KEY TO LIFE

How investing in oxygen gave Kiambu edge in fighting Covid

While other counties sought ventilators, Kiambu bought oxygen in bulk, and it has proved crucial

In Summary

• Ventilators are used for patients who are on the brink of death. Oxygen spares them from getting there if administered early

• Kiambu figured this out early and bought it in bulk. It had zero patients admitted in one Covid centre by the end of February and remains well placed as third wave sets in

Bulk oxygen at Kiambu Level 5 Hospital
Bulk oxygen at Kiambu Level 5 Hospital
Image: NJONJO KIHURIA

As the third Covid-19 wave strains and threatens to overrun health institutions’ capacity, many Kenyans are exasperated by the sense of helplessness since the pandemic hit the country early last year.

Due to its proximity to Nairobi, which has remained the epicentre of the pandemic, Kiambu has suffered high numbers of Covid-19 positive cases since the pandemic hit.

It was among five counties in which President Uhuru Kenyatta ordered a cessation of movements in on Friday to tame the spread of the virus. The others are Nairobi, Kajiado, Machakos and Nakuru.

Kiambu has held its own, however, thanks to its timely decision to stock up on bulk oxygen in its level 4 and 5 hospitals.

The importance of this gas became apparent in November, when a lack of oxygen in Kakamega hospitals was blamed for the death of Matungu MP Justus Murunga.

He was rushed to Matungu Subcounty Hospital, which referred him to St Mary's Mission Hospital. His conditioned deteriorated in transit and he eventually died.

“By God’s grace, when I became governor of Kiambu early last year, I gave priority to the completion of projects in medical institutions that had been started by my predecessors but had for various reasons stalled,” Governor James Nyoro said in an interview.

“With the limited resources available, we initially embarked on completing a new block at the Tigoni Hospital, the Wangige Level 4 Hospital, and did an extra floor at the Rukuma Hospital in Lari.”

Just as the projects were nearing completion, Covid hit the country and Kiambu decided to convert Tigoni into an exclusive Covid Centre.

Opening of the ICU facility at the Kiambu Level 5 Hospital
Opening of the ICU facility at the Kiambu Level 5 Hospital
Image: NJONJO KIHURIA
By God’s grace, when I became governor of Kiambu early last year, I gave priority to the completion of projects in medical institutions
Governor James Nyoro

FIRST LINE OF DEFENCE

Through consultation with the Kiambu diaspora and friendly experts from the west, it became apparent to county officials that oxygen was the first line of defence in the management of Covid patients as opposed to ventilators.

Upon realising this, the county government procured and began installing bulk oxygen in its main hospitals and piping it to patients’ bedsides.

This is proving to be a godsend during the third wave. For example, towards the end of last week, about 70 patients were admitted at Tigoni, and 50 of them were on oxygen. This compares poorly with zero patients by the end of February, at which time the county was considering reverting Tigoni to a general hospital.

Currently, Kiambu has 1,000 Covid beds, and these will go up by next week, when the county commissions the Ruiru Level 4 Hospital.

Meanwhile, contact tracing is ongoing, and the county fumigated all primary schools in Juja that had been used for the nomination of candidates for the upcoming parliamentary by-election.

Nyoro wants to transform Kiambu health institutions to international standards, an objective that has been hastened by the invasion of Covid.

So far, Tigoni has 14 ICU beds. Earlier this month, the governor commissioned 8 more ICU beds at the Kiambu Level 5 Hospital, which since its inception in 1921 had never had ICU facilities. The county has 52 ventilators.

Through collaboration with the Kenyatta University Referral Hospital, the county is upgrading the Gatundu Level 5 Hospital into a Level 6 institution, the only such facility in the county.

The governor visited the hospital alongside KU Referral Hospital chairperson Prof Olive Mugenda last week. He said the level 5 hospital's collaboration with the referral institution and its upgrading will not take it away from the people of Gatundu.

“This institution still belongs to the people of Gatundu, who will now access even better services,” Nyoro said. He added that the collaboration had lifted a load off his government, allowing it to put resources into smaller health institutions in Gatundu.

BENEFICIAL PARTNERSHIP

During the inspection tour, Prof Mugenda said the aim of the collaboration was to improve services and infrastructure at the Gatundu Hospital. “Already, we have attached 10 nurses and seven doctors from KU to this hospital, and we will continue working with the county government to ensure services are at par with those at KU Referral.”

She said the two institutions are collaborating on capacity building, whereby the personnel at Gatundu Hospital will be trained together with those at KU. Patients from health institutions in Kiambu with health complications will, courtesy of the collaboration, be referred to KU Referral.

Professor Mugenda said the ICU unit at the KU Referral was already full due to the increasing severe Covid cases, but said the hospital would by the end of this week acquire an additional 30 ICU beds, raising the institution’s ICU bed capacity to 62.

Mugenda said although the services at Gatundu will now be those of a level 6 hospital, locals will indiscriminately access the institution and all its services. KU Referral and Kiambu county health institutions will also collaborate on research.

Currently, most health institutions in the county are in a position to test and isolate Covid patients, who are later transferred by ambulance to Tigoni. “Our aim is to keep the 2.7 million residents of Kiambu safe and with the hope of overcoming this pandemic and any other diseases,” Nyoro said.

He said the county is ready to deal with the third wave of the coronavirus. And if necessary, the new Wangige Hospital with a 200-bed capacity will also be used as a Covid centre. “We are also enhancing our prevention measures to avert more infections,” Nyoro said.

Kiambu Governor James Nyoro is vaccinated for Covid
Kiambu Governor James Nyoro is vaccinated for Covid
Image: NJONJO KIHURIA

LEADING BY EXAMPLE 

During the recent burial of Muguga MCA Eliud Ngige, MPs Moses Kuria and Kimani Ichungwa called for joint efforts by leaders in Kiambu in the fight against the third wave of Covid.

Nyoro has since committed to bring together all leaders in the county across the political divide to strategise on ways to combat the pandemic. This will bring together the governor, senator, MPs, MCAs and administrators in Zoom meetings that will culminate in a massive public awareness campaign.

Following contradictory messaging, especially on social media, about the Covid vaccination, Nyoro and Deputy Governor Joyce Ngugui were on March 15 among the first political leaders to be vaccinated, thus encouraging frontline workers to take the vaccine.

Since then, more people have come out to be vaccinated, and only a few have suffered minor adverse effects. While most counties have one central vaccination centre, Kiambu is doing vaccination in Kiambu Hospital and Thika.

On Friday, Uhuru and First Lady Margaret led Cabinet Secretaries in taking the jab at State House, Nairobi.

Edited by T Jalio