Embarrassing State of Referral Hospital as Open Defecation Rises.


The allegation of open defecation taking place in the highest health facility in Tana river County might be dismissed as a false allegation and fake news, but this is not a rumour, it is happening.

Members of the public who have visited the Hospital recently can attest to the sorry state of the facility and confirm that patients and caretakers are helping themselves in open spaces in the hospital compound because either the public toilets are not there or they are extremely dirty.

Article 43 (1) (a) of the Constitution provides that every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. The quest for acceptable health standards therefore is not a favour but an obligation on the County Government since health is devolved.

It is not the first time patients and even MCA’s have raised this complaint with the County Health managers, but their cries fall on deaf ears and have been misconstrued as attacking the Governor or the County Executive Committee. It is unfortunate that very little is done to address the endemic problems facing patients and staff at Hola Hospital.

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A referral Hospital should maintain the highest standards of hygiene and have proper infection prevention mechanisms as provided for by Health Act which inter alia states:

“ensuring adequate investment in research for health to promote technology and innovation in health care delivery. … attainable standard of health which shall include progressive access for provision of promotive, preventive, curative, palliative and rehabilitative services.

At this facility cleaning is wanting and the staff doing it don’t have the right tools and detergents. This puts even their health at risk.

According to Public Health Operating standards the facility ought to be condemned and closed until proper measures and standards are in place then it can be given the greenlight to operate again. The way things are now most likely patients, caregivers and staff are getting infected because of the filthy and dirt scattered all over the Hospital.

The worst affected areas are Outpatient where the pit latrines were demolished due to ongoing construction works. The other areas are the male and female ward. The two are sharing one ward due to ongoing renovations in the male ward. This ward has been neglected no cleaning is taking place. Patients clothing are scattered all over and seldom get washed. The worst area is maternity ward where the water tank is leaking. The nearby pit latrines are extremely dirty and patients are helping themselves outside

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All Health Facilities are supposed to achieve Open Defecation Free Standards (ODF). Hola County Referral Hospital has failed to meet these standards.

A level 4 Hospital should also maintain high standards of Waste Disposal, but Hola Hospital has no Incinerator where waste can be disposed professionally without causing harm to public. The Hospital is using a shallow pit and burns the waste taking the toxic smoke to nearby residential and office areas.

The worst bit is operating a Hospital without a morgue (mortuary). When death occurs at the Hospital the relatives have to ferry bodies for preservation 150km to Garissa or 200km to Malindi.

You will be shocked that the facility still has asbestos sheets. Use of Asbestos for roofing has been banned allover the world due to confirmed scientific research that the materials used can cause cancer. The obsolete materials are everywhere in the Hospital including staff quarters.

While the Department of Health and Sanitation has been granted reasonable allocation in terms budgetary allocation, there is nothing to show case how the monies have been utilized to improve health care.


There are many ways of addressing the thorny issues at this facility. First and foremost it is the Governor as the County CEO to take responsibility and initiate remedial measures to ensure this Hospital works as per set standards and guidelines. He can also reshuffle the top managers if they are sleeping on the job.

However, the ultimate decision should come from the Ministry of Health as oversight body. Just like what happened to other Hospitals where the Ministry of Health intervened by sending Inspectors to visit the Hospital and ascertain if facility has met all the set standards to offer services to the public.


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