Family of sick baby stranded with Ksh.1.8M bill after SHA excludes them from treatment package

The shortcomings of the overseas treatment package as stipulated under the Universal Healthcare Coverage (UHC) continue to be felt, as yet another family faces heavy medical bills abroad.

The family of an eight-week-old boy admitted at Mater Hospital says it has been locked out of the benefits package because they are not public servants.

The family’s newest member, two-month-old Callum, spent only one week at home after his birth before heart complications led to his admission to the ICU wing of a city hospital.

“After a week he started experiencing difficulties in breathing, so we took him back to Kijabe but they told us they didn’t have a heart doctor,” Kelly Kamau, Callum’s father, said.

“They said the baby was born with a condition where the main artery supplying blood is narrow and constricted, preventing blood from flowing properly. As a result, the blood returns to the heart and lungs, which causes pulmonary pneumonia,” Callum’s mother, Esther Nyamwero, said.

The illness has taken a toll not only on the tiny baby's body but also on Nyamwero, whose life now revolves around the hospital as she strives to fulfil her motherly duties for her son.

“I am up and about every day because I have to tend to his needs,” she said.

Callum is expected to undergo corrective surgery in India, and the family, who are both registered and have paid for SHA, were looking forward to benefiting from the overseas treatment benefits package to help alleviate the cost of the treatment, which currently stands at Ksh.1.8 million. Beneficiaries of the overseas treatment package receive Ksh.500,000.

“We’ve gone to SHA’s headquarters twice and they told us that the cover only supports public servants only for overseas treatment,” said Kamau.

SHA says the process of empanelling foreign healthcare providers is still ongoing but assures that the benefit for registered members remains at Ksh.500,000. The authority also states that this amount is subject to review soon.

“Very soon we will be guided on the areas of review, it has been fast-tracked, we are looking at our progress, to see where we could have put too little, where we need to enhance. I see us relook at what we have even before the end of this financial year,” SHA Acting CEO, Robert Ingashira, said.

Ingashira also acknowledged the challenges in SHA’s systems that have led to some patients being detained in facilities due to pending payments.

“We have increased the number of technical staff at our high-traffic facilities, if you go to Kenyatta (hospital) you will find them there,” he said.

The authority also says it is working towards streamlining the challenges hindering the full and efficient rollout of UHC.