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Scams, State of Healthcare and Bureaucracy in Kenya

M.P. Shah Hospital scam & inaccurately dangerous test results.

Scams, State of Healthcare and Bureaucracy in Kenya - M.P. Shah Hospital scam & inaccurately dangerous test results.
Abandoned building, Nairobi, Kenya

Intro

During my recent trip to Kenya I needed to do some blood and urine tests while I was in Nairobi. The following is an example of a "real life" scam that I was involved in, that Westerners visiting Kenya should be aware of. It also shows the state of some of the healthcare clinics in that country.

Please make sure to check the important update at the end of this post.

The Setup

This took place at the M.P. Shah Hospital, located in Nairobi Kenya. I am pretty bad with addresses in Nairobi. To the best of my knowledge, I think it was situated at the Shivachi Road. That place had quite a well established Google Maps presence, which in itself may be quite deceiving for people travelling from the West that tend to rely on Google.

The reception area of that place looked quite decent for a Western style walk-in clinic. It had a modern ticket dispenser, a clean waiting area, and the staff promptly helping visitors. (I was with a girl friend at the time that also needed the same tests. She was from Kenya.) So we took a ticket and waited for our turn. It didn't take long before our number was called out by an automated voice with an American accent.

Things started to deviate from the way I was expecting them to go when we approached the counter. Maybe because of the COVID-19 plexiglass, or because of the Kenyan English accent, it was very hard for me to follow what the person was saying. Luckily, my friend, being from Kenya, took charge of communication, and before long we were told to pay roughly $20 USD to proceed.

The first thing that was interesting to me, was that all payments for the services were expected up-front. OK. I can probably understand it for Kenya. I've been told before that there was some fraud and corruption. So it was understandable.

M-Pesa Payment System

As a side note, I need to point out that most payments in Kenya (and now in a good chunk of Eastern Africa) are made with some very unique system, called M-Pesa. It will be very unusual to anyone coming from another country. It works as a sort of a pre-paid debit card, when all transactions are done via text messages (or SMS.) To pay for most services, say, at a grocery store, at a restaurant, or even for an Uber, you will need to ask for their phone number and their M-Pesa ID. After that you would use a special M-Pesa app on your smartphone to send them the payment, which the recipient will be notified of via a text message.

It is a unique and interesting system, especially by the way how widely it was adapted in Kenya. During my visit, I could hardly find any store or service that did not accept it. So that was very convenient.

The Scam

After the initial payment with M-Pesa we were ushered in. Note that at this point, the inside of the clinic did not look like anything Western, as its façade did. It was a hallway with connecting maze of rooms. We were escorted into one such busy room with several dividers. Behind one was a lady at a computer, that took our printed receipt and typed something into her PC. I think she confirmed the procedures that we wanted done and told us to go back to the cashier. Hah!?

(I guess that was the consultation. I am still not very sure why we needed to go to her.)

At the cashier, or the same counter we were just in some 5 minutes ago, we were told to pay for the procedures. That took me somewhat by surprise because we were just there, explaining what we wanted. And now we had to go through this again.

But OK. We were still game.

This time though the charges were somewhat steeper. We were told to pay roughly $158 USD for each of us. We did so, again using M-Pesa, after which we were lead into the same shabby hallway with connecting rooms, where staff were also wheeling around us, what looked like a sick person on a gurney.

Now though we went into a small room packed with medical equipment where the actual procedure should have taken place. Again, I have to point out that the entire décor of that room was a total opposite of how the front of the building looked like.

In that small room, a guy in scrubs looked at a printout that we were handed by the front desk/cashier and was somewhat confused. Again, my lack of good comprehension of the Kenyan accent wasn't helping, but the way my friend explained it, the guy was telling us that they charged us for the wrong procedure, that was more expensive.

I remember that I was quite flabbergasted at that point. And we both were saying, "OK, can we correct that?" The guy in scrubs assured us that everything will be taken care of. I think at some point he even left the room and the first lady from a cubicle with a computer came in and told us that it was her mistake and that they will correct it.

OK. Good deal, so far.

We did our blood tests, which by itself, I'm not gonna lie, were quite unusual for anyone familiar with the Western healthcare system. One by one, we were told to sit on a stool, in the same small room, extend our arm out and roll up our sleeve. After which the guy in scrubs used several plastic vials to draw our blood. Luckily they were one-time-use and sealed. So that was a relief.

Then we were told to go into an adjacent bathroom to fill in the urine test cup.

And then we were done.

Before leaving the clinic though, we stopped at the same front desk to adjust our charges. My understanding back then was that they will simply send what we have overpaid back to us via M-Pesa, as the whole process literally takes seconds.

The Implementation of the Scam

Well, in reality, that is not how they wanted to handle it. And that is when the scam really began to unfold. They told us that their system cannot do partial refunds and that instead we need to make a full payment for the whole procedure again (with the correct amount), and only then they will refund our first incorrect payment.

So in other words, picture that the first charge was this. (I'm giving you made-up amounts, as we weren't given a final receipt for this):

  • Procedure A = $36.
  • Procedure B = $85. (This one was an "incorrect" one, that they told us they overcharged us for.)
  • Procedure C = $37.
  • -----------
  • Total: $158

And then we were told, that this is how it should've been. See that large charge is not there anymore:

  • Procedure A = $36.
  • Procedure B = $18.
  • Procedure C = $37.
  • -----------
  • Total: $91

So in other words, to comply with their system, we needed to pay $91-times-two (for two people), after which they will refund us back $158-times-two (that we paid earlier).

We were already committed. So there was no way back. We made that second payment of $91 x 2.

At that point I was sure that they will use their system to send us the $316 back (or $158 x 2) right away. But that is not what we were told. We were told that it will take a couple of days to process our refund.

Back then we had other plans in mind, which were much more fun than wasting time on red-tape at that clinic, so we were very glad to leave.

Scam Continued - Collecting the Refund

Having forgotten about previous bad experience at that clinic, we were reminded about it by a missed phone call. (I should give credit here to whoever had a decency to call us.) After my friend called them back to confirm, they told her that we needed to come in to collect our refund. Again, it wasn't clear to me why we needed to go there in person as the transaction was done electronically.

Still we had to go there again.

To make long story short, the process of getting anyone to even listen to us was more than arduous. Just as a quick recap: we first had to wait at the front desk, then explain why we want a refund. (Mind you, when we left the clinic at that first day, they did not give us a receipt or anything that said that we were owed any money back. So we had to literally tell some new person at the front desk why we were even there.)

Then we had to go to some adjacent building. Wait in another line. This time it had none of the Western ticket dispensing system, and we had to mingle with a bunch of other confused people waiting alongside us. There was no order, or anything to warrant good customer service. Every customer was there for themselves.

Eventually, two desk-people later, we were actually told to go back to the same front desk/cashier. Then they walked us to the previous guy that we just came from. I kid you not. I thought that this kinda sh*t happens only in bad comedies.

At some point, my friend and I were so exhausted and so ready to leave.

The question though remains, did we get our refund?

The answer is yes and no. What we were eventually told at the front desk - which was, by the way, the same person that we originally dealt with when we came in that second day - was that because of the mistake in procedure B (see my breakdown above) they will refund only that amount and nothing else.

In other words, we got back only $85 x 2, instead of $158 x 2.

Note that it's not a lot of money for one person, but if done often enough could be a good income for the scammer.

At that stage in the game we were utterly exhausted to argue with them, and just looking at my friend's face, I knew that the best thing to do was to leave and to forget about that clinic. Which we did.

Conclusion

Now when I look at what happened with a clear head, I can see the anatomy of the scam.

I would assume that they don't do this to everyone. A Westerner is easy to spot and is probably a good mark.

At first they create confusion. They did it quite well by ushering us into different rooms. The second part is not to leave any paperwork trail. Remember, we left with no receipt. Third, delay and hope that the victim doesn't come back to collect. Fourth, if they do come back, create more confusion, and if the person follows along issue just a partial refund.

I don't know what would happen if we objected to the final stage. I really don't want to know, as that money is not worth dealing with Kenyan security at that clinic.

I just hope that this story will be a lesson and a guide to anyone traveling to Nairobi Kenya, especially from a Western country.

The right thing to do would've been to read every invoice and ask questions before making any payments, as refunds are not an easy option. Or, better still, avoid dealing with that clinic, if you can.

Afterward

You know, one funny thing that I noticed, that actually prompted me to write this blog post. When we were leaving their front desk/cashier, after having been put through the ringer with the refund, I noticed this Western-style sign on their wall in the front waiting area. It really amazed me, so I took a picture:

M.P. Shah Hospital - We Value Your Feedback
A sign requesting feedback for their service, and linking to the mpshahhosp.org website.

How neat, hah? They care 😉

I think I'm gonna tweet at them.

Important Update

I'm posting this update several months after this blog post was written. I'm doing it to let you know about another dangerous discovery that you may want to know.

When my friend and I received our test results from this clinic in October 2020 they were all negative. But those results were not accurate. I repeat, our test results that we received from this clinic were not correct!

I found it out when I re-tested myself less than a month later after I returned to the United States.

So please be aware of this very unfortunate fact. It also seems like this lack of test accuracy is the same in other health clinics in Kenya. When I notified my friend about this discrepancy she tried to re-test herself in other clinics in Nairobi, and also received the same negative results. (Again, my results from several tests done in US proved that I was positive and hers were negative.) I am still truly shocked by this, but I'm just reporting what I see here.

This is very sad, especially considering the fact that many people in Kenya could live with misdiagnosed sexually transmitted diseases.

Unfortunately I don't know which clinics in Kenya I would recommend instead. If you can't leave Kenya, I would use some online Western service (like "Let's Get Checked") to get your results. It's somewhat limited, but may still work. You will need to use an express service, like the one from FedEx, to mail your blood or urine samples back to their lab in the United States or in the Western Europe.

Good luck!

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