Efforts to curb Kenya's latest cholera outbreak have been hampered by a nurses' strike that enters its 54th day Wednesday, putting the lives of hundreds of patients at great risk.
And, while the biggest scares of the highly infectious disease have been concentrated in Nairobi and its environs, doctors on Tuesday confirmed cases of the disease in Lamu and Kisumu counties.
Nurses went on strike in June to protest what they believe is a breach of the collective bargaining agreement (CBA) they signed with the government.
But the industrial action coming soon after the 100-day doctors' strike has seen a number of health facilities shut down.
LACK OF BEDS
At the city's Kenyatta National Hospital, the number of patients admitted with cholera has surpassed the facility's capacity, resigning some patients to using mattresses on the floor for lack of beds.
The situation is worse at the infectious disease unit (IDU), where there is just one nurse attending to eight patients.
"Despite this unit having a capacity of 15 beds, we cannot accept any more patients here," said the nurse at the isolation unit Tuesday.
Inside the isolation ward, there were about 73 patients admitted, 38 of them male.
This, even as the Ministry of Health said the number of new cholera cases reported daily has "significantly" reduced from 60 to 35.
In a press statement to newsrooms, Cabinet Secretary for Health Cleopa Mailu said the ministry was mapping out areas affected by the outbreak.
"All affected persons are strongly advised to visit the aforementioned centres nearest to their residence for advice and management," said Dr Mailu.
Water sources have been identified as a major source of direct contamination, which is propagating the outbreak.
As a result, the ministry said it would distribute nearly 500,000 chlorine tablets and four drums of chlorine liquid to enhance water treatment at the household level and at all water sources.
In Kisumu, county health chiefs were on Tuesday on high alert after two people died and 21 others were admitted to hospital following a suspected outbreak.
About three dozen inmates at the Kodiaga Maximum Prison were also hospitalised with diarrhoea and vomiting, often associated with waterborne diseases such as cholera.
Kisumu County Director of Health Ojwang Lusi confirmed the outbreak, saying the county was doing everything to contain the disease.
Dr Lusi said test results on one of the patients who died confirmed he had cholera.
And in Lamu, doctors were last evening yet to confirm reports of a suspected outbreak at the Katsaka Kairu refugee camp in Witu.
This was after three children -- who were later discharged -- were rushed to hospital complaining of stomachache, diarrhoea and headaches.
Additional reporting by Elizabeth Ojina and Kalume Kazungu