“We would place a baby on oxygen and suddenly realise the cylinder was empty,” recalls Lydia Mukami, a Kenya Registered Nurse and midwife at Mbagathi Teaching and Referral Hospital. “You’d start panicking, calling around, waiting, yet the baby’s condition could continue getting worse. Those moments were terrifying.”
Serving large informal settlements such as Kibera and Kawangware, Mbagathi Teaching and Referral Hospital receives a steady stream of emergency referrals, many arriving in critical condition. In these moments, oxygen is often the first and most vital intervention, especially for newborns struggling to breathe, children with severe pneumonia, and mothers in distress during childbirth. Early oxygen therapy is essential for stabilising patients and preventing avoidable deaths.
“Most of the patients we receive are emergencies,” Lydia explains. “Oxygen is usually the first thing we reach for, especially for babies and mothers in labour. But for a long time, our oxygen supply depended on heavy cylinders that could run out without warning. You could lose precious minutes, and in emergencies, minutes cost lives.”
The risks were not only clinical, but physical.
“There were times when cylinders fell and nearly exploded,” nurses recall. “There were times we had to evacuate patients, including those already on oxygen. It was chaotic and unsafe.”
As part of Kenya’s national effort to strengthen oxygen systems and emergency preparedness through the C19RM oxygen project, Mbagathi Teaching and Referral Hospital upgraded its infrastructure to a centrally managed liquid oxygen system. Oxygen is now piped directly to patients’ bedsides across maternity, the Newborn Unit, emergency theatre, casualty, and general wards, supported by automated monitoring and safety controls that ensure a continuous, reliable supply.
“This is not just about having oxygen, it’s about having a system that works around the clock,” explains Maureen Kidiwa, the hospital’s Head Biomedical Engineer. “Through the C19RM investment, we now have an automatic manifold, bulk liquid oxygen storage, and real-time monitoring. When oxygen levels begin to drop, alarms alert us early, allowing us to intervene before patient care is affected.”
At the centre of this system is a large-capacity cryogenic liquid oxygen tank connected to more than 180 functional outlets across the hospital. Even during power outages or periods of high demand, oxygen flow remains uninterrupted. Maureen and her team continuously monitor pressure, usage, and outlet performance to ensure oxygen is always available where it is needed most.
“Our role is to remove uncertainty,” Maureen adds. “Clinicians should never have to ask whether oxygen is available. The system is designed to make sure it always is.”
“Oxygen is now right there on the wall, next to the patient,” Lydia says. “Care has become faster, safer, and more efficient. We no longer waste time chasing cylinders. We focus on saving lives.”
Nowhere is the impact more profound than in the Newborn Unit.
As a referral facility, Mbagathi receives babies born in severe distress, newborns with low Apgar scores – babies who have inhaled fluid during delivery, and premature infants whose lungs are not yet strong enough to breathe on their own. Many babies weighing under 1.7 kilograms require continuous oxygen to survive their first days of life.
“In the past, delays could cost a baby their life,” says Quinta Kingi, a Nurse in the Newborn Unit. “Today, when a baby needs oxygen, it is available immediately. That single change has transformed our outcomes.”
In just one year, more than 620 newborn lives have been saved, 493 babies delivered at Mbagathi Teaching and Referral Hospital, and 127 referred from nearby health centres. These outcomes reflect the life-saving impact of timely, reliable oxygen for critically ill newborns and demonstrate how strengthened systems translate directly into survival.
“We see babies stabilise faster. We see mothers go home with their children,” Quinta adds. “Those are moments you never forget.”
Beyond improved outcomes, the new oxygen system has eliminated significant safety risks. Wall-mounted outlets have replaced unstable cylinders, freeing up space, reducing hazards, and allowing multiple patients to be safely supported from a single bed station.
About the C19RM Oxygen Project
The COVID-19 Response Mechanism (C19RM) is a Global Fund–supported initiative strengthening Kenya’s oxygen systems for emergency response and everyday care. Implemented with the Ministry of Health, county governments, and Amref Health Africa, the project has delivered over 1.2 million kilograms of medical oxygen, installed bulk liquid oxygen tanks and automatic manifolds, and expanded piped oxygen systems across hundreds of health facilities nationwide.
Edna Mosiara – Ag Communications Manager