Hits and misses: Nightmare of Kenya’s quarantine centres

The announcement by Kenya’s Health Cabinet Secretary Mutahi Kagwe of mandatory quarantine for all travellers who arrived into the country from March 22 was as chilling as it was direct.

The whole world was in a frenzy to shut down borders and airspaces in a bid to stop contact with so-called coronavirus hotspot countries. The Kenya government announced that it was closing its skies to passenger flights and all citizens and residents planning to come back to the country needed to do so before March 25, after which no more passenger flights would be allowed.

The government’s call was heeded by many and within a few days almost 2,000 people arrived at the Jomo Kenyatta International Airport in Nairobi. That’s when the nightmare began.

At the JKIA, the passengers were told they would be taken into mandatory quarantine at their own cost, but no one seemed to know where or how. A group of passengers aboard an Ethiopian Airline that arrived on March 23 were screened, and after a long wait were informed that they would go into mandatory quarantine at the Pride Inn Azure.

They had no problem with the order according to one passenger who talked to us, but they didn’t agree with the seemingly exorbitant charge of $80 a night.

The government has about 53 quarantine centers. However, all government facilities were full and they had no choice. They were herded into buses with no regard for health measures.

It was clear that the government was ill-prepared to implement its own directive on mandatory quarantine. Soon social media was awash with video clips of frustrated passengers who had spent hours at the JKIA and who had refused to go to what they deemed were expensive accommodation. They added that no alternatives were offered to them.

A public letter dated April 7 by a group of civil societies and human rights groups to the Ministry of Health said the government’s mandatory quarantine plan was uncoordinated, unplanned and not guided by any policy.

The letter added there was no transparency in how many people were being kept in the centers, how many had been tested and declared either positive or negative and therefore able to go home for self-isolation under government guidelines.

The civil society and human rights groups want the government to address the issues affecting those in quarantine. In another letter to the Health ministry, they raised a number of issues they say are yet to be resolved.

“We issue this statement following a formal request for information on the mandatory quarantine following complaints from those in your facilities. This follows direct communication, open letters and personal videos posted by those in mandatory quarantine in your government facilities.

“Their accounts show clear cases of recklessness in the way they’re being handled, the exorbitant costs they have been forced to incur, the deplorable living conditions in most quarantine centres, lack of information on any quarantine protocols, and a general lack of regard for their health, safety and well-being,” reads a section of the letter.

Lack of transparency

The group asked the government to make public the number of people in mandatory quarantine, whether they have all been tested and whether the results have been communicated to them.

Recently, those in quarantine at the Pride Inn Azure wrote to CS Kagwe seeking an explanation as to why even before the completion of their 14-day mandatory quarantine on April 6, they had been given a 14-day extension, even for those who had tested negative. Two people from the group in that facility tested positive and were removed for admission.

The Ministry of Health has been faulted for breaching the country’s Constitution, the Public Health Act and international conventions in the way it is handling those in mandatory quarantine.

According to the Public Health Act, an individual who is forcefully quarantined does necessarily have a right to be released from that quarantine, but has a right to demand some sort of adjudicative process to determine whether the quarantine is justified.

The Act states that a person can be placed in isolation and detained there until, in the opinion of the medical officer of health, they are free from infection or able to be discharged without posing a danger to public health. Should they fail to do so the charge could result in a maximum fine of $300 and or imprisonment of not more than three years.

The government has been accused of breaching mandatory quarantine discharge protocols that call for discharge of any person who completes 14 days of quarantine and after proceeds to self-quarantine for a further seven days, up to a total of 21 quarantine days.

However, the government has stood its ground on its controversial decision to extend the quarantine period from 14 to 28 days in some isolation centers.

In a circular issued by the Health ministry dated April 6 and titled Covid-19 Mandatory Quarantine Discharge Protocol, an addendum in the circular says: “As per a directive shared on April 3, people in mandatory quarantine sites with a person who has tested positive for Covid-19 will continue 14 more days on quarantine. Details on how these will be managed will be shared in due course.’’

The human rights groups have asked the ministry to explain its decision to extend the quarantine period beyond 14 days for occupants of all facilities in which positive cases are identified.

A letter dated April 6, 2020 to the Principal Secretary Ministry of Health from a Nairobi law firm representing those quarantined at the Pride Inn Lantana, alleges ‘‘forced quarantine’’ after the mandatory 14 days, citing the illegality of the extension read the MoH circular of April 6.

The firm demanded the immediate release of its clients. On April 9, acting Health Director-General Patrick Amoth announced the centre was closed. The CS has earlier announced the closure of TradeMark Hotel and ParkInn quarantine centres.

Earlier, complaints had emerged of bad living conditions and no access to medical help for those who need it, either for mental of physical health issues, especially those in government-run facilities set up in boarding schools and training colleges around Nairobi.

There are complaints of facilities being overcrowded, unsanitary, and not conducive to isolation and social distancing. A group that was moved to the JKUAT even complained of irregular meals. Those at the Pride Inn Azure say they were only tested 10 days into their quarantine, and two people tested positive, yet centres that had more infection cases, people were released after 14 days.

The Health ministry has been accused of exposing those in the facilities to the virus. However, CS Kagwe has repeatedly apologised for the mess in quarantine facilities and promised action.

“I arrived from Canada on March 23, and upon being cleared by migration, we were bundled to a crowded bus to the government’s quarantine facility at the Kenya Medical Training College. We lived in crowded, untidy rooms,” claimed one passenger.

In daily briefings by the Cabinet Secretary and Dr Amoth, a constant narrative is that those being held in quarantine account for between 45 per cent and 50 per cent of people who have tested positive, which those in the centres say stigmatises them.

Meanwhile the government has created more centres in counties to decongest facilities, as all indications point to more infections in the coming weeks.

Already, at least two isolation centres have been established in each of the 47 counties to supplement those at the Boma Hotel, Kenyatta University Conference Centre, Kenya School of Government and Kenya Medical Training College.

As of Monday last week, the government said it was in discussion with hotel owners to revise charges, and that in government-owned facilities charges had been reduced from $40 to about $20.

By the time of going to press, the Ministry of Health had on Tuesday, released people with special conditions, two parents with children and a diabetic man with hypertension from the Pride Inn Azure facility.

Starting Thursday April 9 to coming Tuesday, the MoH was testing 1,814 people at 34 quarantine centres in Nairobi and they were expecting their results in 24 hours to know their fate.