Kenyatta National Hospital’s ability to manage emergencies involving multiple critically injured patients has come under scrutiny after an audit revealed shortages of essential medical equipment, including ventilators, cardiac monitors and intensive care beds, at its Accident and Emergency Department.
The findings, contained in Auditor General Nancy Gathungu’s review of the hospital’s financial year ending June 2025, show that the department was operating without a range of machines and emergency care tools needed to stabilise patients and deliver urgent treatment. The shortages accounted for between 20 per cent and 100 per cent of the equipment required for its operations.
“The department is significantly under-equipped relative to its operational requirements,” Gathungu said in the report tabled in Parliament.
The report raises concerns about the resources available to medical teams at Kenya’s largest referral hospital, particularly when several patients need immediate and specialised attention.
Among the major deficits were 16 ventilators, 15 cardiac monitors and 16 suction machines. The hospital also lacked 12 advanced intensive care unit beds, 20 procedure trolleys and three advanced point-of-care ultrasound machines.
The list of missing equipment further included four video laryngoscopes, 10 crash carts and 12 wall-mounted suction units. One tourniquet machine was also reported to be faulty.
The shortages could complicate efforts to treat several critically injured patients at once, especially during major accidents or disasters that overwhelm the emergency department.
Crash carts contain medical supplies and tools used when patients require immediate intervention, while procedure trolleys enable healthcare workers to organise equipment for urgent treatment.
Ventilators help patients who are unable to breathe adequately without assistance, while cardiac monitors allow medical staff to track heart activity and other vital signs. Suction machines are used to clear patients’ airways, making them important in situations where breathing is compromised.
The audit also identified gaps in diagnostic devices used to guide treatment and monitor the condition of patients requiring emergency care.
The department was short of 10 glucometers, 12 capnography monitors, one blood gas analyser and one coagulometer. These devices help medical teams assess blood sugar levels, monitor breathing, measure blood gas levels and evaluate blood clotting, providing information needed to make treatment decisions.
In addition to the missing equipment, the report questioned the condition of some machines already in use at the facility.
Automated defibrillators and cardiac monitors were found to be outdated or beyond their expected service life.
Defibrillators deliver controlled electric shocks to restore an effective heart rhythm in certain life-threatening cardiac emergencies. Outdated or unreliable equipment can be a concern in an emergency department, where medical teams need dependable machines to respond quickly during resuscitation.
The report also pointed to shortages of devices used to administer fluids and medication to patients.
KNH lacked 10 infusion pumps and 30 syringe pumps, which allow healthcare workers to deliver fluids and medicines at controlled rates.
The audit further found that eight infusion pumps were working but could not be used because the hospital did not have the required giving sets.
The finding highlights a problem beyond the availability of machines: even equipment that is functional may remain out of service when the accessories needed to operate it are missing.
Other items in short supply included 50 ergonomic chairs, four air-warming blankets, eight patient cabinets and five X-ray viewers.
While these items do not all directly support life-saving procedures, they contribute to the organisation of the emergency department and the delivery of patient care, particularly when demand is high.
The audit's findings have brought renewed attention to the hospital’s preparedness for incidents in which large numbers of casualties require treatment within a short period.
In such situations, medical teams must assess patients rapidly, prioritise those in need of immediate intervention and allocate available staff, beds and equipment to those who need them most.
Limited access to ventilators, monitors, suction machines and critical-care beds could restrict the number of severely injured patients who can receive advanced support at the same time.
The report did not conclude that the hospital had mishandled a particular mass-casualty incident. However, it identified shortcomings in the equipment available to support emergency preparedness and the treatment of critically ill patients.
It also raised concerns about how equipment requirements are planned, how existing machines are maintained and whether the hospital has sufficient supplies and accessories to keep its medical devices operational.
According to KNH’s statement of financial position, the hospital’s property, plant and equipment were valued at Sh12.72 billion.
The hospital’s chief executive officer, Dr Richard Lesiyampe, highlighted the facility’s broader capacity and investments in specialised care, presenting a picture of a hospital that has expanded its ability to provide medical services.
Lesiyampe said KNH was the second-largest hospital in Africa after South Africa’s Chris Hani.
He pointed to an increase in the number of fully equipped operating theatres from 12 to 32 over four years as evidence of the facility’s expanded capacity.
“We have reduced waiting time for surgeries,” he said, indicating that emergency surgeries are done in under 24 hours.
The chief executive also cited the hospital’s two CT scanners and advanced equipment used in cancer management.
“We have a machine that manages 150 to 200 patients daily,” the CEO said, adding that a new link machine was on the way.
Despite the improvements cited by the hospital’s management, the audit found that the Accident and Emergency Department still lacked equipment needed to meet its operational requirements.
The findings highlight the need to distinguish between the hospital’s overall medical facilities and the specific resources available to its emergency unit, where shortages of essential equipment can affect the ability to treat patients who need immediate attention.