Experts demand audit of medical oxygen supply
George Kebaso @Morarak
Medical experts are now questioning the quality of oxygen supplied to health facilities in the country amid reports that unscrupulous individuals may have taken advantage of existing loopholes to offer a substandard commodity.
With oxygen being a key component in the management of Covid-19, fears are now emerging that the high death rates being reported as a result of the virus infection could be connected to the fake oxygen being supplied to hospitals.
Consequently, the Council of Governors (CoG) has now called for a complete audit and verification of the medical oxygen supply chain to hospitals.
“At the moment, nobody is questioning and monitoring the quality of oxygen being supplied to our hospitals.
Neither has the government bothered to upgrade or refurbish the existing medical oxygen infrastructure,” Prof Richard Muga, the Homa Bay county executive in charge of Health told a virtual meeting convened to discuss the issue on Monday afternoon.
Kisumu Governor Anyang’ Nyong’o, who is the chairman of the CoG committee on Health demanded a comprehensive verified list of suppliers of medical oxygen to hospitals.
On the other hand, Joseph Mbae, Murang’a CEC for Health and the chairman of the caucus of county CECs in charge of Health, threw the blame at the Ministry of Health, blaming the Mutahi Kagwe-led team of handling the issue casually.
“Why can’t we get serious on this issue and redirect the funds allocated to fight the pandemic towards containment of the crisis at hand. These people at Afya House are not taking this third wave seriously,” said Mbae.
Medical experts have fallen out with Kagwe over his claims that the oxygen shortage is as a result of hoarding of cylinders.
Instead, they said lack of capacity by oxygen producing companies to meet the current demand coupled with poor infrastructure in hospitals, has occasioned the shortage.
“I wish to make an appeal to those holding cylinders — be they hospital facilities or individuals in other sectors — please return those cylinders to manufacturers so that they can refill and use them in hospitals,” Kagwe said on Monday afternoon.
He and officials of BOC Gases, the main oxygen producer in the country claimed that 20,000 cylinders were being hoarded.
But the experts termed Kagwe’s claims as an excuse for the government’s failure to install oxygen production plants across the 47 counties and high taxation of the commodity and equipment associated with it.
Association of Medical Engineers of Kenya (Amek) Secretary General Millicent Aloh underscored the crisis saying all the facilities in hospitals handling critical care patients are full, with each of the patients requiring a ventilator for oxygen supplementation.
“The CS should just tell Kenyans the truth. There is nothing like hoarding of oxygen cylinders, the true picture is that the demand for this commodity is so high and the production rate cannot match it,” Eng Alooh said yesterday.
She said since all the critical care units are overwhelmed this has led to the consumption reaching unprecedented levels.
“The cylinders said to be in the hands of individuals, are within hospitals on a rotational basis, meaning that health facilities are not releasing them as should be the case.
But then still, the people who are producing oxygen do not have capacity now because the demand is high; patients are many; critical wards are full, Isolation and Care facilities are also overwhelmed,” she added.
There are five main oxygen producers in the country namely; Gas Africa, HewaTele, Simba Africa, and new entrant in the business, Devki Group of companies. However, BOC Gases Company remains the largest producer, which also cannot cope with the current demand.
Production capacity
In the Monday virtual meeting, participants were told some racketeers who had hoarded some of the cylinders were now refilling them with low quality oxygen from the black market.
Muga cited the lack of clear regulatory machinery in the sector for the loopholes that have led to the emergence of cartels taking advantage of the current situation.
“Nobody is concerned with the quality of accessories that come with the gas cylinders such as nozzles, plugging and plates. Nobody even bothers to check on the expiry dates.
The quality of medical oxygen in supply is questionable,” Muga told the meeting that was attended by Ministry of Health Principal Secretary Susan Mochache and governors James Ongwae, Ali Roba, Cornel Rasanga and Moses Lenolkulal, among others.
On the one hand, Mbae and Muga told the meeting that oxygen plants at Kenyatta National Hospital, Jaramogi Oginga Odinga and Nakuru Level Five hospitals were so obsolete that the quality and quantity of oxygen generated from them cannot be guaranteed.
On the other hand, Alooh said even if production capacity was to be increased, new challenges would still hamper oxygen supply in the hospitals.
“We still need sufficient personnel to handle the equipment; proper oxygen piping in the wards; Intensive Care and High Dependency Units (ICU and HDUs); isolation centres and to the rest of the hospital.
“As biomedical engineers, we are calling on both levels of government to work together and ensure all hospitals are equipped with oxygen gauges; flow metres, humidifier bottles and oxygen cylinder trolleys, in order to be able to safely use the portable oxygen,” she noted.
She argues that even if all these things were put in place, there is still the challenge of few biomedical engineers in hospitals, yet the workload is high.
Eng Alooh also revealed that more than 10 oxygen plants in both public and private hospitals are currently not working and called on both levels of government to commit towards investing in liquid oxygen tanks. “The government should invest in the right piping and oxygen tanks. It should also install her own oxygen generating plant to make it affordable and accessible,” she added.
Even in the event that oxygen cylinders were held by individuals, the experts feel that it could be an expensive affair since purchasing one empty container would cost between Sh40,000 to Sh80,000 and to fill it with gas, a person will spend Sh200,000. To install medical oxygen for domestic use one would require at least Sh600,000.
BOC Gases blames the Competition Act that insists on a level playing field in the sector for its inability to produce enough oxygen to satisfy the apparent high demand.
“We have capacity to produce sufficiently, but for now, we can only scale up production to a point. There are other players and oxygen plants are scaling up,” the company’s Chief Executive Officer, Marion Mwangi said last evening.
She said many of the cylinders, with black and white distinct for medical use, could be lying in hospital storerooms, or may have been converted for industrial use such as wielding.
The cost of importing a medical cylinder is Sh80,000, but much of this amount is high due to the taxable charges on importation.
The government has a plan to install oxygen plants in 23 counties, but Alooh argued that why not all the 47 counties.
