar problems. There is no free, national hotline for all emergencies. So when there is an emergency, Kenyans must choose from a mishmash of public and private organisations.

Until a recent court order, the free police hotline (999) had been down for fifteen years, and their priorities had been more with strictly criminal cases than the coordination of fire brigades and ambulance teams.

The National Disaster Operations Center (NDOC), tasked with coordinating national emergencies, and acting as an intermediary between different agencies during crises, has not offered much more hope.

Even finding their number can prove to be an elusive task (0202212386) - it is not on their Twitter profile, or their website, which is down. Importantly, the NDOC doesn't have any resources besides their call centre, so their only option in dealing with disasters such as fires, floods, accidents and other emergencies is to call the separate bureaus to ask for help, which wastes valuable time as they seek assistance.

The public/private divide

However, larger problems arise when one considers the disparity in wealth between public and private agencies.

According to Bethuel Aliwa, secretary of the Kenya Council of Emergency Medical Technicians (KCEMT) only a third - the privately owned ones - of Kenya's 358 ambulances is equipped with basic life support tools. "The government ones," Aliwa says, "are just a van or vehicles that have ambulance written on it."

The fire brigades are also under-funded. The Nairobi County Fire Brigade, which serves a city of 4 million people, only has four working fire trucks, admits Assistant Fire Chief Jacton Agwa. He says the engines are out of date because the fire brigade has no policy for retiring old equipment.

With these public sector services underfunded and forced to rely on outdated, malfunctioning equipment, the NDOC is left with no choice but to turn to private agencies. However, the NDOC has no budget to pay, or a legal mandate to compel private companies to action.

"Take AMREF [Flying Doctors] for example," states Agwa, "they say we will fly from Nairobi to Kisii and back, but the cost is almost a million shillings. Now who is going to pay?" In the best cases, private companies like the Kenyan Red Cross or St. John Ambulance eat the costs. In the worst, emergency services wait until other government ministries front the cash, as was the case in a recent school bus crash that killed over a dozen teachers and students. The government failed to order air evacuation for 12 hours.

Light at the end of the tunnel?

It will be interesting to see if the proposed changes amount to more than political rhetoric. Were they merely intended to pacify an outraged public and will they receive the financial backing from the government to make a real difference?

There might be glimmers of hope. Kenya's Ministry of Health, the John Hopkins University in Baltimore and the US Center for Disease Control, jointly held a National Emergency Medical Services Symposium, which sought to improve the country's emergency medical services.

They devised minimum requirements for ambulances, and are pushing for the adoption of a national disaster management policy that would standardise training programmes, create unified disaster response procedures, and provide the services with a proper budget.

Moreover, they hope to create a single emergency hotline that can immediately dispatch responders to any type of emergency.

But leaders of the Symposium say few policy makers see the urgency of the issue. A draft bill seeking similar amendments has been waiting government approval since 2009, held up by bureaucracy, while disasters continue to occur.

In the meantime, Kibogy of St. John Ambulance fears the worst: "Disasters are like time bombs waiting to explode," she concludes. "We suffer from terrorist attacks, fires, floods and traffic accidents, but nobody seems to take heed of them.

Jason Patinkin is a freelance writer and photographer from Chicago, Illinois. After graduating from Columbia University in New York City, he taught middle school science for three years to some extremely brilliant young adults on the Pine Ridge Indian Reservation in South Dakota.

Jason is now based in Nairobi, Kenya where he believes he has found the world's best cup of coffee. Blog: jasonpatinkin.wordpress.com, follow him on twitter @JasonPatinkin.

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