Waiting in The Nyanza “Russian” Hospital

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Kisumu, Kenya

Kisumu is the third largest city in Kenya, but feels more like a sleepy town in the middle of no where. (I keep needing to redefine where “the middle of no where” is located, because once you’ve been to The Middle Of Nowhere, it is no longer a Nowhere but a Somewhere. Like since I’ve been to Timbuktu– it can’t possibly be no where…)

Anyway, Kisumu apparently was a hot spot to be in at the height of the Ugandan trans-east African railroad’s heyday because it connected land locked Africa with the port of Mombasa on the Eastern Kenyan coast. Kisumu though just has not had as much luck since the advent of better means of transportation of goods and people. It also hasn’t helped that the train has more or less discontinued service through Kisumu.

I spent time both at the Provincial and District hospitals of Kisumu. The Nyanza Provincial General Hospital (known locally as the “Russian Hospital” because it was apparently funded by the Russians back when making Africa red was a real concern) is somewhere it seems that one goes to when there are no other options left. It is more of a place of death than life, which is not so shocking when you have 4 beds in a room, each with 2 people per bed, plus another 4-6 people sitting on the floor–all admitted patients.

The first thing you notice at the hospital in the surgery ward is that the door to exit/enter the ward is a metal bar prison door that is locked from the inside with a hospital guard posted by the lock. Apparently the lock is both to keep patients in and to keep people who are not suppose to be in the hospital ward out (it is common for people to traditionally when staying in the hospital to bring their own food, etc with them and in recent years the hospital has decided that it wanted to curb this practice–yet has not taken up the slack often enough to provide food all the time, so many people still try to have relatives bring them food). Now why would you want to keep patients inside the hospital? Well naturally to ensure that they pay. One patient came in with a festering wound–just imagine necrosis of all the tissue in his arm that was already forming scar tissue ontop of all the embedded dead and bacterial laden tissue, and the wound needed to undergo surgery if the patient wanted to live and not die of sepsis. So because his case was deemed as an emergency they did the surgery, but he couldn’t pay for it. So rather than letting him go and try to find the money, he is being kept more or less a prisoner inside the hospital to ensure that the hospital gets paid. He can’t pay so he sits in the same room with other patients who have various degrees of gangrene and sepsis waiting. Eventually, I am told, the hospital realizes after a few months that they won’t get paid and will let him go. Another woman there had a similar story. She had meningitis and was given penicillin, even though she said she had a known allergy to penicillin. So she naturally went into shock and had to be intubated. She recovered from the shock, was given another non-penicillin antibiotic–but was not allowed to leave the hospital until she paid for the care that she received. Yes, it was care that she needed only because the medical officer on duty didn’t listen to her and caused her to need treatment, but she was apparently still responsible to pay. However, she wasn’t allowed to leave the hospital to go ask family and friends to borrow the money because she hadn’t paid. So when she finally borrowed the 8000 kenyan shillings and went to pay the hospital cashier–they told her that she now owed roughly 5 times that amount for the several weeks that she had stayed in the hospital as their prisoner. And so the cycle continues…

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Filed under Kenya, africa, health care, poverty