It’s a busy Tuesday morning at Lodwar County Referral Hospital. Oxygen cylinders are being pushed in trolleys. The cylinders are either being moved to different wards or taken to be refilled at the newly established 283-litres per minute Pressure Swing Adsorption (PSA) oxygen plant at the facility.
We find Peter Ndegwa, a nursing officer, monitoring one of the patients, who has complicated tuberculosis. A cylinder is placed besides his bed to supply oxygen through a surgical mask over the nasal cannula. He has a persistent cough that is making it difficult to talk.
"The patient was readmitted three months ago and part of his lungs had already collapsed. He thus had breathing difficulties. Upon investigations, it was established that he never completed his dosage the first time he was admitted hence a weakened immune system,” says Peter.
Due to severity of his condition, the patient is using at least three cylinders of oxygen a day, which, luckily, is available.
At the hospital’s maternity wing, Florence Louchum, a teenage mother, says her premature baby, who is relying on oxygen, has recorded significant improvement. She recalls that she had preterm labour in May that was characterised by bleeding. "I rushed to Lokitaung Sub-county Hospital where I was being managed till July when I delivered a premature baby. I was referred here and the hospital assured that my baby would be okay."
The TB patient and Florence are some of the beneficiaries of a Sh26.8 million plant that was installed two months ago under the Reaching Impact Saturation and Epidemic Control project as a donation from USAid.
Lodwar County Referral Hospital CEO Joseph Esekon noted that before the plant was installed, the hospital faced challenges in providing sufficient oxygen supply, and thus many lives were lost. He added that Covid-19 exposed the underbelly of the Ministry of Health’s preparedness both at county and national level on the availability of oxygen.
"We didn't have oxygen in Turkana. During the pandemic, we used to get oxygen from Kitale, which is 300 kilometres away," Dr Esekon recalled.
He said it wasn't sustainable to get oxygen from Kitale, where the county government was spending at least Sh6 million annually on transporting the commodity.
"It was even risky for drivers who were relying on the Lokichar and Marich Pass road, which was prone to highway bandit attacks. The county will now channel the money to other health needs such as purchasing commodities like antivenom for snake bites and medication for cancers," he explained.
He noted that the plant is a relief for more than 1.2 million residents in the county as well as patients from the neighbouring Uganda, who are normally brought in the facility with gunshot wounds patients, South Sudan where the health system is collapsing due to civil war health system and Ethiopia where Kala-azar patients, who present with severe anaemia and breathing problems, are referred to the facility because of readily available oxygen.
The essential resource is vital in treating various respiratory illnesses including pneumonia, malaria and tuberculosis, and in providing critical care.
"The oxygen produced at the plant is 97 per cent pure. Response time to emergency has been shortened as doctors can carry out surgical procedures without being worried about where to get oxygen. We plan to ensure that the oxygen is now piped to all the wards so that we stop pushing trolleys with cylinders around the facility," Dr Epem said.
County Medical Services Chief Officer Gilchrist Lokoel said the facility has since experienced a remarkable improvement in critical care and reduced overall mortalities since the plant’s installation. "The hospital uses nearly 90 per cent of the oxygen generated to saves lives," Dr Lokoel said.
USAid Mission Director David Gosney, who together with Turkana Governor Jeremiah Lomorukai launched the state-of-the-art facility, said it will greatly improve access to quality healthcare. He added that as part of the US government’s continued support, USAid has so far donated five pressure swing adsorption oxygen generators to selected health facilities in Garissa, Marsabit, Turkana, Kitui, and Nandi.
"USAid, through a consultative process with the Ministry of Health and the council of governors, identified and agreed on the five counties. Each plant comes with 10 refillable oxygen cylinders. Each plant can operate for the next 15-20 years," he explained.
Governor Lomorukai said his administration will continue allocating funds and collaborating with other health stakeholders to safeguard lives and address gaps in the health sector.
"We are immensely grateful to USAid for their invaluable support in the health and other sectors in Turkana County. The PSA oxygen generation plant will address a critical demand for medical-grade oxygen at Lodwar Referral Hospital and in nearby medical facilities to treat pneumonia, tuberculosis, malaria, Covid and respiratory illnesses. Additionally, the oxygen will be used during emergencies and surgeries, and will help save many lives.