In the relentless fight against COVID-19, in early 2020, the world turned its attention to the heroes on the frontlines – the doctors, nurses, and healthcare workers. These warriors faced an invisible enemy day and night, but there was another battle, largely unseen by the public – the struggle for access to life-saving medical equipment within the confines of isolation wards.
Hidden behind the heroism, Neville Magomere, a cath lab tech, and nurse at Aga Khan Mombasa, reveals a darker side of the COVID-19 battle. Serving in the isolation ward from March to October 2020, Neville witnessed firsthand the scarcity of life-saving equipment. But the scarcity wasn’t solely due to overwhelming demand; misappropriation had a hand in it.
“At the onset of the COVID-19 pandemic in early 2020, patient survival rates were dishearteningly low. As the virus surged, hospitals saw a constant influx of patients, and a critical point was reached where individuals in severe conditions had no choice but to share rooms, despite the recommended containment measures that prioritized social distancing,” Neville narrated.
Neville recounted a harrowing scenario in which overcrowded isolation wards left severely affected patients without timely medical attention. In some cases, patients occupied beds for up to three weeks before showing signs of recovery, making it impossible to admit new cases, tragically resulting in fatalities.
A special audit report by the Auditor General on COVID-19 fund utilization by National entities points to questionable practices at higher levels. The report unveils the Government of Kenya’s efforts to secure financial support for COVID-19 mitigation programs and budgetary assistance through Economic Stimulus Programs.
Between 1st March and 31st July, 2020, the Ministry of Health received a total of Kshs. 25.5 million from the National Treasury. The report reveals that the government disbursed Kshs. 740 million, the International Monetary Fund contributed Kshs. 13.8 million, the World Bank allocated Kshs. 2.7 billion, and DANIDA Grant extended Kshs. 350 million for COVID-19-related activities, amounting to Kshs. 17.6 billion. But a closer look exposes misappropriation.
From these funds, the Ministry of Health utilized Kshs. 15.8 billion. Kshs. 7.7 million went to counties, and Kshs. 4.6 million was allocated to referral hospitals. But, within the World Bank’s contribution of Kshs. 2.7 billion, Kshs. 170 million was specifically disbursed to Gradian Health Systems for the procurement of ventilators, raising concerns about how these funds were utilized.
The report further reveals that the Ministry of Health disbursed Kshs. 4.6 billion to seven referral hospitals, including the Coast General Hospital, which received Kshs. 500 million for COVID-19 emergency response.
However, a notable observation in the audit pertained to the procurement of medical equipment. It was discovered that the procurement file lacked evidence indicating that the medical equipment, amounting to Kshs. 11.6M, supplied to the hospital by M/s. Surgipham Ltd, underwent proper inspection. Furthermore, the notifications bidders were missing from the procurement files related to the Supply and Delivery of Medical Equipment, awarded to M/S Asterisk Limited at Ksh. 1.4 million.
As a result, the special audit could not verify whether the medical supplies delivered met the requisite standards in terms of quality and quantity. This finding was in contravention of Section 48 (1) of the Public Procurement and Asset Disposal Act, 2015, which mandates the Accounting Officer of a procuring entity to establish an Inspection and Acceptance Committee for testing the quality and quantity of goods delivered to confirm compliance with specifications.
Furthermore, the Mombasa County authorities had not provided a report on the utilization of COVID-19 funds in the special budget review implementation report, covering the utilization of funds by county governments for COVID-19 interventions during the period from March 13 to July 31, 2020. Efforts were made to seek closure and verify these statements, but they proved to be unsuccessful.
Call to Action
Shipeta Mathias, a response officer at Haki Africa brought to light the critical need for comprehensive pandemic preparedness, ensuring that healthcare facilities are adequately equipped with life-saving equipment.
“As we move forward, it’s imperative for governments, healthcare institutions, and communities to invest in better equipment procurement, strategic stockpiling, and distribution plans. Support and funding for healthcare infrastructure must be prioritized, and international collaboration should be fostered to ensure equitable access to vital resources,” said Shipeta.
The special budget review implementation report concerning the utilization of funds by county governments presents a set of important recommendations aimed at enhancing the effectiveness and integrity of emergency procurement processes.
Firstly, the report advises the Ministry of Health to thoroughly reassess the existing systems put in place to address and mitigate the risks associated with procurement fraud during emergency situations.
Additionally, it calls upon the Directorate of Criminal Investigations to conduct comprehensive investigations to ascertain whether any criminal activities were involved in the irregularities identified within the report.
Furthermore, the report underscores the need for referral hospitals to modernize their procurement and asset disposal procedures by implementing automated systems that incorporate robust audit controls. This proactive step is seen as essential for identifying and mitigating risks associated with procurement processes.
By Priscillah Kaigai, AMWIK member