It was meant to be an ambitious upgrade project of the country’s health system, where facilities would be supplied with the latest medical equipment.
But years down the line, the Medical Equipment Service (MES) programme has turned into a scandal, with equipment worth billions lying idle in hospitals across the country.
To cap it all, counties are paying hundreds of millions for these unused kits every year.
The equipment — X-ray machines, C-arm for orthopaedic surgery, and ICU facilities, among other specialised machines bought at inflated rates– remain unused or under-used because of shortage of specialists to operate them, while in some cases, there is neither space nor facilities to house them.
There are no experts
Uasin Gishu, Nandi and West Pokot are among counties hit by serious shortage of orthopaedic surgeons, gynaecologists, physicians, endoscopists and radiologists to operate the machines. At Nandi-Hills Sub-county Hospital, for instance, the devolved unit acquired an endoscopy machine at Sh6.5 million, but it has never been used.
Other machines the county government bought include an MRI digital mammogram used at Kapsabet County Referral Hospital at an estimated cost of Sh2 billion.
The devolved unit has been paying Sh120 million yearly for the machines since 2018.
In Uasin Gishu County, Ziwa Referral Hospital received kits valued at Sh54.1 million, while Burnt Forest Hospital got equipment worth Sh30.7 million.
“The equipment is vital in provision of healthcare, but unfortunately, there are no experts to run them,” said a senior medical officer who requested not to be named.
In Tana River, most of the Sh400 million leased medical equipment is yet to be put to use more than three years after it was procured.
Two equipment sterilisation units have not yet been fitted for use in the earmarked health facilities because of lack of space.
Also, the radiology unit in Garsen is lying idle because of lack of electricity. The equipment sterilisation machine at the referral hospital also lies idle at the newly built maternity wing. The Hola Referral Hospital was set to receive two fully fitted operation theatres, two equipment sterilisation units, a renal (kidney dialysis) unit and a modern radiology unit, but only one operating theatre, one equipment sterilisation unit and the modern radiology unit are in use.
Lack of space
Two theatres and equipment sterilisation units that were to be fitted at Garsen Health Centre were relocated to Ngao Sub-county Hospital and Bura Health Centre because of lack of space. Garsen centre managed to accommodate the modern radiology unit, but with no specialist to run it.
Tana River County continues to pay a whopping Sh200 million for the equipment every financial year despite the machines failing to meet expectations.
In Elgeyo-Marakwet, the Senate ad hoc committee on Health had pointed out that, the county referral hospitals lack space and technical skills to use the equipment.
“It’s disappointing that some of this equipment remains unused, yet the county pays Sh200 million annually,” said Isiolo Senator Fatuma Dulo, who chaired the committee.
In West Pokot, a CT-Scan machine was approved under the contract, but was never delivered to Kacheliba Sub-county Hospital.
Some of the machines are operational while others, like Brivo, have not been installed despite the county paying Sh95 million annually between 2015 and 2017 and Sh200 million from 2018 to date.
In Migori, the recently-launched equipment — computerised tomography scan, renal, dental and radiology machines — lie idle as there is no qualified staff and infrastructural facilities to house some of them.
Last year, the county government in partnership with medical agencies had set aside more than Sh150 million to build a medical laboratory, oxygen plant, and maternal, child and amenities at the county referral hospital.
At Kehancha Level Four Hospital, a radiology machine that was commissioned in 2016 is still lying idle.
But officials from the county’s Health department, who spoke to the Nation, said some equipment are fully operational, and this has minimised referral cases to other neighbouring health facilities.
“We no longer refer patients to Kisii Teaching and Referral Hospital because some of the equipment we received [is] functional. We liaised with Kenya Power on electricity upgrade and a standby generator for the equipment,” said Health Executive Iscah Oluoch.
The Nation, however, found that only one X-Ray machine was operational at Migori County Referral Hospital.
In Kisumu, staffing of specialists to operate the machines has been a major problem. The county government received one endoscopy machine, mammography, 10 cryotherapy and six chemotherapy beds stationed at Jaramogi Oginga Odinga Teaching and Referral Hospital.
The only oncologist
“There’s need for human resource as the number of clients coming for treatment at the hospital keeps increasing. Two years ago, I was the only oncologist and would run the clinic once a week,” Director of Health Gregory Ganda said.
In Siaya, a CT scan machine is among the equipment that the county received six years ago.
However, the critical equipment was idle until two months ago when Governor Cornel Rasanga launched it.
County Director of Medical Services Eunice Fwaya said the machine was not operational because it lacked an uninterruptible power supply. It took engineers almost six years to have the problem fixed.
In Kakamega, the national government installed a bio-safety chemotherapy equipment in the county’s cancer centre at Kakamega General Hospital even though the devolved unit had already acquired its own equipment at Sh4 million. A spot check by the Nation established that one biosafety hood is lying idle with the hospital using only one machine.
In Isiolo, residents have been struggling to access medical services as some of the leased equipment spread across the county are not operational due to lack of electricity.
The Nation established that among the equipment that still lies idle are radiology and mammogram machines at Garbatulla Sub-county Hospital. A CT scan machine and mammogram at the hospital are not working for lack of experts to run them, while at other health facilities, equipment remains unused because of poorly trained or absentee staff.
Residents are forced to travel to Isiolo town, about 150 kilometres away, and Meru town to access these services.
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Health Chief Officer Ibrahim Alio said the county had written to Kenya Power requesting an upgrade of the power system.
In Marsabit, county referral hospital authorities have prided themselves in keeping the MES project up and running.
A spot check revealed that the facility had one renal unit equipped with five running renal dialysis machines and one isolation unit.
The radiology unit had a CT scan, one orthopaedic imaging machine and two X-ray machines, as well as two paediatric and two adult ICUs.
“We’ve strived to keep all our MES projects up and running and even procured some sophisticated renal dialysis to cut the cost for our people who used to travel to Meru or Nairobi in pursuit of specialised healthcare services,” said Marsabit Referral Hospital chief officer Liban Waqo.
In Meru, a nine-bed ICU and HDU facility that was completed at the county’s Level 5 hospital is yet to be operational. The facility also comprises a 10-bed renal unit.
Steady supply of power
Dr William Muraah, a consultant and former Health Executive, said the MES programme failed to work in most counties due to lack of personnel, lack of complementing services such as labs, inconsistent power supply and lack of resources for continuous supply of consumables.
“Dialysis and ICU equipment require steady supply of power as well as well-equipped laboratories to perform well. Counties have also had a challenge attracting the health personnel to run the specialised equipment,” Dr Muraah said.
By Stephen Oduor, Tom Matoke, Florah Koech, Oscar Kaikai, Barnabas Bii, Onyango K’Onyango, Ian Byron, Shaban Makokha, Elizabeth Ojina, David Muchui, Jacob Walter and Waweru Wairimu and Derick Luvega