By Katheru Njagi
Nairobi, Kenya: The first three weeks after Kenya reported its first COVID -19 case in March this year will forever remain etched in Christine Wang’ombe’s mind. Wang’ombe witnessed her friends and colleagues lose jobs as the government imposed lockdown measures to contain the spread of the virus.
But the worst was yet to come, especially for Kenyans like her, who are under treatment for non-communicable diseases.
“I went to see a colleague of mine who was living with her aunt after she was thrown out of her rented house. She was under treatment but could not afford to buy medicine. I did what I could to assist her but deep inside I knew it was not enough because there are many like her out there suffering due to the challenges of COVID- 19,” says Wang’ombe.
It is easy to feel Wang’ombe’s pain.
According to the NCD Alliance of Kenya (NCDAK), persons living with Non-Communicable Diseases (NCDs) are at a high risk of getting infected with COVID 19, a disease that could worsen their condition. In fact, the first few fatalities from COVID 19 reported in Kenya were from persons living with NCDs, says the alliance’s technical advisor, Catherine Karekezi.
She describes NCDs as a health condition where persons living with diseases like hypertension, diabetes, and cancer require lifelong management in terms of medication. But COVID- 19 has disrupted this lifelong treatment chain.
“The key challenge for persons living with NCDs is fear of going to hospitals where they could get infected with COVID- 19. As soon as the pandemic was declared in the country most of them went into self-quarantine. Most have lost their incomes because they cannot go to work,” says Karekezi.
A nurse by profession, Wang’ombe agrees persons living with NCDs like her are facing tough times during these times of COVID -19. Apart from the vulnerability of getting infected with the virus, treatment for life long illnesses is expensive and energy draining.
For instance, Wang’ombe was diagnosed with hypertension in 2010 and later went through a kidney transplant in 2014. This means she has to be on daily medication.
At first, treatment would cost her Ksh. 90,000 per month but lately the cost has come down to Ksh. 40,000, says the mother of two.
“I cannot go to work because of COVID -19. My family is very supportive in terms of getting me treatment but the loss of my income means additional financial pressure for my family,” says Wang’ombe, adding that poor families that have persons living with NCDs cannot afford food and treatment.
The social and financial pressures caused by NCDs could hinder long term economic growth, according to Dr. Ephantus Maree, the head of NCDs prevention and control unit at the Ministry of Health.
This is because NCDs affect the most productive segment of the country’s population, where 50 percent of all admissions in Kenya’s hospitals is due to the health condition.
While the Ministry projects a rise of 55 percent of the NCDs burden by 2030, it says about 38 percent of all deaths in Kenya are due to NCDs.
“If more aggressive action is not taken to address the NCDs burden in Kenya we will definitely land into problems and we may not achieve our universal health coverage goals as set out in the big four agenda by the President,” says Dr. Maree.
That aggressive action appears to have been slowed by COVID -19, according to Dr. Bernard Gitura, the president of Kenya Cardiac Society (KCS).
Studies conducted by the organization indicate that persons living with NCDs are not going to hospitals for treatment due to fear of catching COVID -19, reducing hospital occupancy by more than 50 percent.
“Patients are staying at home with chest pains because they fear being diagnosed with COVID -19 only to go to the hospitals when it is too late and at a time of sudden death,” says Dr. Gitura.
But the cloud should not obscure the silver lining.
One way his organization and NCDAK have been ensuring aggressive action is by encouraging persons living with NCDs to go to hospitals even if they exhibit symptoms resembling COVID- 19.
Another is issuing targeted guidelines to clinicians on how to manage persons living with NCDs. For instance, clinicians can prescribe medicine for persons living with NCDs for lengthy timelines lasting three to six months so that they do not have to travel every month to get their medication, says Dr. Gitura.
Yet another is training clinicians, especially those in counties, on how to use telemedicine to reach out and continue caring for persons living with NCDs, he added.
Karekezi of NCDAK agrees such measures aimed at helping poor persons living with NCDs are working. But drug stock-outs might undermine innovative ways of caring for persons living with NCDs during these times of COVID 19.
According to her, the Kenya Medical Supplies Agency (KEMSA) should do a better job of supplying drugs to medical facilities, especially those in counties.
Drugs and treatment for persons living with NCDs should also be cheaper, says Wang’ombe.
“We are appealing to the government to make drugs cheaper and available. This is because some patients are forced to go for the more expensive dialysis. When one is on dialysis they are immobile and so they cannot be productive,” says Wang’ombe.
