Growing cancer burden leaves trail of death, poverty

Wednesday, July 31st, 2019 00:00 |
Cancer scourge.

Ann Ndichu has lost count of the number of times she has been to India to seek treatment for cancer. The journey has taken a toll on her body and depleted her family’s finances.

Her sojourn to India started in 2015 after she was diagnosed with Cutaneous Lymphoma. In 2016, she was diagnosed with T-cell cancer.  She has spent more than Sh10 million and is among 5,000 Kenyans the National Cancer Institute (NCI) says travel abroad to seek treatment every year. 

At least 70 per cent of them are cancer patients. At the Kenyatta National Hospital between 50 to a 100 cancer patients seek treatment daily. Kenyans have resorted to loans, fund raising and disposing off property to finance treatment. Those who are too poor to pay wait for an uncertain future.

And it is here that the government is on the spot, with little funding going to seeking ways and means to help combat the disease, to smoothen the extremely rough edges that victims endure, some waiting for a slow death.

NCI says Kenyans spend between Sh7 billion and Sh10 billion to search for treatment.

“Some patients seek treatment privately. Therefore, we may not have adequate details but we are in the process of compiling the exact number,” says NCI board chair Ochiba Lukandu.

Diagnosis is costly as many patients move from one hospital to another before they know what ails them. For example, the cost for diagnostic procedures for cervical cancer in Kenya is estimated at Sh18,138 in a public hospital and Sh54, 839 in private hospitals.

That for diagnosing breast cancer is estimated at Sh40, 000 at a public hospital and up to Sh1.2 million in private hospitals, according to a 2018 peer reviewed journal on cost and affordability of Non-Communicable Diseases. 

“These costs are probably incurred through X-rays and tests before and in between treatment. That’s in addition to the consultation fees, which vary from hospital to hospital. 

There is the additional cost of doing blood count tests before every chemotherapy session,” says Dr David Makumi, Vice Chairman, Non-Communicable Diseases Alliance, Kenya.

 The cost of a blood count test, usually done a week before a chemotherapy session, is estimated at between Sh1000 - 2000. 

New, innovative methods for cancer treatment are even more expensive, raising fears that many people whose lives could have been saved die because of the prohibitive cost of drugs.

“The newer model of cancer treatment is expensive. For example, in Targeted Treatment, one of the new ways to treat breast cancer, a treatment for one year goes for around Sh5 million. How many Kenyans can afford that?” posed the immediate former Kenya Pharmaceutical Association (KPA) chairman Newton Siele, also a board member of Kenya Cancer Association.

Black market 

 Some enterprising Kenyans and doctors make a kill out of the cancer menace.

Dr Swarup Mishra, the parliamentary health committee vice chairperson says some doctors are taking advantage of patient’s desperation to make money.

“Cancer treatment has become get-rich-quick scheme for some doctors. Some are making as much as Sh200, 000 for referring a patient to India,” he said.

People Daily learnt that some Kenyans who travel to India for treatment have spawned a black market for cancer drugs. 

Dr Wairimu Mbogo, a pharmacist and head of Commercial and Operations for Meraky Healthcare Limited East Africa says the number of people selling drugs in small quantities is rising.

“These patients have realised that in India the medicines are cheaper, so some of them turn into connections for other patients where they accept to carry the burden of going to procure the medicines for them,” she says.

Even as Kenyans grapple with the high cost of treatment, the fact that 133 people are developing cancer everyday is cause for concern.

A number of medical practitioners believe a confluence of factors explains the rise in cancer cases.

Dr Adarsh Chandramoleswar, a clinical oncologist, is of the opinion that a sedentary lifestyle, junk food, smoking, poor diet, alcohol and exposure to environmental pollutants are to blame. 

“Previously, cancer cases were not recorded independently and would fall under ‘other diseases’, but these days they are recorded independently,” said Prof Jessie Githanga of the University of Nairobi, who specialises in Oncology and Pathology.

Githanga notes increased exposure to carcinogens such as pesticides and herbicides, industrial chemicals and asbestos plays a part. Pollution of air, water and ground by other carcinogens and afloxin, mainly found in cereals and nuts, could also explain the spike.

“It is possible that adulteration of foods may be linked to increased cases of cancer. Certain chemicals reportedly used such as the illegal adulteration of milk using formaldehyde to preserve it pose potential danger,” she explains.

Although Kenya loses 28,000 people each year to cancer no effort has been done to determine its economic burden. That means the government may not have evidence-based data to justify allocation of more funds.

“It is difficult to convince treasury to give us more money. We are exploring the option of partnering with Kenya Institute for Public Policy Research and Analysis (Kippra) to conduct research,” said Karagu.

In Kenya, cancer is the second leading cause of death. At least 70 per cent of people diagnosed with the cancer die because the diagnosis comes late.

 Cost of drugs

Karagu said the government is working towards improving the treatment outcome for cancer and has partnered with several pharmaceutical companies such as Novartis and Roche to lower the cost of drugs to make them more accessible.  

Part of the government’s game plan to fighting cancer is decentralising treatment to counties.

The government is in the process of procuring new radiotherapy machines for Moi Teaching and Referral Hospital by December this year to ease pressure on Kenyatta National Hospital.  

“We have set up chemotherapy units in Mombasa Nakuru, Garissa, Nyeri, Kisumu, Kakamega and Meru. Infrastructure is under construction in Machakos, Embu and Kisii to host these units. 

We also want to send medical pathologists to 15 counties to improve the ability to diagnose. We need to train more health records experts because there is a huge shortage,” he said.

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