How did a boil turn to fistula?

Ambrose Wekesa can afford to smile now, after a year of anguish over his wife’s health. It started with minor surgery to remove a boil in the anus and ended with fistula (a hole between the bladder and anus).

 Ambrose’s wife Naliaka had been suffering from persistent and excruciating lower abdominal pain, so on October 21, 2016 he took her to St Mary’s Mission Hospital in Langata, Nairobi, where, after examination, she was diagnosed with perianal abscess, or simply a boil in her anus. The clinical officer prescribed incision and drainage of pus. Ambrose could not raise the Sh1,800 required for the procedure, so he bought painkillers and took his wife home. He sold his phone and returned to St Mary’s with his wife two days later.

After the procedure, his wife was in great pain and walked with a limp. She was put on painkillers and instructed to sit in a basin full of warm salty water twice a day, but instead of getting better, the pain worsened.

“After a day or two my wife noticed that her underwear was soiled with faeces, every time she changed clothes.

“We thought it meant the wound was healing, that it was some kind of dirt from the wound. But after a month without noticeable change, we made our way back to St Mary for a review,” Ambrose remembers.

The doctor shooed the couple away, inspite of Naliaka’s pleas to find out what was causing her pain. She was given Clozole B, Liquid Paraffin and painkillers, but Naliaka wasn’t getting better and the awful odour drove Ambrose from his marital bed.

“That’s when I decided to have a look to see what was causing the pain and odour. There was a hole near the anus, and waste was coming out of it instead of the anus,” he recalls.

The couple sought a second opinion from a different hospital, where after examination, they were told that Naliaka had fistula. Ambrose returned to St Mary’s and asked them to treat his wife “because the fistula came from the procedure they did.”

“They apologised and owned up to the mistake … but they kept telling me that the administrator was in a meeting and that they would call back, but they never did.”

In a follow-up by HealthyNation, the hospital manager Mr Maurice Audi said that Naliaka was treated before the hospital’s management changed hands. To make matters worse, according to Mr Audi, the old staff disappeared with some patient documents.

DIFFERENT MANAGEMENT

“Ms Naliaka was treated on October 23, 2016 under a different management. We came on board on December 28, 2017, so we do not know who did the surgery. We can’t tell whether it was done here or not. The only thing we can see is that she has documents indicating that the patient was in St Mary’s,” said Mr Audi.

“The moment staff start disappearing, documents also start disappearing. This makes it very difficult for us to take action because we have nothing to refer to,” added Mr Audi.

“Even if her files were handed over, something like a surgical operation is handled by a specific person – the doctor who did the operation. That doctor needs to take responsibility,” Mr Audi conccluded.

Mr Audi said that the patient could go back for treatment, but for the fee to be waived, the hospital’s management would have to meet and make a decision. A frustrated Ambrose went to the Kenya Medical Practitioners and Dentists Board to file a complaint. He was asked to pay a Sh2,000 fee he could not raise.

Daniel Yumbya, the CEO of KMPDB said that the statutory fee could be waived upon request.

 “In the past we had people coming in to file complaints only to withdraw halfway after we have used our time and resources. That is why anyone who wants something investigated is asked to pay the amount.

EXCEPTIONS

“However there are exceptions and the amount can be waived following a letter requesting for the waiver,” said Mr Yumbya.

Back home, all Ambrose wanted was for his wife’s agony to come to an end.

“It is really painful to watch her suffer like this just because of someone’s error,” he said.

Naliaka’s relief came just before Valentine’s Day when she finally had surgery to remedy the fistula at Komarock Modern Healthcare hospital on February 13.

The surgery cost Sh150,000 which Ambrose raised from a harambee.

Naliaka is now recuperating at home, but Ambrose still wonders how a simple boil ended up as fistula, causing his wife anguish for months.