Emmy Senyei has to do manual jobs to get money for food and the drugs that keep her body from rejecting her transplanted kidney, even though her doctor told her to avoid such jobs.
Despite regularly remitting her monthly contribution to the National Health Insurance Fund (NHIF), the insurer doesn’t pay for her medication, so she has to pay for it out of pocket.
Ms Senyei had a kidney transplant in India in 2015, following a year of swollen legs and then a swollen body. Initially, doctors said that it was because she didn’t have enough blood, but the medication they prescribed offered no relief, so she was sent to the Moi Teaching and Referral Hospital in Eldoret, where she was diagnosed with kidney disease and started on dialysis.
High blood pressure (hypertension) and diabetes are the most common causes of kidney disease, but obesity, smoking and high cholesterol are other factors associated with the ailment.
Conditions that put a strain on the kidneys, also lead to kidney disease, which if left untreated leads to kidney failure, which means that the patient has to rely on dialysis to do the work of the kidneys (filtering waste products from blood) or get a kidney transplant.
After a four-month hospital stay, Ms Senyei went to India for a transplant (her son donated his kidney). Thereafter, doctors told her that her previous job as a tea plucker wouldn’t work; that she could no longer do tedious work. But it has been difficult to heed that advice.
“I spend Sh30,000 each month on drugs and tests, so I have no option but to take the jobs I find (even the tedious ones that the doctors forbade). I also need to feed my children and take them to school,” says the mother of six, who takes five prescribed drugs that she will use for the rest of her life.
When she has no money, the members of the North-Rift Kidney Patients Welfare Association, that brings together 150 patients who got kidney transplants, try to chip in to get her the drugs that keep her body from rejecting the transplanted kidney.
According to Dr Philip Cheptinga, a kidney specialist at the Moi Teaching and Referral Hospital, kidney patients need between Sh30,000 to Sh40,000 a month on drugs alone, not forgetting that they need routine clinical check-ups.
And given that NHIF doesn’t cover pre-transplantation and post-transplant costs, the financial burden is shouldered by patients, with many of them depending on fundraisers to foot their medical bills.
About four million Kenyans have chronic kidney disease and NHIF pay-outs' for the ailments keep rising, with figures showing that the insurer paid out Sh64.7 million in 2018 (up to June) for kidney trans-plants, up from Sh21.7 million in 2017; while dialysis pay-outs increased by nearly 50 per cent to Sh1.7 billion.
NHIF pays Sh5,000 and Sh9,500 for dialysis in public and private hospitals respectively. Patients on dialysis are often asked to get transplants, for which NHIF pays Sh500,000 in private hospitals.
Only two public hospitals — Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital in Eldoret — have the capacity to conduct kidney transplants at subsidised rates, also footed by NHIF. And although the insurer has come in handy to cut the costs of treatment, especially for patients from low-income households, patients like Ms Senyei feel that the fund could do so much more to reduce the out-of-pocket costs they incur on life-long treatment.