April 2017 Standardnewspaper;Cancer patients bore the brunt of the stalemate pitting medics against the Government in their push for better pay and working conditions.
Many were forced to turn to private hospitals for treatment – some of them seeking help after defaulting on treatment due to closure of public health facilities.
Others just headed straight to comparatively cheaper facilities to seek treatment. One of the health facilities that took in a majority of the patients was Texas Cancer Centre. It took in most of the patients that were on cancer treatment at the Kenyatta National Hospital (KNH) during the three-month strike by Kenyan medics. But for some it was a little too late.
Mbuya Odhiambo, 46, passed on a few weeks after the strike had been called off. He had arrived at the hospital with advanced cancer of the throat. He had been at the hospital since March 6 after being referred from another private health facility in Nairobi’s Kawangware Area.
Odhiambo was at stage three when he checked in at Texas Cancer Centre. The late discovery cost him his life. He now makes part of the statistics of cancer which is now Kenya’s third leading cause of death annually.
In 2014, one in every 14 deaths was caused by cancer according to the Kenya National Bureau of Statistics.
Dr Catherine Nyongesa who heads Texax Cancer Centre says had he sought treatment earlier, probably things would have been different.
“The problem had advanced that the best option for him would have been radiotherapy,” says Dr Nyongesa. The National Cancer Registry notes that four out of five cases of cancer are diagnosed at late stages. which makes them difficult to manage.
Odhiambo, who lived in Kangemi, started feeling unwell last year and his situation kept worsening. He developed chest problems which forced him to seek traditional remedy from his rural home in Seme, Kisumu County.
The employee of a leading supermarket chain in Nairobi had also been bogged down with family issues which saw him separate with his wife. She left with their three children.
His sister Florence Adhiambo says that Odhiambo lived alone and as the ailment progressed without letting up, he sought treatment from the private hospital as there were no doctors in public health facilities; doctors went on strike for three months beginning December last year.
Adhiambo who had to travel from Eldoret to take care of her brother states, “My brother would have been referred to Kenyatta National Hospital but since the doctors there were also on strike he had to come to Texas which was the next cheapest option for us.”
Majority of Kenyans are diagnosed with cancer at advanced stages due to a raft of factors ranging from lack of awareness to lack of diagnostic equipment for some forms of cancer. The government says it has tried to solve this by equipping hospitals in the counties through the Managed Equipment Services that has procured MRI machines for some of the health facilities.
Dr Joseph Kibachio who heads the Non-Communicable Diseases Division at the Ministry of Health says that the problem does not lie in diagnosis but in the health-seeking behavior of Kenyans.
“The problem is not the testing capacity in our hospitals but negligence which could be due to lack of information and awareness,” says Kibachio.
Kibachio also says that the assumption that it is expensive to test for cancer is another hindrance in the fight against the scourge.
He states, “For instance, to test for prostate cancer costs only Sh300 but those who are not aware may argue that it is very expensive and only seek for treatment when it is in the advanced stages.”
And the Texas Cancer Centre has seen increased numbers of patients since it remains a relatively cheaper option compared to other private hospitals.
Dr Nyongesa notes that in December last year when the strike started, the numbers at the facility did not rise immediately as people thought the strike would just last a few days.
“By the second month – January – we saw an influx which led to doubling of the numbers which we usually handle. A number of them had defaulted in treatment thus making their cases even complex,” says Dr Nyongesa.
In the first two months, the numbers seeking services at the centre rose from 200 to 500 and this has come with its own challenges as she explains.
Key among them is that most patients cannot pay yet the facility has an obligation to offer services. This led to strained facilities like the laboratory and beds.
Dr Nyongesa adds, “Children who are being treated for cancer often need blood and this can be expensive for the patients; with more patients, more supplies are required and with these numbers our team has to go beyond the call of duty.”
The problem is compounded by payment of medical fees, Adhiambo explains. Patients who are covered under the National Hospital Insurance Fund (NHIF) say that the public health insurer can only pay for 20 sessions of radiotheraphy.
“My brother needed 25 days and we were not sure where the funds would come from. We just hoped that he would get well and worried less about where the funds would come from,” she prays.
Initially, NHIF would pay full radiotherapy and chemotherapy sessions but changed tact and started paying for some sessions. However, NHIF counters that it deals with members on a case to case basis and does not fix the number of sessions a patient can receive.
Strain on facilities
Geoffrey Mwangi, the NHIF chief executive officer says safeguards have been put in place to guard the payment system, arguing that if left open, hospitals would use the window to fleece the system.
“If we just leave it open, unscrupulous medical facilities will keep quoting maximum number of sessions that are needed even if that is not the case and that is why we have to work it out and see the average,” says Mwangi.
And the insurance fund can only cover that far and not more. For instance, Odhiambo needed to have a food pipe fixed in his oesophagus as the cheapest option that would allow him eat.
The cost of fixing the pipe is Sh38,000 and was done at a mission hospital here in Nairobi, a cost that he had to bear on his own.
Nyongesa says that with such a strain on the facility, well-wishers came in handy including doctors some of who have been offering free or subsidised services to ease the pressure.
“I must also say that families have also been very supportive to the patients and us, as they bring some of the essentials to help their relatives,” says Dr Nyongesa.