No bed, no shelter: patients sleep outside referral hospitals as costs bite

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Patients travelling to major referral hospitals are sleeping outside facility grounds or crowding into makeshift shelters, unable to afford long stays during treatment.

The pressure is acute at Africa Gospel Church (AGC) Tenwek Hospital in Bomet County and Africa Inland Church (AIC) Kijabe Hospital, which draw patients from across Kenya and more than 12 African countries seeking surgery, rehabilitation and follow-up care, often requiring weeks or months away from home.

Tenwek serves an annual average of 220,000 outpatients and 20,000 inpatients and is a surgery referral centre for a region of more than 8.5 million people.

AIC Kijabe Hospital performs over 8,000 surgical procedures per year and sees over 130,000 outpatients annually.

Many families unable to afford lodging are forced to interrupt care, rely on informal shelters or travel while still recovering.

A study by the International Cancer Institute in Eldoret found that patients in sub-Saharan Africa who live far from specialist hospitals are more likely to present with advanced illness, receive inadequate treatment and face worse outcomes when accommodation near facilities is unavailable.

The same research concluded that the provision of accommodation close to hospitals can greatly improve compliance with treatment.

Faith Aid Kenya, a Christian nonprofit organisation, has been providing accommodation, meals and transport assistance to patients near both hospitals through its Mustard Seed House ministry, stepping in to fill a gap the health system has left unaddressed.

The organisation supported more than 6,000 patients and caregivers in 2025 and disbursed more than Sh18 million to assist patients who could not afford treatment at Tenwek Hospital.

The figures emerged as Faith Aid opened an expansion of its Mustard Seed House facility in Bomet, designed to increase capacity for families requiring shelter during treatment.

Faith Aid Co-Founder and Executive Director Jacob Fraher said families frequently arrived having exhausted their resources.

"We meet people every day who tell us they did not know where they would sleep or what they would eat," Fraher told guests at the opening ceremony.

Chief Executive Officer (CEO) Omega Kivaji said demand for support had continued to rise beyond what the ministry initially anticipated.

"Through Mustard Seed House, we have witnessed healing, hope and restored dignity. This expansion will allow us to reach more patients and families who need support during their medical journeys," Kivaji noted.

Orthopaedic surgeon and Faith Aid board member Dr Ryan Horazdovsky said accommodation support often determined whether patients completed treatment.

"I have seen patients arrive from great distances, often in severe pain and with nowhere else to turn," Horazdovsky told the gathering.

The expansion is phase one of a broader project, Faith Aid says will increase the number of families it can accommodate near Tenwek Hospital, where patients from across the region travel seeking surgery and specialised care unavailable closer to home.