Abdulahi* lies in a hospital bed in Isiolo County, reliant on an oxygen machine that costs Sh700 an hour. It’s been five days, and counting, battling breathing complications while bills mount alarmingly. He needs specialised care to survive.

The 45‑year‑old works for Isiolo County government and holds a valid medical insurance card, at least on paper. Yet when he needs it most, it is worthless. Both public and private hospitals have refused to accept it, and as his condition deteriorates, his family is forced to pay in cash.