Friday Night in Purgatory

By Edith Honan

When an ambulance pulls into Kenyatta National Hospital it has to navigate three speed bumps before it can get to the emergency entrance. Those bumps are a metaphor for your reception in the emergency room.

“You’ll see how they receive us. There’s no priority here. There’s no rushing,” says Levi, a Red Cross ambulance driver and EMT. “If the patient is gushing blood, you can have a little bit of priority. But sometimes even then, you have to keep the patient in the ambulance.”

Levi and Mildred, a nurse, have agreed to let me shadow them for a shift one Friday night.

Once upon a time, Levi had been a tout on a matatu route. Now, after nine years working as an EMT – the last two with the Red Cross – he refuses to ride in one. Off-hours, he jokes, he is perhaps the most cautious driver in Nairobi: “I’m one of the slowest drivers, even my mother complains.”

The Nairobi government estimates that 3,000 people die in road accidents every year, and Levi knows first-hand what those crashes look like. “When you get the call you just adjust yourself to the nature of the call. You make a picture in your mind,” he says. A bus crash means there could be a huge number of deaths, and a nasty, angry crowd. A motorbike accident means a strong likelihood of gruesome lower body injuries. But Levi says the worst thing is when a patient dies in his ambulance. He explains, “that place is not for dying. It’s for saving lives.”

The first distress call comes into the Kenya Red Cross headquarters a little after 8pm: a Toyota Corolla has smashed into a Nissan station-wagon on Mombasa Road. Both cars are totaled. A matatu has already taken the two people in critical condition to the hospital, and someone has called the Red Cross to request an ambulance for the three who remain.

The scene of the accident. (Photo: Edith Honan)

When we arrive, a crowd of maybe a dozen people, many boda boda drivers from up the road, have gathered at the scene; they are watching and mostly getting in the way. The driver of the Nissan, drunk and barely able to speak, has a compound fracture in his right leg and gashes on his head. The other two, from the Toyota, both complain of headaches. As Levi and Mildred are loading the three into the ambulance, we hear the loud crunch of metal, and see that a little white Premio has slowed down to avoid the accident site only to have a Land Cruiser rear-end him. Bits of glass and metal are now littered across the road, and police arrive with tow trucks to clean up the mushrooming accident site. Levi and Mildred continue to work quickly and just a few minutes after arriving, our three patients are packed up and ready to go.

Levi turns on the siren and we start down the highway, towards the hospital. The road was thick with cars, but no one gets out of the way as we navigate across the three lanes. “People are arrogant,” Levi says.

We turn into the hospital, and Levi switches off the siren as he gentle rolls over the speed bumps, jostling our passengers as little as possible.

In the emergency rooms of TV shows and movies, everything moves fast. Doctors run to waiting ambulances, shouting instructions to their colleagues. Stretchers are whisked into operating rooms. Saving lives requires speed.

At Kenyatta, everything moves slowly. Ambulances pull up and no one greets them; it falls on the driver (sometimes a taxi driver or a Good Samaritan) to find a stretcher and unload the patient. Once inside, the patients wait in the intake area, some with their faces knotted in pain, others eyes glazed, while the hospital staff looks at paperwork. Most people who have been to Kenyatta say they would much prefer that their loved ones go to Nairobi Hospital or Aga Kahn, but those hospitals are often too far or expensive.

As we wait with our three patients, Levi and Mildred get visibly frustrated, although both have been through this countless times.

“I told them these are accident cases. These others they are seeing, they have come because they are sick,” Mildred says. “No one wants to hear it.”

“We waste a lot of time here because the service is so slow,” Levi says. “When we are here and someone needs an ambulance, they can’t get one. If a person has just been hit, he’ll have to find another arrangement.”

We watch the steady arrival of other vehicles. One ambulance has come from Murang’a County, a 3 hour drive from Nairobi. Another is from Loitokitok – 5 hours away. A taxi pulls up carrying a gaunt-looking woman, barely able to hold up her head. “She’s very weak,” he says. “I give her one hour. If she doesn’t get attended to in one hour, she’s gone.”

I approach a young man in the waiting area. He is dressed in a tan leather jacket and black trousers and introduces himself as Edwin. That night, his mother was in a hit-and-run car accident on Thika Highway and a Good Samaritan (someone driving a private car) took her to the hospital and called Edwin on her phone.

He tells me that he is waiting for his mother to stabilize, and then he hopes to take her to Nairobi Hospital. Why? Three years earlier his 25-year-old cousin was badly burned in a gas fire in her home. She was taken to Kenyatta Hospital, and died while waiting to be seen. So, he did not trust this hospital with his mother’s life.

He pauses a moment and then says, “I’m very sorry to say this, but this is not a good hospital.”

edith twitterEdith Honan is a freelance journalist who came to Nairobi with Reuters. She is the Editor in Chief of Side Hustle. @edithhonan

3 Comments Add yours

  1. Omollo-Juma says:

    How does a patient with AIDs look? Very unethical of you after years of trying to fight stigma in this country

    1. edithhonan says:

      We think you raise an important point. Thank you for your engagement.

  2. Kagenza says:

    Thank you for this vivid piece!

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