For decades, seeking critical care in Lamu meant preparing for a journey, not within the hospital, but away from it.
When patients couldn’t get help at King Fahd, the only hope lay across the water and then overland, to Mombasa or Malindi. That trip could stretch 7 hours or more. For many, the delay proved fatal.
“We didn’t even have a budget for an oxygen plant,” recalled Member of Parliament Ruweida Mohamed at the July 2025 launch of new infrastructure at King Fahd County Referral Hospital.
“Patients were dying on the road trying to get to Mombasa because of oxygen services.”
Lamu’s unforgiving geography, with its sea barrier and unreliable road links, turned delays into deadly gambles, especially for those needing oxygen or intensive care.
Today, however, a quiet revolution is unfolding, one where preparedness is triumphing over panic.
About King Fahd County Referral Hospital
Established in the 1980s with a generous grant from the Kingdom of Saudi Arabia, King Fahd County Referral Hospital is the largest public health facility in Lamu County.
Located on Lamu Island, it serves as the region’s sole referral hospital, playing a crucial role in providing essential secondary healthcare services, including maternity care, emergency services, and specialized treatments.
The hospital serves not only the island community but also the vast and often hard-to-reach populations across the mainland, navigating the unique logistical challenges presented by Lamu’s diverse terrain.
Yet, for all its critical importance and the vast area it was meant to serve, King Fahd Hospital struggled for a long period to fulfill its mandate.
From a Referral Hospital in Name Only
By 2022, the hospital was in crisis.
Stripped of its Level 4 status, it functioned more as a struggling outpatient clinic than a referral center.
The lab was defunct, unable to run even basic tests, such as liver panels or blood gases.
Patients were referred for conditions that could have been treated locally if the necessary equipment had been available.
“It got to a time it didn’t qualify as a Level 4 in 2022,” said Dr. Mbarak Bahjaj, Lamu County’s Executive Committee Member for Health, during the launch. “There was no single equipment working in the laboratory.”
“Mostly we used to refer to Malindi for the CT scan and Mombasa for cases that needed more tests,” added Dr. Nuru Salim, Superintendent at King Fahd.
These forced journeys often meant lost critical hours traveling back and forth to access medical services..
Infrastructure That Touches Lives
That grim reality began to change on July 3, 2025.
With support from Amref Health Africa and other partners, the county government launched four critical upgrades at the hospital, each addressing an urgent, long-standing need:
- A new oxygen plant, ensuring a continuous, self-reliant oxygen supply
- A five-bed Intensive Care Unit (ICU), including dedicated beds for neonates and pediatric patients
- A CT scan machine, acquired under the National Equipment Support Program (NESP), the first ever in Lamu
- A private wing, designed to generate hospital-retained revenue to fund essential services
During the launch, Yasmini, a lifelong resident of Lamu, stood among the crowd, quietly pleased by what she described as a long-overdue step forward.
She had never personally been evacuated for treatment, but she didn’t need firsthand experience to understand what it meant when someone fell seriously ill in Lamu.
Over the years, she had seen the worry in neighbours’ faces, heard the urgency in relatives’ voices, and lived with the collective awareness that local care often wasn’t enough.
“The trip was never simple,” she explained.
“First, you go by boat to Mokowe. Then it’s by road, past Witu, Garsen, to Malindi or Mombasa. It takes hours, and anything can go wrong.”
She welcomed the oxygen plant and ICU not just as infrastructure upgrades, but as a lifeline for her community.
“Now, at least people can be treated here. They won’t have to risk that journey anymore.”
This new oxygen plant, in particular, was a game-changer.
Amref Health Africa played a critical technical role in its realization, specifically in the installation of the oxygen piping and manifold system.
This pivotal involvement shifted the hospital from a costly, unreliable cylinder-based setup to a streamlined infrastructure that supports real-time response for emergencies.
“Eighty percent of Lamu referrals to Mombasa were because of ICU,” said Dr. Bahjaj.
“At least now we have four hospital beds for adults and one for children, and one more for infants, making King Fahd Hospital able to take care of serious cases.”
For Dr. Nuru, whose office now overlooks the oxygen plant, the impact is personal.
“This is the most amazing thing we’ve had to have a continuous supply of oxygen just outside my office. Having this is going to improve the quality of service.”
When a System Depended on the Sea
Before the plant, King Fahd’s oxygen supply relied on 40 metal cylinders filled in Mombasa and ferried across the sea.
Panic would set in as the count dropped and access to refilling routes faltered.
“We used to use them up till 35 were empty, then rush to Mombasa to fill them up quickly,” Dr. Bahjaj explained.
“And last year, Gamba Road spoiled, and we couldn’t take the oxygen tanks to Mombasa for a refill.”
The cost of that dependency wasn’t only measured in lives lost, but in strained public budgets.
“An estimated cost for transporting 10 oxygen cylinders from here to Mombasa and back would be around 26,000 shillings,” said Dr. Nuru.
Even moving a single cylinder was a gamble.
“There were times when the roads were broken, or flooding happened,” she said. “We had to transport empty and filled cylinders sometimes, just one at a time.”
The highest oxygen demand came from the most vulnerable: newborns and children.
During the rainy season, needs spiked across the general wards and surgical theaters.
“The highest consumption would be in the Newborn Unit (NBU) and Pediatrics. That’s the highest,” Dr. Nuru explained.
“For the general wards, it’s usually seasonal. We get surges in the rainy season and sometimes in the theatre, depending on the cases.”
Beyond these predictable surges, a deeper vulnerability underlies the need for consistent oxygen.
Dr. Nuru explained that “Most patients are already immunocompromised,” especially in a region where baseline health challenges can be prevalent.
This means that even “a small infection can lead to severe complications,” rapidly escalating to a need for oxygen therapy, where a robust supply becomes a matter of life and death.
Diagnosing in Place, Building for the Future
The arrival of a CT scanner is also a game-changer. No longer must patients endure long, dangerous referrals for diagnosis.
“The first CT scan has come to Lamu under that program,” said Dr. Bahjaj.
The machine doesn’t just shorten the diagnostic timeline; it affirms that quality care can now happen right here in Lamu.
The hospital’s new private wing is equally vital for sustainability.
In an era of stretched public budgets, the revenue generated will remain within King Fahd, empowering the hospital to fund repairs, restock essential supplies, and even incentivize staff.
“It’s of importance that a hospital be able to generate its revenue for sustenance,” Dr. Bahjaj affirmed.
“The private ward will generate revenue. 100% is going to be retained by the hospital.”
The hospital has also taken a crucial step towards greater self-reliance: acquiring its generator.
This ensures a stable and uninterrupted power supply, safeguarding critical services, especially those dependent on the new oxygen plant and ICU.
And the work isn’t stopping at equipment. Lamu is actively recruiting to fill the human resource gaps that have long undermined care delivery.
“We’re trying to have more human resources,” said Dr. Nuru. “That’s part of the criteria to be a teaching hospital — not just infrastructure.”
“Right now, we are doing interviews, hiring additional nurses, pharmacists, lab techs, and more. The county is working on it.”
A New Kind of Referral
What Lamu once referred out wasn’t just patients, it was hope, responsibility, and too often, grief. That era is ending.
With locally generated oxygen, a fully operational ICU, and an on-site CT scan, King Fahd Hospital has transformed from a symbol of geographic hardship into a testament to resilience and strategic investment.
It is no longer a layover for the critically ill, but a destination for life itself.
For the people of Lamu, this new chapter means not just better care, but the dignity of healing, close to home.
