By OMBOKI MONAYO
The night *Halima’s labor pains began, her husband was engulfed by fear. At 10 p.m., he rushed her to Merti Sub-County Hospital in Isiolo County, only to discover that her critical condition required immediate transfer to the Isiolo County Hospital, the region’s sole Level 5 referral facility. However, a chilling reality struck: the ambulance essential for such emergencies had been out of service for two weeks.
“We had to think fast and find a way to help the mother and save the pregnancy,” recalled *Jillo Mohammed, a health worker with the county government, his voice heavy with the memory of that frantic night.
Isiolo County, a vast expanse of arid land covering over 25,000 square kilometers, is home to only one public Level 5 referral hospital located in Isiolo town. The county’s road network spans 1,259.9 kilometers, but only 225.7 kilometers are paved with bitumen or tarmac. The remaining roads, often impassable during the rainy season, pose significant challenges for residents seeking healthcare.
On average, residents live 25 kilometers from a health facility, with a mere 5% residing within 1 kilometer of one. Those in the remote northern regions bordering Marsabit and Wajir counties face particularly daunting journeys to access critical emergency services.
In Halima’s case, the medical team turned to Action Against Hunger (ACF), a local NGO, which provided a vehicle for the arduous journey to the referral hospital. The four-hour drive was fraught with peril, navigating rocky terrain and fallen trees, obstacles left by elephants.
“We hoped and prayed and did what we could to help her. By the time we arrived at the hospital, she was in a bad state, delirious from the pain,” Jillo recounted.
Tragically, despite their efforts, Halima lost her baby after being admitted for life-saving treatment. Her experience starkly illustrates the dire consequences of inadequate infrastructure and limited healthcare access in Kenya’s Arid and Semi-Arid Lands (ASALs).
For many expectant mothers, the journey to a referral hospital can exceed 100 kilometers, and can be particularly treacherous during the rainy season.
“Pregnant mothers can find themselves in sudden danger if complications arise,” Jillo warned. “In northern Isiolo County, some areas are over 100 kilometers from Isiolo Town, with roads that deteriorate significantly during rains.”
A 2022 SMART survey, carried out by the government and development partners in Isiolo County including UNICEF, ACF, USAID and others, highlighted the pressing need for comprehensive healthcare initiatives, including the capacity to reach remote populations using medical outreach teams. These measures would include improved ambulance services.
Dr. Abok Roberts, head of the Nutrition and WASH department at Save the Children Kenya, emphasizes the urgent need to protect children under five. Urgent remedial measures are required to save the lives of neonates.
“Neonates, who are aged between 0 and 28 days, are the most delicate and prone to life-threatening complications,” he stated. “When it comes to maternal and child health, where is our biggest fight as a country? Research shows that 51% of under-five deaths occur within 28 days after delivery. Lowering the neonatal fatality rate can be achieved if we ensure that we reduce these deaths,” says Dr Abok.
This crisis is compounded by a systemic issue: corruption within Kenya’s governance which often has negative effects on the healthcare sector. Billions of shillings annually vanish in corruption scandals. If utilized for their intended functions, including healthcare, these funds that could dramatically improve maternal and child outcomes, particularly in underserved ASAL regions.
Corruption manifests in various forms, from misappropriation of funds to substandard service delivery. These practices hinder the government’s ability to invest in necessary healthcare infrastructure, exacerbating an already critical situation.
The impact of corruption is stark. Between 2019 and 2022, Isiolo County lost Ksh 196 million to corruption, according to the Ethics and Anti-Corruption Commission (EACC). This money could have funded a modern Mother and Child Hospital in Merti, akin to the one built in Wote, Makueni County for just Ksh 135 million, with the Ksh 61 million balance being set aside for community health education awareness, purchase of nutritional supplements for selected vulnerable families grappling with malnutrition, revamping the ambulance services and supporting community health providers.
According to the Auditor General’s report covering the 2022/23 financial year, a modern market built by the devolved unit reportedly cost Sh545m, money enough to build 4 mother and child facilities at the Wote hospital’s estimates, provising a facility for each of its four sb-counties. The export abbatoir that cost 651m could fund the building of the four facilities and provide an additional Sh111m for additional healthcare-related expenditure.
These losses extends beyond funds; it signifies lost lives and opportunities for vulnerable populations. Recent scandals, such as the procurement of substandard HIV kits and the misappropriation of COVID-19 response funds, have further devastated the healthcare system, resulting in drug shortages and frequent strikes by healthcare workers.
Imagine the impact had the Ksh 196 million been used as intended. A well-equipped hospital could provide essential services, while remaining funds could support community health initiatives and reliable ambulance services, potentially saving lives.
The fight against corruption in healthcare is a battle for human dignity and the right to health. It necessitates robust accountability mechanisms and community engagement to promote transparency and ethical leadership.
By reclaiming stolen public funds and investing them in vital healthcare initiatives, we can envision a future where mothers and children in Kenya’s ASALs receive the care they deserve, free from the shadow of corruption.
Note: Due to the sensitive nature of the story, names indicated with an asterisk have been changed to protect the individuals interviewed for the story.
Safeguarding Maternal and Child Health is a crucial pillar of healthcare at both national and county levels. Corruption, theft and wastage in public expenditure pose a major stumbling block to this noble goal.
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