Deficient healthcare forces Kenyans to medical tourism

By KENFREY KIBERENGERuth Manoti is fighting a life-threatening disease at the Kenyatta National Hospital. She has two options: To undergo a procedure locally and extend her life for up to 10 years or to fly to India to get corrective surgery that could heal her. In what is the latest indictment of Kenya’s medicare, Ms Manoti has been told she can only get treated if she travels abroad.Manoti’s family is working to raise Sh1.5 million to save her life with two risky procedures – one to treat a deadly rheumatic heart disease (damaged valves), and another to remove fibroids, which will all have to be done at a hospital in India.The family says doctors at the Kenyatta National Hospital (KNH), which boasts as the largest referral hospital in East and Central Africa, told them that a heart operation is possible locally, but would only act as a stopgap measure, lasting 10 years."They said they could only insert ‘some balloon’, which is a temporary measure, but the operation in India is permanent. South Africa, too, offers similar services like India’s, but it’s much more expensive there," said Charles Rasugu, Manoti’s uncle. Manoti, 32, who lost her mother at birth, was last week rushed to KNH after suffering from pneumonia, an ailment that can be fatal if not managed well in its early stages.The total cost for travel, treatment, and accommodation in an Indian hospital is Sh1.5 million, while in South Africa they would have been forced to pay Sh2.1 million. "Here in Kenya, despite its transient nature, the operation would cost Sh900,000,"Rasugu said.Ngilu at KNHEvery year, innumerable Kenyans are forced into medical tourism – travelling abroad to seek proper and cheaper medical attention – as local medical providers are either wanting or beyond their reach. Several firms are also making a killing out of linking suffering families with doctors in the Asian country.But there is now light at the end of the tunnel after the High Court allowed the Government to increase the levies to the National Hospital Insurance Fund (NHIF), in a new scheme that will see improved and broader medical services provided to Kenyans.Kenyan hospitals were given a vote of confidence in September 2005, when Water Minister Charity Ngilu was admitted to KNH.The minister grabbed media headlines, as she went down the annals of history as the first leader to be treated at a public hospital.The previous years had witnessed President Kibaki and his Vice-President Michael Wamalwa treated for various illnesses in hospitals in the UK.But Ngilu left KNH satisfied and challenged Cabinet colleagues and fellow MPs to seek medical services in public hospitals, saying public health institutions had adequate facilities, and qualified medical personnel.Simply deplorableBut that is a far as the story went. Ngilu, Prime Minister Raila Odinga and his wife Ida, former President Moi and former Head of Civil Service Francis Muthaura, among others, have been treated at the privately owned, high-end Nairobi Hospital.The PM Raila Odinga, Ngilu and Muthaura have also been flown out for specialised treatment in either South Africa or in Europe.More recently, in February, former Environment minister John Michuki was admitted to a UK hospital after suffering a mild stroke. He later died while undergoing treatment at the privately owned Aga Khan University Hospital in Nairobi.But the picture of a deficient healthcare is epitomised by the move by the two Health ministers, Anyang’ Nyong’o and Beth Mugo, to seek for specialised cancer treatments in hospitals in the US.While Mugo was treated for breast cancer at one of the leading research centres in the US, the Perelman Centre for Advanced Medicine at the University of Pennsylvania, Nyong’o was attended to for prostate cancer at the University of California San Francisco, Mount Zion.The two were treated on diverse dates and upon return, they announced they had been cured. But Nyong’o was more apologetic declaring: "The situation in our country is simply deplorable and my heart bleeds for our people when I accept this."Barrack Muluka, a commentator on social issues, however, argues that Kenyans are partly to blame for the situation. "It’s a sticky issue: People want proper medicare, but they do not want to pay up. There are no two ways about it. People must be ready to foot the cost of upgrading the health sector," says Muluka.Budgetary allocationsNyong’o has previously blamed this sad state of affairs on a combination of many factors. "The real attraction to medical tourism is saving money on what normally are very costly procedures. The cost of surgery in India, kidney transplants, cancer treatments, among others, can be as low as just a tenth of what is demanded in Kenya," said Prof Nyong’o.Added to this is the fact that the period one waits before being treated is shorter abroad than locally. At KNH, for instance, cancer and kidney transplant patients have complained that a long waiting list can see a patient get attention six months later."KNH, a cancer patient can wait between six months and a year to get treatment," argues Nyong’o, who is in charge of half of the country’s health sector. Luke Kodambo, the chairman of the National Nurses Association of Kenya, complains Kenyans are taking millions of shillings abroad in form of medical tourism, saying the buck stops with the Government.He says the situation is bound to get worse, as budgetary allocations to the ministry continue shrinking. "In the 2010-11 budget, the Health Ministry got just six per cent (from seven per cent the previous financial year), a drop in the ocean compared to the 15 per cent recommended at the Abuja Declaration of 2001," said Kodambo.The Health Ministry got just Sh28.7 billion during the 2010/2011 financial year against Sh75 billion required to bring hospitals up to acceptable standards. The future looks bleak for the Kenyans since the country’s health sector is grappling with shortage of manpower occasioned by brain drain, demotivated workforce, overstretched infrastructure and corruption. There are just 4,500 physicians in the country with a net emigration of 51 per cent for doctors who leave the country to work overseas. As of last year, the country’s 40 million people are being taken care of by only 17,000 nurses and 1,700 doctors who include 331 specialists.Few personnel"The presence of so few health personnel in Kenya can make it difficult for the Government to carry out adequate disease surveillance, maintain accurate statistics regarding disease outbreaks and report relevant finding to neighbouring countries and international organisations," said Nyong’o.Muluka says the new higher NHIF rates expected to commence in May could be a panacea to the troubles bedeviling the country’s health system. "If properly implemented without corruption, then it ought to end medical tourism," says Muluka.Well wishers may send contributions to: Ruth and Others Ac. No. 0470198778200, Equity Bank, Moi Avenue branch.

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