Marsabit County’s emergency healthcare services have come under scrutiny over an ageing ambulance fleet, non-operational oxygen plants and limited funds for maintenance, raising concerns about the reliability of medical services across the vast county.
The county government made the admission while appearing before the Senate Health Committee, chaired by Uasin Gishu Senator Jackson Mandago, to respond to questions on ambulance services, health infrastructure and the implementation of recommendations made after the committee assessed Marsabit County Referral Hospital.
In its response, the county said it had taken steps to improve emergency referrals and upgrade health facilities but continued to face major logistical and financial challenges.
“Marsabit County ambulance service delivery programme faces extreme logistical challenges,” the county said.
The response, signed by County Chief Officer for Medical Services Dr. Adan Al-amin, followed a request by the Senate for information on ambulance services, health infrastructure and action taken on issues raised during the committee’s visit.
The county has 26 ambulances serving patients through emergency response and referrals. Six have been fitted with GPS-based tracking systems, with work on the remaining vehicles still ongoing.
However, the county said rough roads and long distances had increased wear and tear on the vehicles, making repairs expensive and frequent.
“Severe wear and tear necessitate frequent and expensive replacements of specialized mechanical parts to keep the fleet active,” the response said.
The county also cited funding limitations, saying, “Compounding these infrastructure challenges is an aging ambulance fleet, alongside severe maintenance budgetary constraints.”
For the 2026-27 financial year, Marsabit has allocated Sh19 million for ambulance referral services. The county has also changed its free ambulance programme, limiting free services to maternal emergencies and mass casualties while other medical emergencies are handled through cost-sharing.
“Due to growing service need and aging ambulance fleet against budgetary constraints, the free ambulance programme model was restructured to a sustainable cost sharing model, where free ambulatory services are limited to maternal emergencies and mass casualties,” the county said.
Medical oxygen services have also emerged as a major concern. Of the five hospitals with oxygen-generation plants, only three have operational plants.
At Marsabit County Referral Hospital, a liquid oxygen plant bought for Sh26.55 million remains non-operational because of its high electricity demand.
“The equipment requires an exceptionally high startup current that overloads both the standard hospital supply and the standby generator, causing grid line wide power failures when activated.”
At Laisamis Sub-County Hospital, an oxygen plant has not been commissioned because the final 120 metres of copper armoured cable are yet to be installed.
Another plant at Moyale Sub-County Hospital requires a transformer, low-voltage board and generator before it can become operational.
The county said it was addressing the challenges affecting the oxygen infrastructure.
It also reported progress in implementing earlier recommendations at Marsabit County Referral Hospital. Repairs have been carried out on leaking roofs, broken ceilings, exposed wiring and missing taps, while unusable bathrooms in the female and surgical wards have been restored.
“The management confirms that Marsabit Referral Hospital leaking roofs, broken ceilings, exposed wiring and missing taps have been repaired and replaced.”
The county further told the committee that it had procured five ambulances since the Senate’s visit and established an emergency ambulance dispatch centre.
“The management has progressively planned for ambulances acquisition based on the County need and has procured five (5) ambulances after the Senate Health Committee visit for efficient deployment and monitoring and also meet the required international ambulance to population ratio.”