A bumpy ride off the road from Gatundu to Njabini in Kiambu leads us to Gathanje, a small, evergreen village sprinkled with small-scale tea plantations.
Other than the occasional March gusts of wind, everything here is quiet. Quiet and serene. There are hills and valleys. Shops and butcher shops. Schools and dispensaries. Gathanje is your usual rural Kenyan village.
Gathanje is also home to a special 37-year-old woman. Her name is Rebecca Njambi. She lives here with her husband Michael Ndung’u and their three children.
Every time she wakes up in the morning, Njambi is greeted by the dewy majesty of the ridges of Gathanje. The measured cold of the Kiambu night breathes life into the leaves of the tea plant, awakening its green glory before the sun rises to bake it.
And every time she goes to bed, Njambi clutches onto two things: her dog-eared Bible, and the sweet smell of hope.
The young mother is suffering from breast cancer. She was diagnosed with the disease in November last year and is now bearing the brunt of Stage Three of the enervating illness.
“It all started one night in September when I felt a lump in my left breast,” she says. “Although it was not painful, I asked my husband to also feel the lump, just to make sure that I was not imagining it.”
The constant thought of that lump, she says, changed her life and set her on an arduous journey. But the turning point for her was when doctors informed her that they had to remove the affected breast.
“I was very scared,” she says. “And then, just as I was about to go under the knife at Kenyatta National Hospital, doctors went on strike. Luckily, a friend told me I could get help at Tenwek Mission Hospital in Bomet, where doctors removed my breast in December last year.”
Doctors told her she needed to start chemotherapy immediately after the surgery, but, three months later, she has not had a single session. The queue at Kenyatta National Hospital extends all the way to next year and she does not have the money to seek the care of a private doctor.
Before being started on radiotherapy to kill any remaining cancer cells in her body and stop them from multiplying, Njambi needs at least eight sessions of chemotherapy.
Hers is the story of 27,000 other Kenyans clutching onto nothing but dreams and hopes. It illustrates the problem with Kenya’s cancer care pitfalls, as well as the pain that patients must endure before they finally have an appointment with a doctor. Often, that appointment comes too late.
Kenyatta National Hospital and other organisations estimate that about 40,000 new cancer cases are diagnosed every year, resulting to 27,000 deaths, possibly due to inadequate or late treatment.
Kenya has four radiation centres for the treatment of cancer, all of them in Nairobi, and all but one in private hospitals.
Njambi struggled to raise Sh70,000 for the mastectomy at Tenwek, but she cannot afford the Sh159,000 needed to start her on chemotherapy in a private facility.
A chemotherapy session costs between Sh10,000 and Sh82,000 per session at KNH for six to eight sessions, while the same treatment costs anywhere between Sh35,000 and Sh500,000 at a private facility.
Meanwhile, a radiotherapy session at KNH costs around Sh500. Mostly, the patients will need about 30 uninterrupted days or more of the treatment.
Njambi says she could easily afford this, but more than 1,000 people are on the waiting list at Kenyatta. To make matters worse, doctors have been on strike since December last year.
“I need treatment now!” she says, “but I do not have the kind of money the hospital is asking for. If only doctors would have mercy on patients like me. We have sold everything we own just to get treatment. We sold the calf we bought with our tea bonuses and fundraised for the surgery at Tenwek. We have borrowed so much that we can no longer knock on peoples’ doors with outstretched palms.”
In Kenya, the Institute of Economic Affairs reports, between 2010 and 2014, the rate of cancer-related deaths increased from about 31 per 100,000 to 33. This represents an average annual growth of six per cent, which is double the population growth rate of almost three per cent annually. By 2026, at this pace, the rate of death from cancer will almost double, to 64 cancer deaths per 100,000 people.
The IEA has been poring over these figures because they are useful in determining the magnitude of the disease as a public health burden, and also to estimate the risk of dying from cancer in Kenya.
It found that at least 39 Kenyans died every day from cancer last year, up from 33 in 2010.
Treatment, for many patients, come at a huge financial and psychological cost. For instance, in 2015, the radiotherapy equipment at Kenyatta National Hospital — the only radiotherapy centre in a public hospital — broke down from overuse, putting the lives of patients who depended on the machines in danger.
EASE THE BURDEN
Because KNH is the only public health facility offering radiotherapy in the country, it is swamped with patients from all over the country, more often than not begging urgent attention.
Of course treatment is available in private health facilities, but these, though better equipped, are more expensive, charging between Sh5,000 and Sh10,000 per session. Many can scarcely afford these charges.
The KNH centre is, therefore, forced to admit more than its capacity allows.
But even as the number of patients escalates, it is Njambi and other poor patients suffering from cancer who are condemned to a life of pain and misery.
To ease the burden, Indian Prime Minister Narendra Modi, on his trip to the country last year, donated a Sh300 million radiotherapy machine to KNH.
The Cobalt and simulator radiotherapy machine — commonly referred to as Bhabhatron II — arrived in the country in November last year, after a two-month delay.
Apart from shortening the queues at KNH, the machine will reduce the horrible side effects that come with the radiation that destroys the healthy tissue around the parts where the cancerous cells are.
It will change cancer treatment in Kenya as it kills cancer cells by targeting them through “pin-point therapy” without damaging surrounding tissue.
This type of treatment is different from the old one where tissues surrounding the tumour were also damaged. But it is useless to Njambi if she cannot access it.
“It will be any minute now, I know,” says her husband, Ndung’u, not referring to the prospect of his wife finally get the care she so desperately needs, but to the good Lord coming for her.
“If God takes her, I will accept it, but I don’t think our children will.”