How scourge of exploitation compounds cancer menace
Cancer patients are facing a lot of exploitation during diagnosis, treatment and management of the disease, experts have said.
In pursuit for cure, patients have fallen victim to unscrupulous people who lure them with the promise to alleviate their suffering.
Doctors have for instance been accused of colluding with hospitals in India — a preferred medical tourism destination for non-communicable diseases — to give referrals in return for kickbacks.
The chairperson of Kenya Network of Cancer Organisations (Kenco) Catherine Wachira says some doctors are cutting deals with Indian hospitals to refer patients to the Asian country even when the disease can be treat locally.
“It puts to question the integrity of doctors that engage in such activities. We are urging professional and regulatory bodies to take necessary action against such exploitative doctors,” she told People Daily in an interview.
Another avenue for exploitation of cancer patients is the cost of medical procedures and other services.
While there is a clear mechanism for pricing of various health services under the Medical Practitioners and Dentist Board Act, 2016, there are huge variations in costs in various hospitals due to poor enforcement of the law.
The Act, for instance, sets a minimum cost for Chemotherapy – IV treatment at Sh6,000 and a maximum at Sh12,000.
“You may find variations of even close to half a million shillings between the prices of the service in various hospitals,” says David Makumi, vice chairperson of Non Communicable Diseases Alliance Kenya.
Cancer patients are also under the mercy of herbalists and the supplements industry who make false promises of cure to desperate patients.
“Supplements industry in Kenya is poorly regulated with many operating as pyramid schemes and make false claims about their ability to cure diseases,” says Dr Ezra Omolo, General Practitioner, AAR Healthcare.
Besides the exploitation involved in treatment procedures, agencies that provide services related to medical tourism have, too, been accused of taking advantage of the vulnerability of patients to rake in huge profits.
For example, several tour companies now offer logistical support for patients travelling to India and other destinations.
The services include visa processing, airline ticketing, travel, accommodation, transportation, translators and sightseeing during the visit.
The tours mainly offer logistical support for patients travelling to India with Turkey, South Africa and Dubai emerging as upcoming medical tourism destinations.
Medical tourism in India is expected to hit a whopping $9 billion (Sh900 billion) by 2020 up from $3 billion (Sh300 billion) in 2013.
By seeking treatment abroad for diseases that can be treated locally, patients not only get drained financially, some do not get proper treatment, thus return home, broke and their condition worse.
Wachira says that many patients opt for treatment abroad due to the misconception that Kenya has no capacity to treat cancer.
She say Kenya is well equipped and has the skills to treat cancer, save for a few procedures that require special skills and equipment not available in the country.
Wachira admits that there are gaps in the healthcare system, one of them being a poor referral mechanism which, she says, delays the time between when a patient visits a health facility with cancer symptoms and when they are diagnosed and put on treatment, thus leading to poor outcomes.
Kenya, which has an estimated population of 50 million people, has 45 oncologists and about 80 new oncologist nurses who graduated in the past two years under training programmes at Aga Khan Hospital and Moi Teaching and Referral Hospital.
Lack of specialisation for certain treatment procedures like stem cell transplant and bone marrow therapy is also another gap that prompts patients to seek help elsewhere.
Kenya has deficit of machines like the PET scan — an imaging test machine — that is only available at the Aga Khan Hospital.
Medical tourism service providers, however, deny the accusations saying their businesses are based on the demand.
Ruth Kamau, the founder and CEO of Beyond Borders Medtours, a medical tourism company, says there are three major reasons why patients want to travel abroad for treatment.
Some, she says, opt to go abroad due to need for specialisation and due to timeliness of treatment. Others travel due to the frustration of waiting to see specialists for long while the disease is advancing while for others, it is about preference.
“You will find a patient who has their mind made up about going to India for treatment even before trying the local health system,” she says.
How patients access treatment and the payment system is said to be factor in the exploitation of cancer patients who seek treatment outside the country. Patients who pay cash are an easy prey for exploitation.
But patients who have health insurance like the National Hospital Insurance Fund (NHIF) are more protected because of the strict approval system.
Makumi says the medical tourism industry needs to be closely regulated, including stricter enforcement of Kenya Medical Practitioners and Dentists Board (KMPDB) guidelines, to protect patients.