Cost of dialysis keeps patients away

Mr Fosset Munambo, 74, was diagnosed with chronic kidney failure seven months ago as a result of hypertension. Since the diagnosis, his family has to mobilise funds every week to save his life.

A resident of Kapsabet in Uasin Gishu County, Mr Munambo has to travel to Kisumu County three times a week to undergo dialysis at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOORTH), the only public hospital in western Kenya currently handling renal patients.

Each dialysis session costs Mr Munambo Sh15,000.

Munambo is among the many kidney patients who have to make long trips every week for dialysis, incurring heavy travel costs on top of medication and the procedure.

Even though things have improved at the JOORTH after it received 16 dialysis machines worth Sh5million from the Kenya Commercial Bank (KCB) nine months ago, they are not enough.

Before the KCB move, the hosptial had only four machines, two of which were defective, the chief administrator, Dr Juliana Otieno, reveals. As a result, some patients had to wait for up to six months for treatment.

DONATIONS HAVE IMPROVED CONDITIONS

Dr Otieno says thanks to the donations by well-wishers, things have improved slightly for renal patients. ‘‘The dialysis sessions have increased from 230 to 822 a day because we have at least 16 machines in place,” she says.

However, she notes that the number of patients seeking renal treatment has increased tremendously, so the government should increase funding to enable the hospital to buy more dialysis machines.

Indeed, patients like Mr Munambo are sometimes forced to go without treatment since all the machines at the JOORTH are overbooked.

Lack of skilled medical personnel has also been a challenge to many public health facilities. At the JOORTH, for instance, the staff now conducting dialysis had to undergo training before they could start treating patients.

‘‘During that period, the renal unit was closed and the patients had to wait for some time before they could receive treatment,” says one kidney patient.

Also forced to seek treatment far away is 59-year-old Patrick Otieno, who was diagnosed with end-stage renal disease (ESRD).

Mr Otieno, a father of eight from Oyugis in Homa Bay County, has to travel to Nairobi every week for treatment, with a session costing Sh15,000.

He also has to raise transport and accommodation costs. To cut down costs, he sometimes goes for just one session instead of the recommended three.

‘‘I have undergone this for the past four years since I was diagnosed with ESRD. The journey has been financially and emotionally draining on my family,” he says.

YET ANOTHER STORY...

This is the lot of many Kenyans suffering from kidney and other diseases that are expensive to treat, as 28-year-old Dennis Odumbe well knows.

In 2011,  Mr Odumbe was diagnosed with kidney failure at Kisii Level Five Hospital but due to lack of renal facilities, he was referred to the Moi Teaching and Referral Hospital in Eldoret and Kenyatta National Hospital in Nairobi.

‘‘There were no services in any public hospitals in the region at the time so kidney patients were forced to travel to other parts of the country to seek medical help,” says the administration police officer.

As he was undergoing dialysis, Mr Odumbe was advised to look for a kidney donor to save his life.

Fortunately, he found a willing uncle and after a compatibility test, he was referred to a hospital in India, where he underwent a transplant. He says the huge cost of transport and treatment left him financially drained.

‘‘I spent Sh3 million on the transplant and transport, and I still have to take medication for the rest of my life,” says Mr Odumbe.

Odumbe says the drugs, which must be taken daily, cost sh300,000 and must be accompanied by a proper diet.

Besides, they are not available in the country so patients have to order them from India.

BARELY ANY MACHINES

KNH currently has 20 dialysis machines, 14 of which have broken down.

So dire is the shortage that in June last year, kidney patients sued the Ministry of Health for failing to buy adequate dialysis equipment.

The more than 300 patients from across the country argued that the government’s failure to buy the machines contravened the Constitutional provision regarding the right to life.

“The net effect is that very few patients access the working dialysis machines since the hospital gives preference to admitted patients, sidelining the petitioners,” said Luco Njagi, who is undergoing dialysis, in a sworn affidavit.

They said the ministry had the primary obligation to protect and promote the petitioners’ right to health, which is defined and guaranteed by international customary law, international human rights treaties and the Constitution.

A kidney patient has to undergo dialysis three times a week to be fit.

The patients noted that the cost of treatment was unaffordable to many of them and wanted the court to compel the Ministry of Health to pay for their treatment at eight private hospitals in the city pending the purchase of the equipment by the Government.

Because of the high cost of dialysis and transport, some patients routinely skip sessions.

‘‘Treatment is very expensive and beyond the means of many of us, says 29-year-old Raychel Khahandi, who makes weekly trips from Kakamega to Nairobi for treatment.

Her family has to raise funds to cover the treatment, as well as transport, accommodation and food. She is supposed to have at least two sessions a week but since she cannot raise enough money, she goes for only one.

According to her brother, Mr Solomo Wekesa, the situation is sometimes worsened by the fact that his sister cannot get a slot at the hospital.

Recently, for instance, Ms Khahandi went to Nairobi for treatment on a Friday but could not get a slot until Sunday morning at KNH.