Kenya: The urgent search for life-saving medical oxygen

These patients need medical oxygen, not the normal oxygen that we breathe.

In Summary

•In most cases, oxygen is a life saver that if not used at an appropriate time, a patient might die.

•With the Covid-19 pandemic, the world has been left looking for life saving oxygen cylinders.

A patient suffering from Covid-19 wears a full-face mask linked to a ventilator for oxygen supply in an ICU.
A patient suffering from Covid-19 wears a full-face mask linked to a ventilator for oxygen supply in an ICU.
Image: file

Oxygen is an essential commodity used to care for patients at all levels of the healthcare system.

This includes in surgery, trauma, heart failure, asthma, pneumonia, Covid-19 and maternal and child care.

In most cases, oxygen is a life saver that if not used at an appropriate time, a patient might die.

With the Covid-19 pandemic, the world has been left looking for life saving oxygen cylinders.

Kenya has not been left behind as the pandemic made people realise the importance of the cylinders.

A symptom related to Covid-19 infection is shortness in breath which many have been witnessing here in Kenya and also globally.

These patients need medical oxygen, not the normal oxygen that we breathe.

The air we breathe is only about 21 percent oxygen and 78 percent nitrogen. The last one per cent is a mix of other gases like carbon dioxide and hydrogen.

However, medical oxygen is expected to be about 99 percent oxygen.

Only then will it be useful for a variety of procedures, such as during anesthesia, first aid resuscitation for emergencies, life support for patients who can’t breathe on their own, and oxygen therapy.

According to the World Health Organisation, the need for oxygen has increased to 1.1 million cylinders in low to middle-income countries alone.

In a recent survey of emergency care centres across Kenya, over 30 per cent of the facilities did not have a regular supply of oxygen.

Close to 90 per cent of those with oxygen did not have piped oxygen in the emergency department and delivered oxygen directly from the tanks to the patient.

But with the rising cases of critical care patients in need of oxygen in the country, that has quickly gone up to about 560 tonnes in January and the country is now heading for demand of double the last year figure at 880 tonnes.

The government has called on individuals holding cylinders at home, those idle in health facilities and other institutions to release them as requirement for oxygen is critical, to allow for refill.

It is estimated that more than 20,000 cylinders are lying idle in various hands in the country. Each cylinder costs roughly Sh40,000.

Demand for oxygen has gone up in hospitals due to COVID-19. Many hospitals are struggling because the demand is higher than the supply. This means we have to take away from non-emergency situations to support emergencies,” Dr Loice Ombajo said.

Data by the Council of Governors on April 9, shows that cumulatively, there are 58 oxygen plants distributed across the 47 counties, of which only 42 are functional.

CoG Health committee chairman Anyang Nyong'o said 2,828 oxygen cylinders and 730 concentrators are also available, with 3,601 isolation beds having been connected to oxygen across the counties.

According to the Emergency Medicine Kenya Foundation, each Oxygen Gas Manifold costs $ 5,200 (Sh557,440) and can be installed in five days. The manifolds are designed to supply the correct pressure and volume of oxygen from gas cylinders located outside the building through a pipeline system to the emergency department.

As of February 2021, WHO and partners have distributed over 30 000 concentrators and 40 000 pulse oximeters and patient monitors, reaching 121 countries, including 37 countries that are classified as “fragile”.

WHO is also supporting with technical advice and, in some places, procurement of oxygen sources at scale. This includes pressure swing absorption plants that would be able to cover higher oxygen demand in larger health facilities.

Specific barriers to oxygen systems include cost, human resources, technical training, and continuous and reliable power supply.