Healthcare crisis in North Eastern: Neglect, shortages, expired drugs

Imagine walking into a hospital in North Eastern Kenya, only to find expired drugs lining the shelves, broken equipment that can't be repaired, and a skeleton staff trying to manage an overwhelming number of patients.

This was the reality uncovered by the Senate Health Committee during their recent visit to Marsabit, Wajir, and Mandera counties.

The delegation, led by Uasin Gishu Senator Jackson Mandago, set out to assess the state of healthcare services in the region—and what they discovered was a system on the brink of collapse.

The Senate committee’s visit to revealed a healthcare system straining under the weight of its own inefficiencies. At Marsabit County Referral Hospital, the situation was bleak.

Despite a rise in the number of cancer patients at the clinic, more than 20 patients are seen monthly, up from 10, the hospital's diagnostic capacity remained limited.

Most tests had to be sent to Nairobi for processing, causing significant delays in patient care.

The hospital was also grappling with neglected infrastructure: dirty wheelchairs, unkempt gardens, and broken plumbing systems added to the growing list of issues.

Nurse Lokho, a staff member at the hospital, did not hold back when discussing the problems.

"We have a shortage of essential drugs, and even worse, expired medicines are still being used," he said.

When asked about hazardous waste disposal, he revealed that medical waste was being stored in abandoned toilets or dumped in open air, posing serious health risks to both patients and staff.

The facility’s conditions were compounded by the absence of key health workers and a lack of transparency surrounding the hospital's funding.

"One of the most alarming issues we found was the missing SH200 million allocated for the ICU," said Senator Richard Onyonka, who was part of the oversight team.

"The funds were supposed to improve healthcare, but no one could account for them."

Although Marsabit County Governor Mohamud Mohamed Ali attempted to provide clarification, stating that only KSh 18 million of the ICU budget had been earmarked for ICU equipment, the absence of accountability raised further concerns.

The county's health sector, it seemed, was beset with mismanagement at every level.

In Wajir, the story was no less grim. The Manyatta TB Centre and Wajir County Teaching and Referral Hospital also suffered from outdated facilities and lack of resources.

At the TB Centre, medical staff voiced safety concerns, with a critical lack of modern lab equipment to handle TB specimens safely.

"Our biggest challenge is the safety of the medical staff," said the facility manager.

The situation was no better in the maternity ward, where nurse Henry Kiplangat described the poor conditions: "We lack mosquito nets, and the laundry system is broken. We don't even have automated records. It’s chaos."

A serious issue raised at the Wajir facilities was the shortage of transportation.

Staff members repeatedly called for at least two additional utility vehicles to handle the transportation needs of patients and medical staff, especially during the rainy season when the roads become impassable.

Additionally, the reimbursement process for healthcare workers under the Social Health Insurance Fund (SHIF) and Facility Improvement Financing (FIF) schemes was slow and inefficient, delaying payments and adding stress to an already fragile system.

But it was Mandera that perhaps offered the clearest picture of the healthcare crisis.

At Mandera Teaching and Referral Hospital, Khadija Dispensary, and Elwak Sub-County Hospital, the issues were stark.

Only three out of five dialysis machines were operational, and even then, staff admitted that more were needed to meet the rising demand.

"We need at least 10 functioning machines," said CEO Okash Adan, acknowledging the hospital's struggle to provide adequate care. Staffing shortages were widespread, with untrained personnel being tasked with dispensing medication at some facilities.

"We have serious staffing issues, expired drugs, and some facilities without pharmacists," Senator Mariam Omar pointed out.

Perhaps most concerning were the allegations of drug theft, which surfaced during the committee's visit.

Senator Richard Onyonka raised questions about missing medical supplies, suggesting that government-provided medicines might have been diverted to private pharmacies.

Although the hospital's pharmacist denied the claims, it highlighted the lack of accountability in managing crucial medical resources.

The visit to Khadija Dispensary revealed expired drugs still sitting on shelves, some of which were being dispensed by clinical officer Abdihaziz Mustafa, despite not having proper pharmacy training.

"Who is dispensing drugs here?" Senator Tabitha Mutinda demanded, highlighting the grave risks posed by such practices. At Elwak Sub-County Hospital, the lack of vehicles to transport patients further highlighted the dire situation, with staff members requesting at least two more utility vehicles to improve service delivery.

The visit culminated with Senator Mandago's sobering assessment: “Healthcare is not just about buildings, it’s about human resources, accountability, and systems that work.”

He called for immediate reforms to address the systemic failures in healthcare delivery across the region.

Across the three counties, the recurring themes were impossible to ignore.

Chronic understaffing, expired drugs, broken sanitation systems, and a lack of critical medical supplies seemed to plague nearly every facility.

The region's healthcare system was in a state of disrepair, with essential services being undermined by mismanagement and neglect.

As private healthcare facilities continue to rise in the region, the future of public healthcare remains uncertain.

Despite the bleak outlook, the governors of the affected counties have promised action. Marsabit’s Governor Mohamud Mohamed Ali has pledged to improve the hospital’s management and ensure that vital funds are properly allocated.

Wajir’s Governor, Mohamed Khalif, has also promised reforms, including completing a World Bank-funded modern dumpsite by September and addressing the supply shortages. But for many, these promises ring hollow until tangible results are seen.

The Senate committee’s findings serve as a wake-up call for the government, demanding urgent intervention to address the deep-rooted issues affecting healthcare in Northeastern Kenya.