A Senate Health Committee oversight mission has laid bare a litany of failures in Mandera, Wajir and Marsabit counties, exposing deep-rooted cracks in Kenya’s healthcare system that disproportionately affect marginalised regions. The inquiry, led by Sen Jackson Mandago (Uasin Gishu), revealed a crisis spanning drug shortages, outdated equipment, understaffing, neglected infrastructure and questionable financial accountability.

𝑴𝒂𝒏𝒅𝒆𝒓𝒂: 𝑩𝒓𝒐𝒌𝒆𝒏 𝒎𝒂𝒄𝒉𝒊𝒏𝒆𝒔, 𝒔𝒕𝒂𝒇𝒇 𝒈𝒂𝒑𝒔 𝒂𝒏𝒅 𝒂𝒍𝒍𝒆𝒈𝒆𝒅 𝒅𝒓𝒖𝒈 𝒕𝒉𝒆𝒇𝒕

In Mandera, the delegation visited Mandera Teaching and Referral Hospital, Khadija Dispensary and Elwak Sub-County Hospital. The picture was bleak. Of the hospital’s five dialysis machines, only three were functioning. CEO Okash Adan admitted they needed at least 10. Staffing levels were equally dire, with untrained personnel found dispensing medication in some facilities.

“We have serious staffing issues, expired drugs and some facilities without pharmacists,” said Sen Mariam Omar. Allegations of drug theft surfaced, with Sen Richard Onyonka (Kisii) questioning whether government-supplied medicine was being diverted to private pharmacies. “That is not true,” replied Dr Khadija, a pharmacist. “We follow proper procedures.”

At Khadija Dispensary, Senators were alarmed to find expired drugs on shelves. “Who is dispensing drugs here?” asked Sen Tabitha Mutinda. Clinical officer Abdihaziz Mustafa admitted he was doing so without pharmacy training. At Elwak, the shortage of vehicles was flagged, with staff requesting at least two more utility vehicles.

Summing up, Sen Mandago said: “Healthcare is not just about buildings, it’s about personnel, accountability and systems that work.”

𝑾𝒂𝒋𝒊𝒓: 𝑻𝑩 𝒍𝒂𝒑𝒔𝒆𝒔, 𝒆𝒙𝒑𝒊𝒓𝒆𝒅 𝒅𝒓𝒖𝒈𝒔 𝒂𝒏𝒅 𝒎𝒂𝒕𝒆𝒓𝒏𝒊𝒕𝒚 𝒄𝒉𝒂𝒍𝒍𝒆𝒏𝒈𝒆𝒔

In Wajir, the Committee toured Manyatta TB Centre and Wajir County Teaching and Referral Hospital. At Manyatta, officials cited poor safety for staff and the absence of a functioning lab. Startlingly, the centre’s in-charge said he didn’t have keys to access vital reagents — which were controlled by the county pharmacist — and that the site doubled as a dumping ground for expired drugs.

Senators grilled officials over a stalled incinerator project, the cause of TB prevalence and the quality of maternal care. Maternity nurse Henry Kiplangat listed mosquito net shortages, unmaintained laundry equipment and lack of digitised records as major issues. “We also face accessibility problems due to poor roads,” he added.

Reimbursement under the Social Health Authority (SHA) and Facility Improvement Financing (FIF) schemes were under scrutiny by Sen Abbas Sheikh Mohammed (Wajir). Kiplangat reported that KSh received 11 million from SHA and KSh 5.7 million from FIF, adding that SHA was working seamlessly.

Nutritional complaints from TB patients prompted a sharp exchange. “Nutrition is the hospital’s responsibility,” said the facility’s nutritionist, when pressed on food quality.

Later, Governor Mohamed Khalif acknowledged the problems and pledged reforms — including mosquito net provision, appointment of a substantive hospital CEO and completion of a KSh 600 million World Bank-funded modern dumpsite by September.

𝑴𝒂𝒓𝒔𝒂𝒃𝒊𝒕: 𝑬𝒙𝒑𝒊𝒓𝒆𝒅 𝒅𝒓𝒖𝒈𝒔, 𝒂𝒃𝒔𝒆𝒏𝒕𝒆𝒆 𝒔𝒕𝒂𝒇𝒇 𝒂𝒏𝒅 𝒖𝒏𝒂𝒄𝒄𝒐𝒖𝒏𝒕𝒆𝒅 𝒎𝒊𝒍𝒍𝒊𝒐𝒏𝒔

In Marsabit, the Committee visited the Marsabit County Referral Hospital and found a system overwhelmed and poorly managed. Cancer clinic monthly attendance has doubled, yet essential lab tests are sent to Nairobi due to lack of local diagnostic capacity.

Toilets were dry, wheelchairs dirty and gardens unkempt. Nurse Lokho admitted the plumbing system was in disrepair. More troubling, staff confirmed the routine use of expired drugs and sanitizers, and revealed that hazardous medical waste was being stored in abandoned toilets or dumped in open air.

An ICU budget reportedly worth KSh 200 million could not be accounted for. Neither the hospital CEO nor the county’s CEC Health was aware of the fund’s breakdown. Governor Mohamud Mohamed Ali attempted to clarify: “We received KSh 200 million in 2020 for Covid-19 containment. Only KSh 18 million was budgeted for ICU work. What you saw is functional.”

The Committee also discovered the facility sourced drugs from Adhi Pharmacy in addition to KEMSA — raising questions about procurement irregularities.

𝑨 𝒃𝒓𝒐𝒂𝒅𝒆𝒓 𝒄𝒓𝒊𝒔𝒊𝒔

Across all three counties, Senators noted recurring themes: chronic understaffing, expired drugs, broken sanitation, missing supplies and lack of financial transparency. Key health workers were absent. Infrastructure was in decay. Drug storage and disposal practices were dangerously inadequate.

Sen Wakoli Wafula (Bungoma) said the Committee was shocked by the level of dysfunction. “We found expired drugs dumped in open fields and no incinerators. In one hospital, we found them stored in a disused toilet.”

With private health facilities rising even as public ones fall into neglect, the Committee has called for urgent intervention. Each governor has promised swift action, with commitments to improve staffing, equipment and financial oversight.

Senators on the mission included Mariam Omar, Wafula Wakoli, Richard Onyonka, Tabitha Mutinda and Abbas Sheikh Mohamed.