Dealing with emergency situations in Kenya

Here is my contribution:

Health;  decent and comprehensive health insurance is important, particularly hospital inpatient insurance. An emergency admission to hospital can be very costly indeed. It is particularly important if you are travelling a lot, as the road accident rate is high. Some insurers, such as AAR have a fleet of ambulances and also offer air rescue. Emergency contact numbers are given.  Insurers will usually require you to have a medical and may not cover pre existing medical conditions. Therefore, if you have a condition which might flare up unexpectedly and require hospital admission, then you should carefully weigh your options.

Personal security: many apartments in better areas are likely to come with security guards as part of the service charge.  If yours is the only property in the compound, at least consider having a night watchman  It can also be useful to find out the number of your local police station - police services are patchy and some will just want bribes to protect you.  You therefore have to take steps to proctect yourself.  Security companies such as G4S offer a service whereby, for a monthly fee you have a personal alarm module, or panic buttons, which can be used in the home, or out and about. Activate it and assistance will be dispatched to you.  I understand that they are very rapid. 

On the road: AA membership is worth considering, they will rescue you if you break down and also have other medical insurance/evacuation services. It's also worth carrying the number of a trusted friend, who can be called upon to come and rescue you, if you break down.  In the event of an accident, the law states that the vehicles must be left in situ until the police arrive.  If the accident is serious and people are trapped, lots of people are likely to appear. Some will help, but others may rob you, so the mobile panic alarms are worth considering.  There is a lot you can do, through driving defensively and keeping off the road at night, to prevent accidents. Be aware of people driving behind you, particularly at night. If concerned, proceed to a well lit public place, or police station.  Driving courses are available to teach defensive driving and how to cope with emergencies.

Other:  power outages and water shortages are not unknown. Find out the emergency contacts of the utility companies, so they can be contacted easily. It can also be useful to have a 'basic' mobile phone to hand, which is kept charged, in case of lengthy power cuts and the battery of your phone being depleted.

999 is never answered, 112 is better.

Depending on situations:

Car jack, or home robbery, be polite, comply with requests, give them anything asked for, don't delay them also don't rush them.

Street shootings, get down immediately, look for something to hide behind or under (like a car), in that order.

Bomb/terrorists, just run, there is nothing else you can do

Political violence (like 2007/08), and elections in general, have food in the house for at least 10 days, including drinking water. If living near hotspot, leave car-keys in ignition at all times.

In general, never keep cash in the house, what is small to you might be big to others. Drive with windows up (I never do, but have been told many times to do so) and doors locked.

If puncture at night, just drive to nearest petrol station, a tyre will cost 10k.

Hi Priscilla,

You have already received some really great advice but coincidentally I wrote a post about dealing with emergency medical situations in Nairobi here: http://africaexpatwivesclub.com/2016/03 … n-nairobi/  (following recent experience).
It's a contentious issue because, since we rely solely on private healthcare here, you'll find that in emergency (or even more routine) situations medical bills can rack up and doctors' advice can vary dramatically. One gets the feeling in private clinics and hospitals, of being sent around various departments for costly and sometimes unnecessary tests and scans at a time when we are emotionally vulnerable, for no better reason than just to generate additional income for the hospital.
And this scenario by no means just relates to expats. Local Kenyans are regularly crippled by medical bills for private healthcare when a relative is taken ill. Our house help is currently faced with a 500,000/-  (US$5,000) bill following her father having been taken into ICU for 3 days following a stroke and a taxi driver we know called me last weekend because he doesn't know how to foot a 280,000/- (US$2,800) hospital bill from when his 91 year old grandmother went into hospital for 2 days. The only way that they can begin to deal with this is by ringing around all of their friends/family/colleagues to appeal for contributions - however small.
As has already been said already in this chat, medical insurance with contingency for medical evacuation back to your home country is an absolute must and overseas providers are definitely recommended.
There's more info about power cuts, water shortages, vaccinations etc here:
http://africaexpatwivesclub.com/2016/04 … st-africa/
Hope this helps!
Frances

'999 is never answered, 112 is better.'  Its best to have the direct number of your local police station, as you are far more likely to get a response!

Hello Frances.  Thanks for your piece on dealing with your daughters injury.  You didn't say which hospital you went to.  This information would have been valuable for other expats to know, so that they could pursue similar avenues.  We take our 8 year old grand daughter to Gertudes for non emergency appointments - its a children's hospital and more reasonable that Aga Khan, or Nairobi Hospital, which are outrageously expensive (unless you have insurance).

With regard to health insurance, I don't think its always practical, or affordable to buy from an overseas provider - not all expats are on large western salaries!  We are with AAR at the moment (but may well be changing).  They have the option of outpatients cover, so that you can claim for clinic visits, etc. 

I am a healthcare professional, so don't tend to get ripped off with unnecessary tests, but agree that these tend to be done, with the assumption that the patient and family will be unaware.

Regarding power outages and water shortages, these are a reality of life in Nairobi, it would seem.  Out here, in the sticks, we rarely get power outages and certainly no water rationing.  I think that living in Nairobi throws up quite a few issues that we don't experience in places like Nyeri.  Perhaps your advice could have included information about who you go to when the power, or water goes off.  When we lived in Nairobi, in 2004, we obtained the number of a manager with Kenya Power, who we called when the power went out.  It was helpful, as the outage was sometimes local and used to get fixed quickly - of course a small 'gratuity' had to be provided.

I realise, reading your blog, that there is quite a difference living as an expat, married to a 'local', especially when ones spouse knows a lot of people!

We did go to Gertrude's Garden hospital with our daughter (the previous case was Nairobi hospital) and the experience was a good one - but since then I've heard an absolute horror story about the same place involving wrong prognosis, unnecessary tests and differing advice from doctors causing massive stress and expense to the patient's parents - so experiences obviously differ.

As I mentioned in the article, we called our local GP clinic for advice on which consultant to meet at which hospital relating particularly to the situation we were in - which I think we were fortunate to be able to do. I've had experiences at Nairobi Hospital, Aga Khan and Gertrudes and overall, they have been good but largely because I received good advice at the outset, on which consultant to ask for.

Re: health insurance. Yes, an overseas policy is horribly expensive but I wanted to point out that many expats I know are not on large western salaries these days, but rather paid in local currency as a lump sum without historic 'benefits' covered such as housing, medical, school fees, so it increasingly falls to the individual to foot these bills. The reality is that generous expat 'packages' are a thing of the past, however, in the event of terminal illnesses or life threatening injuries in the family, you would certainly benefit from the choice of being repatriated if it were possible - so these hefty insurance cover options are still worth considering, even if you are paying for them yourself.

You are a healthcare professional so obviously know a lot more about this than I do.

Re: Power and Water shortages - yes, we do report these. KPLC are good at coming out to fix a problem (when you can get through) - though at the moment we have power outages at least x3 time per week. In the case of water shortages, when I go down to the local office then there doesn't appear to be anything anyone can do to fix the problem - it's just a case of wait it out and in the meantime, order a supply truck from a local borehole provider.

From our medical contacts, it would appear that in general you may well be subjected to all sorts of tests and possibly unnecessary procedures particularly if your insurance company will be billed.  Costs for basic items such as rubber gloves are 'bigged up'.  Misdiagnosis is not uncommon in Kenya, even in the top hospitals.   Having some medical knowledge helps.

Our last visit to Gertrudes resulted in a simple diagnosis if asthma.  They attempted to sell us a new volumiser at a rather inflated price and we decided to ignore the request for a follow-up assessment.

It is worth noting that an emergency admission to say, Nairobi Hospital, if you are NOT covered by medical insurance will require the payment of a 'full deposit', on admission which was around Ksh 75,000 in 2005, so insurance is definitely well worth considering.

Our worst experience was with an outfit called 'Mediheal' who have hospitals and clinics in several areas.  Our daughter (visiting from the UK) needed to be admitted overnight at their Nakuru branch.  We were billed for a variety of tests. one of these I refused to pay for as I was able to evidence that it hadn't been carried out.  I took the tests to be analysed, elsewhere and found out that the 'results' were absolutely meaningless and the one test that was absolutely essential, wasn't carried out at all. 

Re; power and water shortages:  A big difference.........In Nyeri, the power goes out maybe once every two or three weeks, for between 30 mins and a couple of hours.  Water........an unfailing supply, it would appear, with the added advantage of being safe to drink from the tap!  I am suddenly revisiting all the reasons why we got out of Nairobi, but I realise its not necessarily easy, if your work is based there.

I wasn't being rude about salaries. Nevertheless, expat salaries are still rather more generous than local ones, in my personal experience.