Herdsboy who rose to become CEO of region’s referral hospital


Originally Published: April 14, 2012

Richard Leresian Lesiyampe’s life has taken him through an interesting, even adventurous journey.

From a seminary to a classroom as a teacher; from provincial administration to banking, and then to wildlife management.

Today, Mr Lesiyampe is the chief executive of the largest referral hospital in East and Central Africa — Kenyatta National Hospital.

The first KNH chief executive who is not a health professional, it was a baptism of fire – quite literally – when he got into the job.

Two months into his appointment, straight from his previous job as finance director at the Kenya Wildlife Service, the Sinai fire tragedy happened.

The incident, in which more than 100 people perished as they scooped fuel from a sewer, had the potential to turn into a public relations disaster for the referral hospital. There was chaos at the hospital’s emergency wing.

“In a matter of hours I was thrust into the limelight addressing press conferences, giving media updates. It all went pretty fast,” he recalls reflectively. “But, thankfully, I had people around with whom I shared the purpose of putting lives and public interests first.”

That fateful Monday morning, Kenyatta National Hospital received 112 severely burnt patients in an hour.

Unknown to him, the Sinai fire was just the first of a series of unfortunate events that were to test his resolve as the chief executive officer of a hospital with little public sympathy and loads of expectations.

And this after he had spent the first couple of months dealing with pockets of resistance to his appointment.

“Resistance was expected, the lack of it would have been abnormal,” he says, adjusting himself in the conference chair. He takes a pose, perhaps reflecting on battles past or maybe counting the little victories the hospital has had over the past nine months of his tenure.

He clears his throat, and asks for a glass of water, then reclines in his seat once again. For a few seconds, he retreats into himself then decides to reveal the thoughts running through his mind.

“I never really had a frame in which I wanted the picture of my life to fit. Ambition was a day-to-day affair. As a toddler, all I wanted to do was grow big enough to be allowed to look after kids.

When this came to pass, I dreamt of looking after the goats and sheep. Then as I grew into my late teens, the sole ambition, as that of my age mates, was to be allowed to look after the old man’s cattle,” he says.

Some men of a certain age, and of certain achievement are known to exaggerate the grandness of the dreams they had as children. Others don’t. Mr Lesiyampe is one of those who don’t.

As he grew older in idyll Samburu, education rubbed off on him. His perceptions of the world changed. Herding cattle stopped being exciting and, after his ‘O’ levels and much more interaction with the world, he changed his world view.

“I come from a tribe of warriors. Naturally, I was inclined to join the military,” he says.

So, even after being among the top students in his district in national examinations, he made up his mind to join the military.

“After all,” he says, “at that time every village in Samburu had at least one person in the army. I thought it was my turn to be the recruit.”

But this was not to be as young Lesiyampe was a good pupil. From primary school to secondary school he had shown exemplary academic ability.

He says he is not particularly clever, but was just lucky to know the answers to the questions in the exams.

So, when he passed his exams, extended family members put their heads together and decided that he wasn’t going to the military. He was to further his education, and the military remained a dream for the moran.

That was in the mid 1980s, when the institution he currently runs was one of the best hospitals in Africa.

Those who have a history with it say at the time the hospital staff handled referrals from as far as South Africa. Drug stockouts, congestion, double-bed occupancy, industrial strikes never seemed a possibility. Over the years, all this have come to pass.

And even in his young tenure, the 48- year old has had his fair share of crises to manage.

“We know the public confidence in the hospital has waned over the years. We know that we have a long way to go but we are determined to make this hospital a choice of destination for all Kenyans,” he says.

Lesiyampe believes a lot of the hospital’s woes are directly related to the huge numbers of patients it receives.

“On paper we are only supposed to deal with referral cases. But our doctors do everything. They handle cases that, in a fully functioning system, are supposed to be handled by other levels of care. Things like diarrhoea, malaria, colds are supposed to be treated at dispensaries, district hospitals and such levels,” he says.

“But we see these cases. We cannot turn patients away because they have not been referred to Kenyatta.”

The father of six talks about KNH the way a father would talk about an under-achieving son; he sees the potential in him, but only wishes the child could see himself through his father’s eyes.

One doesn’t need to do much to coax a laugh off him. A trait that may have developed to disarm his audiences during his years as a human resources specialist at various companies, including the Co-operative Bank of Kenya, and at the Kenya Wildlife Service.

“We have the best brains here. All of us should be at pains whenever friends and family seek services outside the country. Why go to the UK for treatment, be operated on by a Kenyan surgeon, attended to by a Kenyan nurse and only come back for recuperation? We can do all these things, but only if we believe,” he says.

And belief is something he holds close to his heart.

“I walked into an institution that had been in operation for decades. There was a certain way that things were done. I had to make those I found here believe that I came with some sort of solution and that it would work,” he says.

It hasn’t been an easy walk.

“I am grateful that I have a board that stands by me and a receptive staff. All we need to do now is to provide an environment in which the good people at Kenyatta will thrive,” he says.

In the cutthroat world of health care provision, he knows some of his competitors have a head start in terms of public goodwill and perceptions.

“Each time someone tells me he didn’t come to KNH because his doctor is at another private hospital, I smile. Because he doesn’t know that probably before the doctor made time for him at his premier clinic, he was at KNH attending to patients,” he says.

Mr Lesiyampe adds that he is well aware that the journey to improving services at the hospital will be a long one.

“We acknowledge our inadequacies. We know we are far from being where we ought to be. But we are inspired to walk it,” he says.

Behind the veneer of confidence in his staff and board lies a secret fear. He still hasn’t got used to the idea that, as he runs the hospital, lives will continue to be lost under his watch.

“I cannot bear the loss of life, particularly to things that can be prevented like the unavailability of a bed at the ICU. To this date this remains my biggest fear,” he says. “But that pain is numbed somewhat by the knowledge that for every such case, there is another one of success.”

Away from his office at the administration block, there is a general feeling among his staff that there is definitely a shift in their work ethic.

But the direction of the shift is not yet clear-cut.

“It takes between three and five years for an organisation to change to an enabling culture. We will need time. But some improvements can already be seen,” he says. “I have no other option than to do my best. I have a performance contract, which I cannot afford to breach.”

Mr Lesiyampe is grounded in belief but only time will tell whether he has what it takes to move KNH from the rut in which it has been over the past two decades.

“We will make mistakes. Errors. Omissions. The important thing is that we have the desire and the will to provide the best service to our patients and keep them happy and healthy. Forgive us when we do wrong, and celebrate us when we do right,” he says.


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