Why Nakuru hospital is detaining 132 infants

The surgery was supposed to end their pain. Instead, the noble initiative for 132 children, who received surgery during a paediatric surgical camp at Nakuru Level Five Hospital, has turned into a nightmare for both the minors and their parents.

This is thanks to the inefficiencies of the Social Health Authority (SHA) and its failure to clear payments, resulting in the detention of the children and their parents at the facility.

For the past four days, the children have been crammed into Ward 5, which has a capacity of only 38, sharing beds and spilling over into adult wards.

Parents have spent sleepless nights taking turns to care for their children because they cannot go home due to the delayed clearance by the SHA.

In a desperate attempt to accommodate the children, the hospital has extended the children’s ward to manage the surplus.

Some of the children have even had to move into adult wards, complicating the situation at the health facility further.

Four to six children are now sharing the limited number of available beds, and their parents have become their primary caregivers.

Beth Wacheke, a parent whose seven-year-old child underwent hernia surgery, cannot leave the facility before her bill is cleared.

Before admission, Wacheke paid Sh7,800 in annual premiums to SHA, expecting that her son’s surgery and hospital stay would be fully covered.

Instead, her child remains in the hospital, sharing a bed with five other children while she endures sleepless nights on cold hospital floors.

“My son was admitted on Monday and wheeled into the theatre on Tuesday. The surgery went well, and I was happy when he came out safely,” said Wacheke.

She added, “But since then, we have not been allowed to go home. I visit the SHA booth every single minute, but no one can clear us. They tell me to wait.”

No communication

Wacheke is in despair. There has been no communication from SHA officials regarding the reason for the delay in clearing her son for discharge.

The prolonged stay has resulted in overcrowding in the wards, posing serious risks to her son’s recovery.

“Sleeping on the bed is hard as the children have fresh wounds. They accidentally hurt each other when they move, and I fear my child may develop complications from being mixed with others who have different conditions,” she said. The desperate mother explains that she has not slept for days, as parents of admitted children are given no bedding or space to rest.

“Parents are sleeping while standing. We are told children are the patients, so there is no provision for us. But how can we care for them if we are too exhausted to function?” she asked.

Wacheke’s story highlights the growing frustration among Kenyans who are unable to access timely services despite paying premiums to SHA, the body meant to support President William Ruto’s Universal Health Coverage (UHC) plan.

For Wacheke, the delay represents more than just an inconvenience — it is a matter of life and dignity. “I just want to take my child home to heal,” she said. “I did everything right. Why is my son still here?” She expressed concern that keeping her child in the hospital might result in him missing important examinations. 

Pre-authorization requests

Wacheke’s experience is not isolated; dozens of children remain in the facility as SHA has remained silent on the issue.

What is, however, shocking is that this arrangement contradicts a directive issued by Health Cabinet Secretary Aden Duale, who recently launched Taifa Care in Nakuru City.

Duale introduced a one-patient-one-bed policy aimed at reducing congestion in public health facilities, stating, “Patients will no longer share beds. We are working on transforming the health sector, including improving the efficiency of the SHA system.”

However, the situation at Nakuru Level Five Hospital seems to convey a different message to the public, as SHA policies continue to create significant inconveniences for patients seeking care in health facilities across Kenya.

The Social Health Insurance Regulations 2024 stipulate that the SHA’s claims management office must respond to pre-authorisation requests within 72 hours, yet many patients are experiencing delays that exceed this timeframe.

Unfortunately, this policy is rarely discussed by officials during public engagements, leaving many patients and families unaware of it until they are ready for discharge.

Under this policy, patients who are medically fit for discharge before the lapse of the period are being compelled to remain unnecessarily hospitalised, simply to meet the SHA’s billing requirements.

Alternatively, such patients would be required to clear the bill out of pocket for an early discharge, an unexpected financial burden and beyond the reach of many.

On Friday, a nurse at the Nakuru Level Five Hospital explained that the camp, which began on Monday, was organised to address a backlog of children with congenital conditions such as hernias, hypospadias (requiring hypospadias repair), and undescended testes (orchidopexy).

“At least 20 children have undergone surgery every day since Monday,” the nurse said. “These children were supposed to be operated on in 2024, but due to delays, we decided to hold this camp to prevent them from being pushed into 2026.”

The children, aged between four months and 12 years, were selected from hospital records and invited for surgery.

The hospital’s medical superintendent Dr James Waweru said that the beneficiaries of the medical camp will have their bills covered by SHA. “The surgeries were mainly on hernia and undescended testes. 104 children have already been operated on during the medical camp,” said Dr Waweru.

While the children were clinically due for discharge shortly after the surgery, they are still stuck within the hospital waiting for pre-authorization of their bills by SHA.

[Reports by Ken Gachuhi, Yvonne Chepkwony and Mercy Kahenda]