Palliative care revives hope for 13-year-old cancer patient

Access to palliative care for Kevin Muriungi, a 13-year-old cancer patient from Kimate Village, Imenti Central Sub-County in Meru, is great relief to his aged grandmother and 10-year-old sister.

Palliative care is specialised medical attention for people with serious illnesses focusing on providing pain and stress relief as well as improving quality of life for the patient and the family.

Muriungi lost his mother who died after a short illness 10 years ago and was abandoned by his father who is an alcoholic. The boy found refuge at his grandmother’s home.

He was diagnosed with cancer of adenitis with post nasal tumour at Chaaria Mission Hospital in September 2014.

He was referred to Kenyatta National Hospital (KNH) for further treatment.

Having been abandoned and shunned by his father due to his health condition, no attempt was made to take him to KNH.

The class six drop-out and his sister, Hilda Kanja now live with their grandmother Jacinta Kabithi who is in her 80s.

The boy has been suffering searing pain with a tumour having blocked his nasal cavity while the right eye has been blinded by the swelling.

LIVING IN POVERTY

A visit to his grandmother’s home established that the boy, his sister and the granny sleep in a three by six feet bed without a mattress. The bed and one stool are their only furniture.

Their small semi-permanent house and a tiny mud-walled kitchen is a statement of their humble life. It serves as the bedroom, store and chicken house.

Muriungi lies under a shade outside his granny’s house writhing in pain and beside him, a cup of porridge, the only food he can manage to swallow. His swollen eye and strained breathing gives a glimpse of the agony the boy is going through.

Ms Kabithi says she has undergone untold suffering since her son-in-law abandoned the sick boy.

“When my daughter fell sick, her husband refused to bury her. He later rejected the boy after he realised he had cancer. I struggle to take care of him and his younger sister who is in Class Six.

“At night, I cannot sleep as the boy keeps crying and struggling to breath. I have suffered so much and pray that well-wishers would come to his aid. The father has never come to see his sick son,” Ms Kabithi says.

Kanja, who is a Class Six pupil at Runywene Primary School says she cannot read or do her assignments at home due to her brother’s condition.

GOOD SAMARITAN COMES TO HIS AID

Until last month when a Good Samaritan took Muriungi to Meru Hospice, he has been living in agony.

The grandma can only afford normal pain killer tablets that cannot manage his condition.

This is the state of many cancer and other terminal illness patients in Kenya who have been deprived of the health, wealth and comfort by disease.

Despite the Ministry of Health launching the Kenya National Patients’ Rights Charter of 2013 that incorporates palliative care as a basic health right, many patients are yet to access the service.

Meru Hospice, which is taking care of Muriungi and some other 490 terminally ill patients from upper eastern region is struggling to keep afloat due to lack of funding.

Meru Hospice Coordinator Gladys Mucee says the organisation has put Muriungi on liquid morphine and multivitamin drugs to manage the disease.

They have also provided the family with food, clothing and toiletries.

“Muriungi was brought to us in a lot of pain. Due to the tumour, he struggles to breathe through his mouth while one eye has been affected. His Cass Six sister also suffers trauma due to her brother’s condition.

“We are calling on well-wishers to support the family with food, bedding and clothes to enable him live a better life. He also needs support for further treatment at Kenyatta National Hospital,” Mrs Mucee says.

PAIN AND AGONY

She notes that families of patients with serious illnesses who cannot access palliative care live in pain while the sick face a painful death.

The Palliative care nurse says it costs about Sh8,000 to take care of one patient an amount that only a few families can afford.

“Access to palliative care remains low in Kenya due to lack of awareness. Only national referral and level five hospitals have palliative care units.

“There are a few palliative care nurses in the country since the course was introduced at the Kenya Medical Training College two years ago,” Mrs Mucee adds.

Mrs Mucee says the Meru Hospice whose annual budget is Sh10 million is currently relying on friends, an income generating project and money collection tins that raise a paltry Sh60,000 monthly.

Most hospices, including Meru, have been relying on funding from the Diana Memorial Fund (DMF) that closed in 2012 leaving local organisations struggling financially. DMF was providing 75 per cent of hospice budgets.

“We are calling on people of good will, corporates and the government to support hospices to provide the vital service.

“We have money enough to support patients until June this year (2015). After June, we may not be able to serve the patients or pay staff.

“This would be a big blow to patients like Muriungi who need palliative care for symptom management, psychosocial and material support,” the nurse remarks.

PALLIATIVE CARE POLICY

According to Kenya Hospices and Palliative Care Association (KEHPCA) Programmes Director Asaph Kinyanjui, development of palliative care policy is in progress to enable the government allocate resources.

“Since 2012, the number of palliative care providers has risen from 30 to 70. The government is integrating palliative care into the health sector as well as including it in performance contracting.

“The Ministry of Health has indicated the inclusion of palliative care in the national budget,” Dr Kinyanjui says.

He says palliative care is very expensive as it involves medication, psychosocial support, legal support and home visits yet hospices have been able to subsidise and provide free services to the needy.

Dr Kinyanjui adds that the association has also been engaging with county governments with Nyeri being the first devolved unit to include palliative care in its strategic plan.

With 80 per cent of cancer patients in Kenya diagnosed at advanced stages, palliative care becomes a vital unit in the health sector.