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Kenyatta National Hospital Rot, The Untold Side Of The Coin



Doctors at KNH performing a procedure at the theatre.

Being the country’s top referral hospital, chances are, if you’re poor to afford private hospital and developed a severe health complication, you’ll end up at the institution that handles average 30,000 patients on a daily basis, lemme add that the general staff is around 6,000 with a bed capacity of 1,600. With such statistics showing the imbalance, you already got a hint on where this article will be going.

Last time KNH made a positive public news was in November 1st, 2016, for 23 hours, a group of over 50 doctors worked uninterrupted to separate conjoined twins, this was a landmark stride in Kenya’s medical history of not Africa, it has us walking shoulders above the ears.

However, the country’s top public hospital has been engulfed in scandals hence becoming a reference to mediocrity in healthcare. Everyone who has been to KNH has a distinct story, I’ve been there both as a patient, visitor and also as an observer, I have a pack of stories.

KNH has experienced several challenges since the early 1980s in its endeavors to provide quality health care. These have included overcrowding, quality of care, poor attitudes, under-establishment in human resource and deterioration of medical equipment.

This has been attributed to management weaknesses, both in structure and staffing, the absence of good controls and system, and the slow bureaucratic decision process.

Currently, the hospital is on the public’s radar following jaws dropping allegations of rape cases on just delivered mothers! The thought of a straight from the delivery room mother being raped in the corridors of a hospital that is supposed to give utmost protection is vexatious. It highlights how to the bottom of the barrel the society has sunk.

KNH, CEO, Lily Koros.

When the accusations started flowing on the internet, a never seen before outrage was sparked and honestly, you’d never anticipate anything below. Rape is a sensitive matter that does not only wreck the lives of victims but their families, the thought of it is frustrating. It didn’t come as a surprise that a mob lynching reaction to the accusations would become the next most effective reaction, in such a devastating situation, you’d least expect sound, calm reasoning and this is very normal.

KNH CEO, Lily Koros, like any other head of an institution, took a familiar root by downplaying the accusations a natural response for the reputation protection of KNH, I’d expect nothing less. From confessions, the magnitude of this scandal is beyond imagination, I won’t dwell much on the rape accusations instead, will await the police report and then comment after. For now, let’s focus on the angle that no one is really paying attention to.

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Unless you just landed from another planet, it wouldn’t shock much that these heinous acts are coming to surface just at the helm of cabinet and management announcements. For those in the know, when analyzing a situation especially on a public institution, never told out political invisible hands.

The conjoined twins at KNH before separation.

It didn’t come as a surprise that insiders too, saw the underlining. The Kenya Medical Practitioners Pharmacists and Dentists Union (KMPDU) had sensed politics and boardroom fights over the matter.

“Jostling for positions of management of the parastatal called KNH and the Ministry of Health at large could be behind these unfortunate incidents and allegations at KNH,” the union’s secretary general Ouma Oluga said in a Tweet.

Kenya Insights has learned that KNH CEO, Soros had been slotted for the MoH CS post that’s yet to be announced, she has been facing fierce opposition at KNH with many salivating and planning her ouster. This doesn’t exonerate her from the horror stories but meant to give you a different perspective. It, therefore, doesn’t surprise that these accusations that runover lengthened period, only came to surface at a time when the president is planning to announce his last batch of the cabinet.

Doctors went on strike for over 100 days, throughout, the medics were highlighting the public on the pathetic conditions at KNH and other public hospitals, instead, the call for better healthcare was marred with politics and the doctors accused of sabotaging Jubilee. It is the same horrible conditions they were fighting for that the public is still fighting for.

Doctors and staff at KNH average at 6,000 compare that with over 30,000 patients daily on a hospital with 1,800-bed capacity and designed to handle lesser numbers then you’ll notice the problem. Understaffed, overworked, under-motivated doctors and staff, a disaster recipe. Doctors are in plain, overwhelmed, they’ve stretched beyond limits, part of CBA was hiring more doctors to balance doctor to patient ratio, fell on deaf ears.

The conjoined twins after separation.

KNH problems are structural, fixing them need sobriety, rising above mob lynching and tasking the government to implement the proposed CBA instead of dancing around it. Being the national referral hospital, patients have escaped from Kenyatta National Hospital without paying Sh5.4 billion.

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The growing debt at the national referral institution continues to threaten service delivery, further raising queries about the effectiveness of services by the hospital. Hospital CEO Lily Koros explained that the hospital has accumulated the debt from defaulting patients and other institutions.

“The unpaid bills are to the tune of Sh5.4 billion. We have been writing letters to those whose contacts we have, asking them to pay. However, some are from street families and there is not much we can do about that,” she said.

KNH was designed to take up serious medical cases, however, this has not been the case entirely. KNH has become the dumping site for Nairobi’s sick who are poor:

Kenya will pay heavily for converting KNH into a Health Centre for everything instead of the Specialty referral hospital it was designed to be. KNH MUST stop being the triage desk for Nairobi and its environs. Surrounding hospitals have to be empowered to do their work.

Thinking a bit more, why should KNH even be admitting mothers who need to deliver normally? And children with diarrhea and vomiting who only need IV fluids for rehydration?

Look, normal pregnancy, labor and delivery are classified by WHO AS BASIC ESSENTIAL OBSTETRIC CARE. In a well-functioning health system, such issues should not go beyond a Health Center. As a matter of FACT, none should go past a District Hospital that has a basic obstetric theatre and can transfuse blood. In Nairobi, these are the things that crowd a National Specialized Teaching Hospital at the expense of real cutting edge care like Gynecologic cancer care, Artificial Reproductive Technology and complex Surgeries and management of Blood cancers, real issues.

But why?

Nearly all hospitals surrounding KNH have technically stopped working be it Mbagathi, Mama Lucy just name it. Even drunkards engaged in a brawl who need a few stitches that can be done in a dispensary all find themselves at the KNH Casualty. As a result, the place is teeming with humanity day and night. And where there are such crowds, definitely security breaches will inevitably happen as there are opportunists masquerading as patients or patient attendants with criminal intent. This is not even mentioning the poor and homeless Nairobians like street children who find the KNH A&E a welcome shelter from rain, cold and other vagaries on the streets, of course, they may never pass an opportunity to steal or commit crimes in such a messy crowded place.

Protesters during the #EndKNHRot demos held in Nairobi on Tuesday.

The TRUTH be said, KNH STILL has the same infrastructure it had in 1976, in FACT, it still has the same 12 OPERATING THEATRES IT HAD IN 1993! 25 Years on, Nairobi’s population has almost quadrupled and Health facilities run by Nairobi County have almost all ground to a halt, KNH now uses the structures of 1993 to serve 4 times the population.

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So, when I see a Senator castigating KNH and not asking his/ her Governor on what plan the Governor has to get County Hospitals within Nairobi working and working well, I just read vendetta and political lynching instead of a genuine desire to deal with the problem.

I would challenge anyone to go and camp at KNH A&E the whole night and count the number of ambulances from counties referring basic things like Caesarian sections to KNH. It is a farce!

Get peripheral Hospitals in Nairobi and its environs to work so that KNH can stick to the mandate it was founded to deliver on: Offer Specialized and Sub Specialized care, do Research and Teach to advance the Science and practice of Medicine.

Sometimes I am even tempted to sympathize with the unlucky Kenyan who finds himself or herself as the CEO of KNH. You have to spend so much of your time firefighting as you try to lead an Institution expected to work on the backdrop of a FAILED SYSTEM and SECTOR. In FACT, the KNH CEO needs more support than condemnation so that SHE CAN SHUT CLOSED the A&E Department so that that traffic filling KNH A&E is diverted to peripheral Hospitals in Nairobi. KNH then should only run Specialized and Sub Specialized Clinics where patients only come on Referral and on prior appointment.

The Kenyan Health Sector is still crying out for major Reforms, an overhaul of the Colonial system we inherited and not merely piecemeal token changes. In a now custom design, the noise will go off but as long as the structural failures remain embedded, expect nothing less instead, postponed problems. Drum beats to the dead.

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Lobby Group Wants Co-Operative Bank And Nairobi County Assembly’s Salary Deal Investigated With Corruption Red Flags Raised



Nairobi County’s Assembly.

A concerned city resident, Kelvin Njihia has written to the anti corruption body EACC and DCI to launch investigations into widespread corruption and impunity cases at the capital’s county assembly.

In a letter addressed to the two bodies, Njihia claims  there are serious integrity and public trust issues within City Hall. He alleges that the County assembly has gone against the set threshold by Salaries and remuneration commission restricting members not be in more than four committees.

According to his findings, most senior members in the board and their allies, have occupied more than four committees thereby contravening the law. The petitioner want members of the assembly occupying the extra committees to be investigated and prosecuted over corruption and the impunity displayed. He lists top officials flagged in his findings including;

  • Elias Otieno Okumu- 7 committees.
  • Esther Waithera Chege- 6 committees
  • Abdi Ibrahim Hassan- 6 committees
  • Peter Wahinya Njau- 5 committees
  • Peter Anyule Mwatok- 5 committees
  • Juliet June Ndegwa- 5 committees


Rest of the list

Besides, the concerned citizen coalition want the assembly to be probed as to how salaries of the members is channeled through cooperative bank contrary to the SRC’s directive and s contravention of county and national laws.

The petition also noted that the suspended County’s assembly clerk Jacob Ngwele who’s out of office over miss appropriation of funds still executes official duties despite the court’s directive. Ngwele in what the petition claims to be a contempt of court, recently invited public’s participation in approval of Halkano Dida Waqo as County’s Chief Executive Officer for ICT in what is flagged as one of many suspicious appointments.

The questionable advertisement signed by Ngwele on Daily Nation.

Ngwele himself was illegally appointed into office and being investigated for the same. Petition also want the commission to speed investigations and findings following the impeachment of County’s Speaker Beatrice Elachi.

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They want the Ethics and Anti-Corruption Commission to give updates on the Majority leader of the Nairobi County Assembly Mr Ibrahim Abdi Hassan who had been summoned by the commission over the City Hall clash pitting members against Speaker Beatrice Elachi.

EACC ordered Hassan to appear at the Integrity Centre on September 12, 2018 to record a statement that will aid in the investigation of members’ conducts. He’s alleged to have conspired with members in wider plot to oust the speaker. According to the petition, Elachi was kicked out due to her lack of corporation in fraud schemes hatched by the board members.

Petitioner wants the DCI to dive in and investigate why the county’s salaries are being channeled through co-operative bank and not directly from central bank to individual’s accounts in what is read with suspicions.

Kenya Insights allows guest blogging, if you want to be published on Kenya’s most authoritative and accurate blog, have an expose, news, story angles, human interest stories, drop us an email on [email protected] or via Telegram
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FRAUD: Bungoma County’s Nzoia Water Services Board Sneakily Attempts To Impose Kennedy Wekesa Kilali As The MD



Ag. MD Kennedy Wekesa.

Nzoia Water made an advertisement for open positions of Managing Director and Head of Internal Audit and Risk Management in daily nation dated October 23,2018 page 18 under anonymous company in western Kenya.

The following non conformities were noted which do not either conform with industry practices and approved operational HR Manual of the company as per the attached Advertisement:

1. The advertisement was only mentioning a leading water company in Western Kenya,excluding Kitale which falls in Rift Valley. Does it mean Kitale has separated from Bungoma and they have formed their own company? If not what is the effect of these on long term relationship with Trans-nzoia County?
2. The advertisement of MD’s position failed to meet the minimum threshold as per legal notice no.137 of 2012 which requires inviting the prospective candidates to have Masters Degree and registered members of respective bodies e.g  for Engineers should be registered with Engineers Registration Board(ERB) OR Institute of Engineers of Kenya ( IEK) and not Institute of Engineering Technicians (IET)  meant for Technicians who are lower cadre staff of the company.

The advertisement as it appeared on the dailies.

3. The requirements of chapter six was not observed in the advertisement which requires the prospective applicants to submit their chapter six compliance during the application as it forms part of shortlisting process and not to produce them during the interview.
4. The last advertisement through daily Nation were received without matching list from them,which resulted in most candidates who had applied not being shortlisted as their applications never reached the company’s offices. There’s no surety that the process will not be compromised in favour of specific candidates?
5. The Ag. Managing Director has failed to implement the inspection report by WASREB.(According to workers petition)
6. The advertisement should have been made either through the consultant or in the company’s name for it to attract competitive qualified candidates and not the way it is hidden as it is aimed to prevent competition and thus attract less applicants.
7. Therefore ,the recruitment process be stopped and the position be re-advertised in line with the above requirements.

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Ruto And Duale Buys Off Biwott’s Air Kenya Limited As Attempts To Exempt The Duale’s From KPC Prosecutions Revealed



Duale(L) and Ruto(R)

In Kenya, the more things change, the more they remain the same. Since the President intensified the fight and crackdown on corruption, we’ve witnessed arrests and ongoing prosecutions but at the same time, new scandals continue to crop up.

President announced a lifestyle audit on public officers and we’re yet to see the full implementation, however, we’re aware of ongoing money laundering schemes where ‘smart’ public officials including those in executive, are desperately laundering their ill acquired wealth before the lifestyle audit bell is hit.

Talking Of wealth, reports reaching Kenya Insights allege that DP and Duale jointly bought off Air Kenya Ltd previously owned by the late Biwott in what we’re told was a cool Sh1.8B deal sealed about two months ago. According to a source, the ownership is based on a 50/50 agreement between the two.

Air Kenyan is  now registered under Focus Aviation Mauritius and the Directors are Abdulaziz Aden (Duale’s son) and Adil Khawaja ( representing William).

Away from that, Kenya Pipeline is proving to be a hard not to crack for the DPP, for a parastatal with endless scandals, many have been wondering what’s taking Noordin too long to press play on his reggae playlist. But you’ll have to wait a bit longer, KPC comes with heavy political baggage.

Duale and Abdul Duale are heavily implicated in the KPC mess a detective source intimated to Kenya Insights. Joe Sang, the company’s MD who’s whole body deep in the murky scandal world will not go down without the Duale’s we’re told to show the levels of complexity in the case. Sources at DCI say that there have been open threats by the Duales and told that they had seriously invested in the government and that they are untouchable.

There’s a developing narrative that the DPP is delaying prosecutions yet the DCI have concluded their investigations on the KPC corruption. This one case that comes with political ramifications and questions are arising whether the DPP who happens to come from the same region with the Duale’s is hesitant on the consequences.

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”Touching Duale Family is a direct attack on WsR. That is a live wire.  Infact Dualle son Abdul is so close to Joe sang and Keter. DPP Knows touching that file is war.” Says a source privy to the investigations.

DCI uncovered transactions amounting to hundreds of Millions between Abdul Duale and Joe Sang’s cousin Hillary. When both parties we queried what the transactions were for they both claimed that it was not a crime to give money to friends.

“Chief architects of tender fixing at KPC are the Duale boys, they are so entrenched at KPC that even removing Joe Sang wont affect their activities.” Said another source speaking to KI. He continues, “KPC is a chess board for WSR and the Duale’s. At times they are united in Looting however sometimes they clash and fight bitterly when things don’t go their way. Duale’s are cunningly smart and share what they steal with management but for WSR its me, Myself and I. Thats what is going to finish WSR. His selfishness Unmatched.”

Abdul Duale is said to be the father’s right hand man. His finger prints all over state parastatals. At KPC they are involved in
1. Fibre- total was 1.8B
2. Devolution of KPC – 200M given to them. There was a big war between them and WSR over this.

3. Industrial area land was bought by a Company called Focus Logistics( Director is Abdulaziz Aden) at 150m and later sold to KPC at 600m 3 months later
4. Security consultancy. Awarded to Optilan UK and Black hawks eye (Aden duale and Abdul are Directors) value was 800m.

Mid November 2015 a meeting was called by One Abdul Duale ( Son of Aden Duale) at boma hotel. In attendance was Faith( Director KPC), Felicity Biriri( Director KPC), Joe sang (AG GM Finance then). The agenda was lack of control in KPC. The cartels had lost control as Previous MD Charles Tanui was sacked after Corruption allegations and his replacement was Mrs Florence.

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At this meeting of this 4 individuals a plan to oust was mooted. They had 2 Directors on their side already. Joe sang said he would convince Jerry and Neepee ( also Directors). The Kalenjins tasked Abdul Duale to Onboard John ngumi (Chair KPC) with whom they enjoyed a Cordial relationship.

A board meeting was subsequently scheduled 1 day before the Christmas holidays so that no eyebrows would be raised. In a Span of less than 1 hour Florence (Ag MD KPC) was ousted and replaced with Joe sang in Acting capacity. Mr Director kindly check the visitors book and Examine CCTV footage on 23Rd December 2015 at exactly 2:31 till 4:00pmYou will notice that Abdul Duale personally supervised the removal of Florence (Ag MD). Cctv footage from security will help you.

Abdul Duale was a close ally of Charles Tanui and often sat at the negotiating table for kickbacks on behalf of Tanui. When tanui left he became an orphan. Ag MD Florence had blocked all his contracts. Works were stopped and payments stopped also. He would visit Charles Tanui every other day probably to brief him on matters kickback.

After their successful mission to replace Florence the Cartel rejoiced and celebrated for days. Fast forward January 2016 Joe Sang os in office and alll cancelled contracts were reinstated. To begin with their was a Tender for Rehabilitation of the Nairobi – mombasa Pipeline that was awarded to The Duale family via Proxy during the Tanui Reign. It was Awarded to Center star Ltd. Amount was 490M. Florence (Ag MD) cancelled it after several issues were raised on the shell company.

The company had no experience for the sophisticated job that was to be undertaken. Mid January 2016 Abdul duale pushes for the reinstatement of the contract. Joe sang instructed the Mechanical team to reinstate it and he signed it off. A Kickback of 20M was delivered at Intercontinental Basement.
joe Sang -6m
Faith and Felicity 6m
Legal – 2M

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The Cartel at KPC needed political protection and someone who also allowed them to eat unlike the DP who offered them protection but never allowed them to eat. DP would eat alone forgetting the team always. Political protection came via the Duale Family. Aden Duale and His son Abdul would protect Joe Sang from EACC, DCI and parliamentary Committees. In Return Joe Sang would be paying to the Duale family via Kickbacks.

The duales also provided the KPC cartel with money laundering options often charging them upto to 20% of the looted proceeds

1.Fibre Optic Cable

The Budget for this project was 300M. Joe sang gave instructions 6 months before the tender was advertised that this One belongs to Aden Duale. Duale and Son setup a Shell company and partnered it with JV of Express Automation.

All bidders quoted less than 300M including ZTE. Express Automation/white space quoted 880M. 500m Above the budgeted amount. The tender was marred by threats of deportation to ZTE from abdul duale if they ever appealed.

Beneficiary of the Kickbacks
Keter and PS – 100m
Joe Sang -20M
Lamek Rotich and Evaluation team -10m
Vincent Cheriyout – 1M

It will be a Futility if the political engines are not touched in cleaning up the KPC mess. As it stands, the political weight on KPC corruption continues to take toll as reports point at s conflict in the sense that both Ruto and Uhuru’s allies are swallowed into the multi billion theft at the oil courier. Kenyans are keen to see how the DPP will handle this case.

Kenya Insights allows guest blogging, if you want to be published on Kenya’s most authoritative and accurate blog, have an expose, news, story angles, human interest stories, drop us an email on [email protected] or via Telegram
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