It is 8am and Diana Nthenya is busy washing her baby’s clothes. Nthenya, who lives in Mukuru Kwa Ruben slums in Nairobi, gave birth to her firstborn a month ago, and she says she is already enjoying motherhood.
“My baby is one month now. I put him to sleep just before I embarked on cleaning,” says the 23-year-old.
For many years, most women in the slum, it is reported, would deliver at home with the help of traditional birth attendants, and a few still do even today. The area has a shortage of hospitals and the few health centres that were there suffered shortages of personnel and equipment. Delivering in a hospital, therefore, meant incurring transport costs besides paying medical bills yet most of them are poor.
But Nthenya was lucky. She escaped the risks that come with delivering at home when she was taken to Ruben Centre, a faith-based health facility under Christian Brothers that has been offering health services to residents over the years.
It was one of the facilities that President Uhuru Kenyatta made an impromptu visit to recently when he opened Maendeleo Hospital, one of the 24 similar health facilities the National Government, through Nairobi Metropolitan Services (NMS), hopes to construct and rehabilitate in informal settlements in Nairobi to enhance health services.
The 24 facilities that were expected to be ready by July 1 are part of a bigger plan to ease pressure on Kenyatta National Hospital so it can concentrate on referral cases as the other facilities attend to walk-in patients. The project is expected to cost Sh2 billion and will increase bed capacity to about 280.
Aside from Maendeleo, a 24-bed level three hospital in Mukuru Kwa Ruben slums, Uhuru also commissioned two other hospitals, at Gichagi in Kangemi and another one at Gatina in Kawangware, both level two facilities.
Two other hospitals, both level three, were opened at Tasia Kwa Ndege and Our Lady of Nazareth, both in Mukuru Kwa Njenga slums.
During his tour of Mukuru slums, Uhuru, who was flanked by NMS boss Mohamed Badi, recounted how he witnessed suffering with over 500,000 people depending on a private health facility with only eight maternity beds.
Nthenya said she feared delivering at home. “Being my first child, many things scared me. I knew I needed to deliver in a hospital. I didn’t have so much faith in the traditional birth attendants. I feared something would go wrong if I delivered at home,” she said, adding, “I was told about Ruben Centre where I started attending antenatal clinics. I was guided on what I needed to do before and even after the child was born.”
The hospital is just about 500 metres from Nthenya’s house. Many residents say the centre has given them hope of improved health. It has also reduced the costs they had been incurring travelling in search of health services. Hundreds of women have been thronging the centre since it introduced maternity services in 2018. Over 300,000 women have delivered at the facility since.
And residents are hopeful that things will get even better with the expansion of the facility that has a 12-bed maternity wing.
The hospital’s manager, Zippora Mwangi, told The Standard they record over 120 deliveries every month. She said teenagers account for 11 per cent of the deliveries. “Most of the teenage mothers are between 13 and 19 years. Overall, the facility is changing the health indicators of this otherwise underprivileged community,” Ms Mwangi said. “We carried out a study and discovered a good number of mothers (38 per cent) were delivering at home. But establishment of the maternity wing here has brought this number down to just three per cent,” said Mwangi.
Meanwhile, the hospital has been treating many cases of upper respiratory track infections, which Mwangi attributed to pollution by the nearby factories. There are also many cases of urinary tract infections, diarrhoea, pneumonia and anaemia, she said.
Rose Mbithe, a community health volunteer at the slum, said poor sanitation had compounded their efforts to improve the health of residents. “Poor drainage is a major issue here. The drainage system is clogged with garbage. Wait until it rains and you will see stagnant flood waters everywhere. This has caused an outbreak of diseases, including cholera, that overwhelm the hospital,” Mbithe said.
In 2017, at least 106 were treated at the hospital following an outbreak of cholera. The hospital was forced to make makeshift wards in tents to attend to the cholera victims as it did not have isolation wards. “The cholera outbreak was one of the emergencies that the hospital handled and it was a major challenge because we lacked the capacity,” Mbithe said.
The new Maendeleo Hospital came as a relief to residents of Mukuru Kwa Ruben as most of them cannot afford services in private hospitals. “The new hospital is not only a reprieve for residents, but also to Ruben Centre as it will help us handle some of the patients,” said Mwangi.
Ruben Centre attends to up to 300 patients in a day and it is the only hospital the slum dwellers know. The centre also offers rehabilitation services.
“Initially, the women who wanted to deliver in hospital would go all the way to Mama Lucy Hospital. However, the distance came with additional costs, which discouraged many. People would also spend a lot of time in traffic and would be discouraged from attending hospital,” said Mbithe.
She said the facility attends to over 100 conditions in children below the age of five. The hospital has eight midwives and four nursing assistants.
Mwangi said they need more staff to better their services. She said they are also hoping the hospital would be expanded to meet the growing demand for health services.
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