In Kenya, Covid-19's rural spread strains creaky healthcare

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People are seen in a street of Mathare Settlement in Nairobi, Kenya.
People are seen in a street of Mathare Settlement in Nairobi, Kenya.
Billy Mutai/Anadolu Agency via Getty Images
  • Nearly three quarters of Kenya's intensive care unit (ICU) beds are in the two largest cities, Nairobi and Mombasa.
  • Africa is recording 10 000-12 000 cases daily, moving toward a July peak of 14 000.
  • After measures were softened, Kenya had record daily cases and deaths in November, taking the  totals to nearly 90 000 infections and 1 500 fatalities.


The recent deaths from Covid-19 in Kenya of a refugee, a member of parliament and a retired civil servant all happened for the same reason: emergency help was hours away.

Nearly three quarters of Kenya's intensive care unit (ICU) beds are in the two largest cities, Nairobi and Mombasa.

Yet the new coronavirus is spreading into rural areas where the public health system is creaking and scarce ICU units are full and turning patients away, medics round the nation told Reuters.

Christmas travel may worsen the problem - and not just in Kenya.

"That is our biggest fear now," said John Nkengasong, head of the Africa Centres for Disease Control and Prevention, a branch of the African Union bloc.

"During the holiday season, there will be a tendency for large movement from capital cities to villages, remote areas, for people to connect with families. That might drive the pandemic," he told a news conference from Ethiopia this week.

Africa is recording 10 000-12 000 cases daily, moving toward a July peak of 14 000, after most governments eased lockdowns that curbed the disease but decimated jobs.

After measures were softened, Kenya had record daily cases and deaths in November, taking the totals to nearly 90 000 infections and 1 500 fatalities.

Experts say the real tally is much higher due to inadequate testing and a policy of only counting hospital deaths.

One of those was Justus Murunga, a member of parliament who died on 14 November after developing breathing problems on a visit to his rural home in the Kagamega area of rural west Kenya.

When he arrived at the nearest public hospital, he was turned away because there was no oxygen.

At a private hospital, a 20-minute drive further, medics could not resuscitate him, the Nation newspaper reported.

"Had our hospital been well equipped, our brother could have been saved," his brother Henry Washiswa was quoted as saying.

Airlifts for politicians?

Fellow legislators suggested creating a helicopter service for politicians, drawing outrage on social media.

Kenya's 51 million people have only 537 ICU beds and 256 ventilators, according to a July 2020 study.

"We will have a high mortality rate in the rural areas," Chibanzi Mwachonda, secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union, told Reuters.

"Ambulances don't have fuel, there's a lack of reagents for testing, contract tracing is weak and referral hospitals are overburdened," added Mwachonda, whose union is threatening to strike.

The health ministry did not respond to requests for interviews.

In the Kakuma refugee camp in Kenya's remote north west, ICU care is a nine-hour drive away.

That has led to six Covid-19 deaths in a camp clinic due to lack of equipment like a ventilator, a doctor there told Reuters. A 40-year-old South Sudanese woman was the latest.

In the Indian Ocean coastal county of Kilifi, critical patients are referred to ICU wards in Kwale, two hours by ferry, or Mombasa, a one-hour drive away.

The county's chief health officer Charles Dadu Karisa recounted the case of a former government employee in his 50s who died shortly after being sent to Mombasa. "The patient may have survived if we had our own ICU facilities," he said.

Even in Mombasa, though, ICU wards at both the biggest public and private hospitals have been full since early November.

"We have no more space," said a doctor at The Mombasa Hospital, the largest private health facility on Kenya's coast, lamenting that patients had died at home after being refused admission. "What do we do?"

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