World Kidney Day – March 8, 2018
By Gatonye Gathura
Four years ago Joyce Njeri Rore had her lifetime dream within reach with a flourishing business in Nairobi and a settled family.
This was until November 2014, when Njeri, then 32, delivered safely at Kenyatta National Hospital.
“The delivery went well but to be followed with excessive bleeding which kept me at the hospital for one and a half months,” Njeri told the Standard.
In the process, Njeri had suffered acute kidney failure and since then has been on a twice-a-week dialysis at the hospital.
But now she has developed high blood pressure, an inflamed heart and diagnosed with the end stage kidney disease.
“The only alternative, doctors say is an urgent kidney transplant for which we are in the process of raising Sh3 million,” she told the Standard on Thursday.
Due to the complications, she is advised not to engage in heavy chores. This coupled by her frequent hospital visits have led to collapse of the family business and wiped out their lifetime savings.
Njeri’s story, of a disease that is killing young ambitions is being repeated every day in thousands of home across Kenya.
A study carried out by the charity group Haki Foundation to coincide with the World Kidney Day to be observed on Thursday (8th MARCH) shows most kidney patients in Nairobi County are aged 21 to 40 years.
While the risk of kidney disease increases with age the Nairobi study involving 294 patients and 11doctors and nurses shows increasing kidney problems in young people.
The study carried out in two major hospitals in Nairobi, a public and a private facility shows up to 30 per cent of dialysis patients were aged between 10 and 30.
Cumulatively, Ephantus Muhunyo the Executive Director of Haki Foundation says 41.1 per cent of the renal patients in Nairobi County were young adults aged between 21 to 40 years.
“We are talking of lives disrupted at their most productive time, which should be cause for concern,” says Dr Benjamin Wambugu, a kidney specialist with the Kenya Renal Association.
But getting dialysis treatment in Nairobi, the study shows presents serious problems for lack of finances, inadequate machines and shortage of personnel and pharmaceutical products.
Though more than 90 per cent of the study patients were registered with the National Hospital Insurance Fund (NHIF) a significant number still missed treatment.
“NHIF only covers two sessions while I am recommend for three per week so I have to get Sh 7,000 for the extra session,” explains Richard, another patient aged 26.
While three sessions per week are the ideal and the number recommended by doctors the study shows up to 87 per cent of patients in Nairobi are on two sessions only.
The study shows majority of the patients about 53 percent did not have a source of livelihood or they were unemployed.
Some say employers could not afford to have workers out twice a week hence had to release them.
For the few lucky enough to get leave to attend treatment most reported being too tired to go back to work after dialysis hence deemed to be a liability.
This, Muhunyo says has serious implications on their treatment because they still have to meet costs not covered by NHIF such as doctors’ consultations’ and accompanying tests.
The patients, the research say have also to meet the cost of drugs such as for high blood pressure and diabetes which in most cases go hand in hand with kidney failure.
“Currently I spend up to Sh40, 000 per week on drugs to treat various complications,” says Njeri.
Impoverishment, more than a half of patients in Nairobi say they hold harambees on a weekly basis to raise money for treatment.
But even with insurance coverage or even with successful fundraising getting the weekly dialysis still remains a herculean task.
The researchers found dialysis machines, especially at the public facility are not enough to meet demand while most are broken down due to overuse.
“Patients have to wake up as early as 3.00 am, so that they could get a spot for dialysis,” says Muhunyo.
“You can go up to three days without getting an opportunity to be dialyzed,” says. Njeri
Most of the patients in Nairobi, 57 per cent have considered getting a kidney transplant but regretting that they can’t afford.
“A transplant is the ideal solution to patients with end stage kidney disease especially young people who have all their lives ahead of them,” says Dr Wambugu.
Cost of transplant, lack of organ donor, long queues and uncertainty of outcome in that order are the man barriers for kidney transplant in Nairobi.
NHIF will meet up to Sh 500,000 for kidney transplant but will not cover for the required life-long support drugs. In private hospitals a transplant can cost up to Sh2 million.
Njeri, who has been lucky to get her brother to donate a kidney, now undergoing the necessary tests, says her case like most is urgent.
“The current queue at KNH is too long hence my best option is to travel to India as soon as we raise funds and complete the necessary medical tests.”
In Kenya organ donation remain voluntary and only among relatives. While the Health Act 2017 allows for organs from deceased persons regulations are still being formulated but any commercial organ transaction remains illegal in Kenya.