High risk patients have it rough in Covid-19 war

Last week Lea Kilenga, 20, distributed a vital drug to fellow sickle cell patients in Taita Taveta County despite the fact that it is unethical to share out one’s prescription.

She did this because her fellow patients were staring at graves as the clinics they draw their medicines from, on the account of National Hospital Insurance Fund (NHIF), have been closed due to the Covid-19 pandemic that is ravaging the world.

At Mathari Hospital in Nairobi, a violent, mentally ill patient, brought all the way from Mandera, was turned away; kicking, screaming and punching the caregivers who had persevered his fierceness and resistance hoping that by the time they return from the referral hospital he would be peaceful.

Ordinarily, such a patient would have received a lulling injection and admission, but Mathari now has a rule against admitting patients as part of the directives seeking to decongest hospitals and curb the spread of coronavirus.

The patient only got a prescription and off they went to start their long return leg of despair and disillusionment.

WEARY SYSTEM

Several other patients suffering from non-communicable diseases (NCD), such as diabetes, cancer, respiratory and heart diseases have been thrown into a similar crisis.

They feel neglected as the government shifts focus to containing the spread of coronavirus, which broke out in Wuhan, China, late last year.

NCD Alliance Kenya, which champions the rights of such patients, has warned the government against focusing on coronavirus and neglecting vulnerable citizens.

The lobby said that unless persons with pre-existing conditions are taken care of, the impact of Covid-19 will not be minimised, adding that the country could lose the battle against the new flu altogether.

“Even before corona, our healthcare system had been struggling with disgruntled medics and disease burdens.

“Up to 60 per cent of health facilities are occupied by patients of NCDs, which is second to infectious diseases in terms of incidences and deaths caused,” said Mr David Mukami, the vice-chairman for NCD Alliance Kenya.

“Should we now assume that those patients have already got well because focus has shifted to the coronavirus outbreak?” he posed.

Ms Charity Muturi, a mental health advocate and bipolar patient, said that those living with the condition have been the most neglected.

PROVIDE DRUGS

Worse still, she said, patients cannot access intensive care services in their leading hospital, Mathari, while provincial facilities are wanting.

“Whereas anxiety is high across the country, it is even higher among those with mental issues like epilepsy, dementia, autism, cerebral palsy, schizophrenia, bipolar and drug addiction. They could quickly relapse if they are unable to access medical attention,” said Ms Muturi, who is also a member of the national mental health task-force and founder of Tunawiri Initiative.

She relived her experience when she missed her medication about a fortnight ago and couldn’t sleep the entire night.

Amnesia is a side effect of skipping a dose. “There are other brands of the drug, but changing is not easy for us; we take up to four months trying to adjust to a particular drug because of serious side-effects, like damaging the kidney,” she explained.

“I feel the pain of others who can’t find friendly drugs because of the lockdown in India, where the drugs come from.”

Ms Muturi asked the government to ensure availability of crucial drugs.

NCDs, the experts said, are defined by their chronic nature. Patients need long-term medication, special diets and frequent hospital visits.

MARKET DISRUPTED

A heavy financial burden, emotional and psychological turmoil affecting careers and families are common to the above conditions.

These problems have been compounded by the advent of coronavirus mainly because patients are unable to access or afford medication, stock-outs of vital drugs due to impulse buying and interrupted importation following travel restrictions around the world.

The 5am to 7pm curfew and long distances to major hospitals, economic challenges and the fact that the government has put NCD care on the back-burner is hindering patients’ access to emergency care services, such as intensive care units and vital care particularly for those with complications.

Ms Leah Soi, a breast cancer patient from Kipkelion in Kericho County, for instance, cannot travel to Texas Cancer Centre in Nairobi, where she receives palliative care.

“My left breast had to be removed and that affected my lymph nodes and the mobility of my left hand. I go for check-up and to fetch my drugs every three months. At the moment, I can’t travel,” she told Saturday Nation on phone.

Pharmacies in Kericho sell a single tablet of the drug she takes at Sh200, which the single mother cannot afford as she has exhausted all her resources managing her condition.

Last week, Kenyatta National Hospital suspended bookings for first-time cancer patients who were meant to start radiotherapy treatment and rationed visits for those booked for the life-saving therapy.

PATIENTS FRUSTRATED

Dr Evans Kamuri confirmed the scale down, which greatly affected patients who had travelled to the facility that deals with over 200 patients a day.

Diabetic patients, who constitute 4.5 per cent of the Kenyan population, have also been affected by government neglect in the wake of coronavirus.

Mr Eric Omondi, an ambassador for diabetes Type 1 patients, said that public health facilities had run out of their drugs and most of them cannot afford the high cost charged by private hospitals.

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to enable sugar to enter cells and produce energy.

“There are many types on insulin but currently the government provides only one type, Premix, which is made of fast acting and intermediate insulin.

“However, it is recommended that Type 1 patients buy the fast-acting and intermediate insulin separately, so they can adjust ratios as per individual sugar level, age and lifestyle. You can’t adjust Premix which is already determined at the factory,” said Mr Omondi.

An injection of Premix, which lasts for between two and four weeks, costs between Sh500 and Sh700 in private facilities. But even Premix out of stock.

Last week a patient travelled all the way from Kitale to Moi Teaching and Referral Hospital in Eldoret town to procure his life saving drugs — spending money for a two months dose on the road and facing inconveniences of the curfew.

COSTLY EFFORTS

From Kabete, things almost got out hand for a young father who could not afford the hiked fares he needed to go check his rising blood sugar at Kenya Diabetes Management and Information Centre on Ngong Road.

Mr Omondi came to his rescue by paying for drugs and dispatching them to him.

The situation is worse for sickle cell patients who often end up hospitalised when they miss drugs.

More than 60 such patients in Taita Taveta County cannot access critical care following the closure of clinics in Voi and Taveta towns.

Ms Kilenga, the founder of Africa Sickle Cell Organisation, said three patients admitted at Taveta Sub-County Hospital were discharged before they could fully recover, while many have no drugs.

“The closure of clinics is catastrophic for us who need regular blood boosting drugs, follow-ups and consistent medication. We have been forced to either fundraise or crowdsource tablets, which is not a good idea because we all end up not having enough,” she said.

A week’s dose costs about Sh600 - which is too costly for most patients living in a country where 16.9 per cent of the population dabble below the poverty line.

Skipping drugs is dangerous because malaria prone areas like the Coast and Nyanza are a threat to the survival of sickle cell patients.

NCD Alliance Kenya recommends that the government should urgently provide drugs to patients suffering from chronic conditions.

IMMUNE SYSTEM

The alliance says that patients should have two to three months’ medical supplies as recommended by the World Health Organisation.

But there is a ray of hope amid the gloom. Some medics have been attending to critical patients remotely.

Some pharmacies have also been dispensing drugs to patients. Also, some patients have been accessing drugs at level three hospitals and above.

Patients suffering from chronic diseases need uninterrupted access to affordable healthcare to manage their conditions and prevent falling victim to coronavirus.

“NCD compromises their immune system, making them more likely to get poor outcomes from Covid-19 infection. Those with inadequately controlled NCDs are at more risk of severe infection,” read an NCD Alliance Kenya statement in part.