Figures do not lie but they could about beds and cots in public hospitals in Kenya’. From the statistics provided, in 2014 there were 1.65 hospital beds per 1,000 people. This is the second part of this section covering unique characteristics of sub-Saharan Africa’s health care settings which include among others – turbulence and holidaying while we wait. We also explored laycaretakers.
There was nothing like the holding capacity in our public hospitals, transport, schools, stadiums, prisons, churches et cetera. There is always room for one more; after all where else do we want them to go? But why?
Blame the Africans’ good-naturednesss, and so we ease our space for them –
Someone said, ‘coz who knows I could be the next one in need of same kindness. So we reciprocate and the cycle continues.
Another one added, ‘It was like the Biblical Peter and John [Acts 3:6] when they encountered the stretched hand of crippled beggar at the temple entrance, ‘silver and gold we have none but as much we have we give it unto you…’ Could be to share as much as we have and don’t have? See my posting on Zusha.
Allow me to philosophize about a basic fact of bed/cots: ours is a typical case where figures lie. Saying that this is a 600-bed capacity hospital says nothing. The number of patients inside there at any given time could be exponential. About
About the number of beds and cots in our hospitals the following postings from an online discussion and a media expose attempted to interrogate this point:
‘…may be, maybe not about the interpretation of cots vis-a-vis beds. If you allow us to go our way we will tell you that there are coaches, stretchers, wheelchairs, incubators and even benches and the floor where a sizeable number of our patients and lay care givers sleep in the hospital every day’.
‘We will even tell you of bed sharing by two or more patients as a fair norm in our public facilities. No cot (and I suppose a number of healthcare providers from most of our care providers reading this will attest to it), no cot belongs to one child at least in Kenya. Really there is no substitute for a bed in a hospital when the patient needs one and we don’t have enough’.
Picture shows overcrowding, bed sharing a common sight in many public health facilities in Kenya (Picture courtesy of NASCOP treatment consultative conference, Nov 2013)
‘Mothers who had just delivered had to take turns to sleep as they share beds… a 24-bed ward in one sub-county hospital had up to 40 patients with the tiny beds hosting up to three patients’ One post natal mother said. ‘Sometimes we take turns to sleep allowing whoever has come from the delivery room latest to sleep first’ another mother said. Indeed, each bed has two or three mothers seated, unable to lie down no matter how tired and uncomfortable they were. (J. Kubania, State of Health, July 24, 2015, County pp25, Daily Nation).
‘…and we need more space: the patient does not get rest because of all the visitors. It is as if five or six extra people are with the patient. The hospital ward looks like a market place. Even the football team is coming to hospital if a player is hurt’ (Fuglesang, 1982). Let us consider this aspect from the testimony of an exchange programme student: Testimony 1
Although my electives placement was within a tertiary public hospital, I was still aware of economic constraints, particularly in the choice of drugs. One of the main reasons I am fond of the National Health Service (NHS) in the United Kingdom is the fact that, in general, the same treatments are available to everyone, regardless of their economic status. I feel uneasy in situations where poorer people receive an inferior standard of care simply because they have less money.
Having said this, one has to work within the constraints of the system and do the best you can to help people within these barriers. I am glad that I put myself in this situation because, after all, this is how health care is organised in the vast majority of countries. 15’x15′. This incredibly tight space was cramped even more during rounds, when the team of 6 medical students, a pharmacy student, the attending physician, and my student colleague and I would huddle around a bed to discuss patients.
Patients did not have rooms, and curtain dividers were seldom used – so approximately 16 patients were grouped together in each block (8 beds per block, 2 patients per bed). On top of this, the apparent lack of nurses precipitated care of patients by family members, which meant 20-25 people were generally packed into an area that was about 15×15 feet.
Next we explore what options we might be having in as far as beds and cots are concerned.
Just before you go, do you see this bed sharing as a problem? I am asking for your help in the way forward and spreading the word.