How State failure to implement oxygen project is costing lives

Wednesday, April 21st, 2021 00:00 |
A patient on oxygen. The country is experiencing a shortage of the commodity. Photo/PD/Courtesy

George Kebaso @Morarak

Details have emerged about how Kenya failed to implement a donor funded strategy that would have ensured adequate stocks of medical oxygen.

Had the strategy, dubbed Oxygen Access in Kenya Health Facilities and Covid-19 Management Centre, been implemented, Kenya would not be facing an acute shortage of medical oxygen that is threatening the lives of hundreds of Covid-19 patients.

Experts are blaming Kenya’s lethargic approach to the implementation of the strategy, formulated by the Clinton Health Access Initiative (CHAI), for the current crisis in the manufacture, procurement and supply of medical oxygen.

The strategy, aimed at covering the areas of procurement, storage and supply of medical oxygen to hospitals was developed by donors in conjunction with the Ministry of Health as early as June 2020 when the country started recording Covid-19 deaths.

Donors such as CHAI, the French government and the World Bank had given Kenya millions of shillings either in grants or loans.

Gerald Macharia, the CHAI regional director for East and Southern Africa, who is also the Country Director in Kenya, said he did not know why the Ministry of Health and Treasury opted out of the deal.

Oxygen infrastructure

“Nobody knows what made the MoH and Treasury pull out of the programme that was to be fully funded by World Bank, the French government and other donors,” he said.

But by the time Kenya developed cold feet about the deal, some progress had been made in Kiambu and Kajiado counties where some work had been done in terms of putting in place efficient oxygen infrastructure and assembling of cylinder barracks with comprehensive logistics for distribution.

One of the health facilities that benefitted from the project is Ngong’ Hospital where a liquid oxygen tank was built through the support of Amref.

“Because there was proper planning at the Ngong Hospital, the facility was facilitated with a good deal of support from BOC and it is well equipped in terms of medical oxygen supply,” Macharia disclosed.

CHAI helped a few counties equip wards, Intensive Care Units and High Dependency Units with medical oxygen infrastructure.

“Through the project, a number of health facilities in some select counties were to be fixed with piped oxygen facilities and have them installed with liquid oxygen tanks that would have sorted out the current crisis.

But because the infrastructure is terrible, the plan is to keep installing cylinders which are not reliable,” he said.

According to stakeholders who were part of the planning and development of the strategy, the process kicked off between January and February 2020.

The Ministry of Health was to lead the process which brought together Semi-Autonomous Government Agencies, including the Kenya Medical Supplies Authority (Kemsa).

“We started planning meetings for Covid-19 preparedness and by June 2020 we had a workable document on the table.

However, why it has never been implemented despite formulation of clear guidelines and timelines remains a mystery,” a source at Afya House told People Daily.

Corrupt individuals

The source dismissed the claim that hoarding of oxygen cylinders was to blame for the current shortage.

Planners of the project had foreseen the crisis and entered into negotiations with the British Oxygen Company (BOC) to procure and distribute oxygen in bulk to Covid-19 management centres and Level 4, 5 and 6 hospitals in the country.

“The shortage of oxygen that has resulted in several deaths could have been avoided had we been allowed to implement this strategy.

The Clinton Health Access Initiative was willing to fund the project but we suspect that some corrupt individuals scuttled the whole thing,” the source added.

Stakeholders blame some Ministry of Health officers, whom they accuse of being inept, insensitive and not proactive in the Covid-19 response, for the failed project.

Another source claimed there was little response in government because the identified supplier had declined to give a kickback.

“Now they are blaming hoarding of oxygen cylinders by members of the public. We call for an overhaul of MoH leadership,” the source added.

But asked about the project, Health Chief Administrative (CAS) Rashid Aman insisted that it is on course.

“It is in progress and there is no cause for alarm. If you can remember, last year we advised county governments to install oxygen plants.

That was part of the implementation of the strategy,” Aman told People Daily.

But sources say that as panic gripped the country with the number of Covid-19 cases and fatalities rising, some counties embarked on impulse procurement and installation of oxygen plants, some of which were obsolete.

Macharia urged the government to reconsider its position on the project.

“The capacity to keep refilling the cylinders is the problem. Refilling the cylinders alone is a tedious exercise since it takes time,” he said, adding that there is enough oxygen in the country contrary to the belief that there is a shortage.

BOC Managing Director Marion Mwangi, however, said despite the oxygen crisis, a lot that has been done in the past one year.

“There is amazing work that has been done and oxygen access systems have been installed across the country,” she said.

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