Open letter to Taita Taveta CECM Health services Dr. Frank Mwangemi

Dear Dr. Frank Mwangemi,

You are a rare man to find. No surprises there. A man whose key stock-in-trade is matters of life and death should indeed be a rare man.

But we have to talk.

Being less than a year old as boss of the most vital sector in TTC, it’s time the Herculean task ahead is laid bare. Other CECMs can take a sabbatical. You can’t. No time for such indulgences.

We address what might become the mother of all your headaches.

Moi County Referral Hospital.

She is dying. She has been on a Kamikaze nosedive since 2012. Somewhere in her 50 plus years of existence, she contacted an alien bug that is killing her. Whether her ailment is terminal is a matter you only must decide.

In March this year, Moi almost shut down after she ran out of water. The renal unit definitely closed down. Patients, bodies bloated with toxins, were turned away. In mid-April, patients were kept waiting for hours because digital x-ray machines were charging. Currently, expectant mothers in need of CS are being referred to Taveta District Hospital. Moi has no surgeons for such operations.

Do you know Moi still has a 2-phase power connection installed in 1960s? Power so weak if it operates CT scan and Mammogram at the same time, it will blow? Do you know Moi has a single water line which if it breaks, we are all screwed? Your docket has the biggest budgetary allocation every year; it is the Night’s Watch that keeps the death at bay. Yet Moi is lurching from one crisis to another.

Get my drift? Good.

When we talk of Moi, it’s just not any other rundown ramshackle facility! We talk of a level 5 referral facility; the biggest, most-populated, best equipped medical facility in TTC. Moi is our KNH. She is not Wesu, Kambi La Punda or even Taveta Hospital.

Moi is Moi.

To thousands of folks from Kamutonga to Njukini; from Kitukunyi to Zungulukani; folks from across the breadth and length of TTC, Moi is the difference between Life and Death. It center of restoration to fullness. It is the gold-standard of medical professionalism. It is a place where the dying are brought back to life. It is a Beacon of Hope.

Like a patient on life support, the Moi’s ECG monitor shows her vitals are stable. But the life line is becoming flatter with each day. Resuscitation won’t work. She needs to be rushed to a theater for an extensive operation. The cancerous tumor eating away into her heart must be excised. It will be agonizingly painful but it must be done. For Moi to live, her disease must die.

Moi County Referral Hospital must start operating like a Mini-Parastatal complete with her own budget. She must have some semi-autonomy, away from the rigid bureaucracy associated with government operations. She must operate alongside the models of KNH or MTRH.

Allow me to explain how.

In the 90’s and 2000’s, Moi operated her budget based on what she required. Health Management Teams (HMTs) agreed on what was needed. The budget was scrutinized (approved or adjusted) by Expenditure Executive Committee (EEC) as part of Facility Improvement Infrastructure Fund (FIF). The main advantage was services were never disrupted. Emergency cases were acted on promptly. Moi could meet her own unique needs.

With devolution, all monies collected from hospitals are pooled in a centralized account. Top honchos in Health Docket make decision on which facility gets what. The time spent means a life at stake. Moi, a level 5, is forced to wait just like a Level 0 facility at Mkuki. This is a recipe for disaster. When Equitable share is late, Moi is paralyzed like all other facilities yet she has her own internally generated revenue she can utilize to continue offering services.

But we crave for control. Remember the chaos in 2014 after the County grabbed sh 830,000 (from NHIF) and sh 1.2M (for Maternity fee) sent to Moi? This was capitation money paid to a facility based on number of patients attended to. Moi still has the highest number. This means her share remains the largest. She is the main revenue earner from medical services. But all monies are controlled from a center.

She must wait for her slashed share to be dished out to like small morsels to nestlings. You can’t treat a Level 5 facility like that and expect good results. You can train medics on PR and customer services but we will still complain of poor services there are delays, no drugs, equipment etc.

Your staff can do nothing about that. But You can.

Bring back that system. Supervise it yourself to ensure no money is stolen if you have to. Bottom line is Moi must be treated like a Princess because she is.


A believer that Moi can shine.

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