A bed. A transistor radio. And a peeling ceiling. Nothing much to write home about, but for one man in Karatina, these three things mean the world.
Peter Gitonga, 38, has not left his bed at Karatina Sub-County Hospital for the last three years; not even when doctors go on strike, or nurses.
Bedridden since 2001 following a quarry accident that paralysed him from the waist down, Gitonga was transferred here three years ago, and since then the ceiling and the small transistor radio have been his only constant companions.
We met him last week at the hospital. From a distance, the facility looked lifeless, its energetic buzz lost in the wake of a nurses strike. But as we walked around the winding corridors, something stirred inside one of the wards.
We peeped in to see what was going on, and there, on a small bed, lay the emblem of what happens when health care goes to the dogs.
He wore a sad face. Sad and lonely.
The stare of his eyes was empty, communicating nothing in its haunting muteness. Beside him a green vacuum flask kept his beverage warm, and next to the flask his small radio crackled the world into the empty ward.
“I don’t like switching it off,” she said. “It keeps me busy and brings the world to me. I do not want to shut off the world from me.”
But the world has run away from this man. Because nurses, the backbone of Kenya’s public health care system, are on strike as a result of a pay dispute, the patients who filled this ward moved to other hospitals, leaving Gitonga alone.
His is a lonely, heartbreaking, and emotionally draining existence. Without the medical care he desperately needs, his chances of making a full recovery are dim.
Yet, 16 years ago, Gitonga was an energetic young man who spent his days in a quarry, digging up his sustenance and dreaming big stuff.
And then one morning in October 2001 he finished his breakfast, bid his wife and two-year-old son goodbye, stepped out of their single-roomed house in Chaka, and headed for the quarry.
A few hours into the dig, the walls of the quarry gave in, partly entombing him. He tried to free himself, but a boulder has landed on his pelvis, and was slowly crashing his pelvic bone and spine. Within a few minutes, he stopped feeling his legs.
“All I remember was being unable to move and feeling sharp pain in my legs and back,” he says. “I have never felt such pain in my life. Actually, I never imagined such pain existed.”
His friends rushed him to Nyeri Provincial General Hospital, and thus started his journey of pain, misery, loneliness, and survival.
Doctors at the hospital kept him under basic nursing care for the better part of his 11-year stay here. With no orthopedic specialists to attend to him, he only received care for soft tissue injuries.
At the beginning of his stay at the hospital, Gitonga enjoyed the warmth of visitors coming to see him and tell him what the world beyond his village was up to, but as time went by the frequency of the visits reduced. Eventually, they stopped altogether.
“Nobody comes anymore,” he says, the tone of his voice haunting more than the words. “I can’t, for instance, remember the last time I saw my wife and child. I do not know where she is, whether she is okay, whether she remarried… nothing.”
After more than 10 years confined to a drab hospital bed, Gitonga lost his track of time and the events outside his ward. He did not even notice that doctors had gone on strike in 2012 until someone informed him that he had to go home since there was nobody to attend to him.
“I did not know what was happening,” he says. “I just found myself alone in the ward. Some workers came and told me doctors had gone on strike and I had to go home. They did not even ask for money.”
And so Gitonga was wheeled back to his tin house in Chaka. Immediately he opened the door he knew something was not right. A dense air of solitude hang in the air like a virus, rubbing against the walls and shooing him off. Against his better judgment, he crawled in, and immediately felt imprisoned. This was home, but he did not belong. His wife had long packed and left, leaving him nothing but memories and the godforsaken air suffocating him.
“Now I was at the mercy of neighbours, who would occasionally pass by to give me food,” he says.
If nobody came to see him, he dragged himself around the house, braving the immense pain from the untreated fractures to fix himself the occasional meal. And, like it happened during his time at Nyeri PGH, the neighbours stopped attending to him.
“Maybe it is human nature to get tired of a person when the person becomes sick,” he philosophises. “Maybe people don’t like burdens that come in human form.”
But humans, too, are not designed to handle neglect, and two years of abandonment and neglect took a toll on Gitonga. He developed bed sores that quickly turned into wounds, and when the neighbours could no longer handle the stench, they politely informed him that he had to go back to hospital.
“That is how I ended up here,” he smiles. The hospital’s orthopaedic surgeon, Dr David Ndegwa, says when Gitonga was wheeled into the outpatient section in October 2014, medics could hardly believe that he was still alive.
“We could not treat his fractures at the time and even now we still cannot do it because the sores have not healed yet,” he says. “The wounds had worsened because he was not receiving any care when he was at home.”
But just as Gitonga was beginning to see some light at the end of the long tunnel, industrial action and agitation for better pay and working conditions stepped in and blocked the view. In the past three years, nurses and doctors have gone on strike six times, and he has borne the brunt of it all from his bed at Karatina Sub-County Hospital.
On December 5 last year, doctors went on a nationwide strike that would soon break the record as the longest in Kenyan history, paralysing health care in all public hospitals. For 100 days, Gitonga stared into the nothingness of walls and ceilings, every now and then turning the dial on his radio to change the ambient mood in his miserable ward.
While nurses fed him and basically made him comfortable, his slow and delicate recovery suffered a major setback as there were no doctors to treat him.
Three months into the strike, Gitonga heard on his radio that doctors had signed a return-to-work formula with the government, and as sure as the sun rises from the east, the men and women in white coats streamed back to the wards. Light at the end of the tunnel, again.
But not every good thing seems to last in Kenya’s public health care anymore, and so on May 7 this year, nurses in Nyeri County downed their tools, and once again everyone started clearing patients from the hospitals. Peter had nowhere to go, and so he stayed on.
“I am used to it, really,” he says. “There is nothing I can do to change the situation, but at least I get some help.”
Nurses are entangled in a labour dispute that has dragged on since the devolution of health services in 2013. Only recently hired nurses, most of them on contract, are attending to the maternity wing, outpatients and the few patients left in the wards waiting for referrals or to be discharged.
The hospital matron, Ms Virginia Mwatha, has become Gitonga’s companion and takes care of him even when the other nurses are out of hospital.
“I cannot go on strike, so together with other nurses who refuse to go on strike on humanitarian grounds we look after him,” she says.
Mr James Nyagah, a social worker at the hospital, says a recent search for Gitonga’s family revealed that Gitonga’s brother and father had died. Gitonga was never informed of the deaths, and so did not attend any of the funerals.
“Now we do not know anybody else that is related to him and he does not talk much about distant relatives,” says Mr Nyagah.
Ms Mwatha, the social worker, says the need to locate his relatives is quite dire as any form of treatment will require constant nursing even when he leaves hospital.
“He has to be rehabilitated in an environment outside the hospital, with the community and those related to him taking care of him, but as of now his wellness is greatly hindered,” adds Mr Nyagah.
Peter requires tissue grafting and reconstructive surgery before he can be put through physiotherapy, but the hospital does not have a reconstructive surgeon and a referral cannot be made since none of his relatives can be traced.
According to the orthopedic expert, his spinal injuries can best be treated at the Spinal Injury Hospital and the tissue grafting can be performed at the Kenyatta National Hospital.
The cost of the surgeries, according to Dr Ndegwa, will be approximately Sh1 million, but Gitonga, abandoned in this ward for years, cannot even raise Sh20. During his three year stay at the hospital, he has accrued a bill of about Sh600,000, but the hospital is considering to waive the fees.
“I need the treatment but I know I do not have any money or any way of getting it,” says Gitonga, and then, as if consumed by this masculine need to be the provider, he adds, “but I will pay. Somehow. Someday.”
His son turns 18 this year. He does not know how he looks like, whether he still lives with his mother, or whether he is even alive. That, however, is a chapter Gitonga does not want to revise. He has a much bigger battle to fight, a spine to heal, a pelvic bone to correct, a life to fight for.
In a deserted ward at Karatina Sub-County Hospital, a transistor radio crackles on. And in a bed in that ward, a man hopes and dreams that somehow, someday, he will heal, pay his bills, and walk out into the sun-kissed vales of Nyeri.
And when you have lied on a bed for 14 years, hope is such a comforting thing.
Somehow. Someday. Ultimately.
Health risk allowance was Sh3,800, negotiated to Sh15,400 but not paid
Extraneous allowance negotiated for an additional Sh5,000 which has not been paid
Uniform allowance for those working in rural areas, at Sh10,000 annually, negotiated for an additional Sh50,000 per year, but not paid
Responsibility allowance not paid currently, but nurses proposing Sh5,000 for those with additional administrative duties over their core work
Call allowance does not exist, but proposed for those who work in dispensaries and health centres
Nursing allowance was Sh20,000 for job groups G to L and Sh15,000 for M to T, but negotiated in the current CBA to a flat rate of Sh20,000 for all cadres