18 July 2017

Kenya: Two Die at KNH as Ministry Spells Out Stop-Gap Measures

Photo: Lauren Everitt/AllAfrica
A fruit vendor's stand in Nairobi.

Two people have died of cholera at the Kenyatta National Hospital, the Nation has established, as the Ministry of Health and Nairobi's health department employ stringent measures to handle the outbreak.

A health worker at the emergency ward that the hospital has opened for the rising number of the patients, told Nation that one of the patients died before getting to the ward due to severe dehydration.

KNH's communication officer Simon Ithai neither denied nor confirmed the deaths, but said "all that KNH needs to say on cholera is with the Director of Medical Services".

A conversation overheard between medics at the emergency ward revealed that the number of patients had risen from 18 over the weekend to more than 35.


The ward, near the paediatric oncology ward, is usually opened during emergencies, and was last opened during the Sinai fire in 2011, and during a free fistula camp that the hospital held.

At the entrance, another health worker asked a doctor: "Doc, how are you managing?" "The numbers are high, and they are getting higher by the minute," he replied.

One of the dead is 30-year-old Rasoa Lutenyi from Kawangware. She adds to the three deaths that the city has reported since May.

The Director of Medical Services, Dr Jackson Kioko, said, in a statement sent to newsrooms, that there have been 336 cholera cases since May.


According to Lutenyi's sister, Ms Faith Amkoa, the deceased, who worked as a house help, woke up at 7am last Friday to go to work. In the evening, at about 5pm she was vomiting and was taken to KNH the following day at 9pm. She died at noon on Sunday.

"It happened so fast I have not even processed it," said Ms Amkoa.

In this ward, F1, and another labelled 42, floors are mopped every few seconds, with the pungent smell of bleach filling the air.

Staff in the wards are in green polythene protective gear. The nurses are keen to turn people away from the isolation wards.


An infectious disease expert and senior researcher from Kemri, Dr John Kiiru, explained why more people could die of the disease.

"With cholera, the diarrhoea and vomiting are effortless such that you can lose up to 30 litres in just five hours, making your blood so heavy that it cannot even be pumped", he said, adding that: "then the organs fail, coma and then death is inevitable."

Dr Kiiru said that since cholera does not cause fever, many people brush it aside as a case of bad food and seek care when it is too late.

"The rice white (diarrhoea) is because the cholera pathogen corrodes the walls of the intestines such that even when you get to the hospital, the drugs will not be absorbed," he said.


After sharp criticism, both from the public and the Ministry of Health on the lethargic response that the county has had on the outbreak, Nairobi's health department announced that it will start a fresh validation of all certificates issued to the over 500 food handlers in the city.

The Health ministry and the county have not yet pinpointed what may have caused the outbreak since the day it started, but water contamination, poor food handling hygiene, among others, have been mentioned.

County executive for Health Bernard Muia said all eateries without permits will be closed immediately.

Without disclosing their names, Dr Muia said authorities had zeroed in on the caterers who supplied food to both Weston Hotel and the event at KICC and have had their licences withdrawn pending an investigation to ascertain their hygiene standards.


He seemed to have acted on Dr Kioko's concerns that outsourcing food was a great public health issue and said that he would inspect food supplied to hotels, and offer oral vaccination to all food handlers.

This has further pushed the Health ministry to bring together medical experts and departments such as the Ministry of Water and Irrigation as well as UN agencies such as UNHCR, Unicef and WHO, and other non-governmental entities such as Amref.

Dr Muia also cautioned public health officers against receiving bribes from eateries, saying "those caught will be sacked".

But even as these measures and processes are being enforced, there are still gaps.

The issue of garbage and broken sewers, termed by infectious disease experts as a driver of the disease, have not been tackled.


As early as Monday, an open sewer was spotted in the upmarket Westlands.

Dr Kiiru noted that as long as there was a shortage of water in Nairobi, the disease would spread across all classes.

"If there is water heading to Karen, the pipe is passing through the slums and the people in the slums lack water, they will tap into the pipe and contaminate it," he said.


The chairman of Country Bus terminus traders, Mr John Kariuki, said the garbage behind the terminus on Gikomba Lane has been there for four years and despite their pleas to the county government, not much has been done to remove the waste from the area where they eke out a living.

Another trader Elizabeth Kamau who has worked there since 2012, sipped her tea, holding two slices of bread.

"We are used to this smell," she said.


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