Ambulance sirens pierce the night, sharp and urgent,with a commanding promise that help is on the way. In those moments, families surrender everything to the men in uniform: trust, hope, and the fragile belief that every second counts. But what if the race to save a life is quietly rerouted? What if, somewhere between the scene of the crisis and the hospital gate, care is exchanged for cash? In the shadows of Eastleigh’s fast growing and bustling business district, an unspoken system thrives. One where ambulances do not just respond to emergencies, they negotiate them.
“Kulola Apiah,” an Emergency Medical Technician with five years of experience, steps forward as a whistleblower in the Africa Uncensored series Voices of Darkness, In Episode 1 her steady voice reveals fractures in the foundation of emergency care. Behind the flashing lights and life-saving equipment lies a disturbing playbook: critically ill patients diverted not to the best equipped facilities, but to the highest bidders.
Screengrab of “KULOLA APIAH “whistleblower Voices in Darkness by Africa uncensored
“Tuko biashara,” she says, meaning “we are doing business”. In an interview with Africa Uncensored’s Elijah Kanyi, Kulola pulls back the curtain on a system where lives are monetized in real time. For every patient redirected, ambulance crews can earn up to KSh 50,000, quietly splitting between technician and driver. The transaction is simple, almost routine. Deliver the patient. Collect your cut. Move on to the next. “After I get to the hospital, they take the patient and I get my cut. The next client that comes, I will do the same thing with the same hospital so that I can get my cut.”
It does not end there. In covert meetings, some private facilities allegedly offer upfront tokens, small, deliberate incentives that transform EMTs into unofficial sales agents. The oath to save lives becomes negotiable. The destination becomes transactional. And for patients and their families, the cost is invisible, until it is not. Because in this silent detour, the question is no longer how fast you get help, but where that help is taking you, and why.
The pattern Kulola describes does not exist in isolation. It echoes painfully in another story already on record. In Fatal Detour, an investigative documentary by Africa Uncensored’s reporter William Moige, the same invisible hand appears to guide a different ambulance, carrying a different life toward a similar fate. Vickram’s mother, Esther Ulavu, recounts a journey that was supposed to save her son, but instead became a series of choices made without her consent. Her one-year-old boy, Baby Vickram King, had already been referred from Oloitokitok Level IV Hospital to Kenyatta National Hospital, the country’s premier referral facility equipped to handle critical pediatric emergencies.
Born on June 16, 2024, Vickram had been diagnosed with hypospadias, a congenital condition requiring corrective surgery. The procedure was performed, but complications followed. According to medical notes, he suffered a reaction to anesthesia. When he failed to regain consciousness, his condition was classified as pathological, critical, urgent, and requiring immediate intensive care.
Everything pointed to one destination, Kenyatta National Hospital. But somewhere along that route, the trajectory changed. Instead of heading to the national referral hospital, the ambulance diverted to Abyan Hospital Level III, a facility far less equipped to manage such a critical case. For Esther, the shift was abrupt, unexplained, and irreversible. The referral letter is still named Kenyatta National Hospital. The ambulance chose otherwise.
In that moment, Kulola’s words take on chilling clarity. What appears to be a single decision on the road may in fact be part of a larger coordinated system. A system where even the most vulnerable patients, a child fighting to wake up, can become part of a transaction.
Ambulance services, in principle, are the backbone of emergency care. They operate within a structured referral network, linking facilities, coordinating transfers, and responding through multiple call channels where services are actively marketed. At their best, they are the bridge between life and death. But Kulola describes how that bridge is sometimes manipulated.
In a typical transfer from Hospital A, the referring facility, to Hospital B, the intended referral, often a public or well equipped private hospital, the critical moment comes en route. It is here, she says, that an EMT may turn to the most emotionally invested relative and begin to plant doubt. “We have seen you have been referred to Kenyatta National Hospital, and huko kunakuanga na line kubwa (There is always a very long cue). Will your patient be able to survive the waiting period?” The family hesitates and pushes back ; “We’ve been advised this is the best place to go.” But the script is already in motion. “We have a good place where you can take your patient.” What follows is not medical advice. It is a pitch.
Instead of Kenyatta National Hospital, families are sold the idea of a faster, more attentive facility. ICU costs at the referral hospital are exaggerated. Waiting times are weaponized. Then comes the incentive, a carefully crafted alternative. “If you go to this hospital, you will have a lower down payment of about KSh 50,000. It is not congested. Your patient will get one on one interaction with the doctor.” In that moment of fear and urgency, desperation becomes currency.
Watch Voices in Darkness on YouTube by Africa Uncensored.
Kulola says it was not just the act of diversion that drove her to speak out, but what followed. Families would spend between KSh 1 to 2 million, only to realize too late that the promised care did not exist. The facilities, in many cases, were ill equipped to handle critical conditions. “You realize that people lose a lot of money. They do not get the quality of treatment they expected. They feel duped. But most victims are too overwhelmed, or they do not have someone to guide them.”
Behind the scenes, the economics are stark. “Tuko biashara.” Diverting a single patient earns an EMT up to KSh 25,000, nearly a month’s salary, while their official pay ranges between KSh 600 to 800 for a 12 hour shift. In one shift, an EMT may handle 5 to 10 critical cases. The incentive is clear. The system is vulnerable.
Regulation exists, at least on paper. The Kenya Council of Emergency Medical Technicians mandates professionalism and ethical conduct. The Kenya Medical Practitioners and Dentists Council has taken action in the past, shutting down 544 health facilities and revoking 454 licenses for non compliance in August 2025, and later issuing directives requiring registration of private ambulances and emergency personnel. But enforcement, as Kulola notes, remains inconsistent, often reduced to individual morality meeting opportunities.
In its Right of Reply to Africa Uncensored, KMPDC described Baby Vickram’s case as an ethical violation, confirming that both Abyan and Oloitokitok facilities are under investigation.Baby Vickram King did not survive. He died of a heart attack during treatment, leaving behind a grieving mother and a question that refuses to fade. Was the greed of the EMT and the operator worth her child’s life?
KMPDC’s Right of Reply to Africa Uncensored alleging to investigate the Baby Vikram diversion
In its response, Abyan Hospital distanced itself from any wrongdoing. Through its managing director, Abdiqani Noor Omar, the hospital stated that ongoing investigations have affected its operations. He maintained that patients are free to seek referrals if dissatisfied with services and dismissed the allegations as business rivalry, saying the issue is more political than factual.
Emergency care is built on trust, on the belief that every second and every decision is made in the patient’s best interest. But when that trust is weaponized for profit, the system begins to collapse. Sirens that once signaled hope begin to echo with deception.
In the fragile space between life and death, families are no longer choosing care. They are being sold an illusion. If the system remains unchecked, the next siren you hear may not be coming to save you, but to sell you.
Watch Voices of Darkness on YouTube by Africa Uncensored- https://youtu.be/4WYq2XHlx8Q
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