Mending broken hearts: Kenya's fight against cardiovascular disease

(From left): Evans Majau Project program coordinator Kenya Mended Hearts Association, Millicent Mwangi 41 Heart Patient, Dr. Yvette Kisaka, Tech Lead CVDs Ministry of Health, Dr. Benard Samia President Kenya Cardiac Society, Dr. Elizabeth Gitau Assistant Sec- general Kenya Medical Association at the Kenya Science UON campus celebrating World Heart Day. [Courtesy: Kenya Cardiac Society] As the sun rose over the University of Nairobi on World Heart Day 2024, the campus buzzed with an unusual energy. Amidst the beehive of activities-from spirited sports matches to lively dancing-one figure stood out. Millicent Mwangi, 41, walked with a bounce in her step, her radiant smile belying the harrowing medical journey she had endured just three years prior. "I'm a heart patient," Millicent said, her voice strong and clear. "I had surgery three years ago for rheumatic heart disease, and now I'm doing well." Millicent's story is a powerful testament to both the challenges and triumphs in Kenya's ongoing battle against cardiovascular disease (CVD). Her journey from the brink of heart failure to vibrant health mirrors the nation's evolving approach to heart health. According to the World Health Organisation (WHO), cardiovascular diseases remain the leading cause of death globally. In 2019, an estimated 17.9 million people died from CVDs, representing 32 per cent of all global deaths. Of these deaths, 85 per cent were due to heart attack and stroke. The World Heart Federation, in marking this year's World Heart Day, has chosen the theme "Use Heart for Action." This call to action emphasises the need for increased awareness, prevention, and management of CVDs worldwide. In Kenya, the situation is equally pressing. Dr Bernard Samia, President of the Kenya Cardiac Society, paints a sobering picture: "The disease burden is on the rise. Up to a quarter of hospital bed occupants are there because of cardiovascular diseases, and the death rate from these conditions is extremely high." Dr Yvette Nafula-Kisaka from the Ministry of Health adds, "In Kenya, cardiovascular diseases are the second leading cause of mortality. About 24 per cent of Kenyans have hypertension, a major risk factor for heart disease." For years, Millicent ignored the warning signs - swollen legs, chest congestion, unexplained weight loss, and extreme fatigue. "I never took action," she says. "If I had acted earlier, it could have been rectified sooner." When Millicent finally sought medical attention, the diagnosis was grim. Her mitral valve had stenosis, severely restricting blood flow. The solution was a valve replacement surgery, a procedure that cost her Kshs 2.5 million. Millicent's successful surgery at Karen Hospital in Nairobi represents a significant advancement in Kenya's cardiac care capabilities. However, it also highlights the financial barriers many Kenyans face in accessing such care. Dr Elizabeth Gitau, Assistant Secretary General of the Kenya Medical Association (KMA), emphasizes the need for better healthcare financing: "Heart treatment is very expensive. The government must ensure this is funded through social health insurance so that patients can access care." While Millicent's story has a happy ending, health experts stress the importance of prevention. The European Society of Cardiology estimates that up to 80 per cent of premature heart attacks and strokes are preventable. Dr Samia concurs: "We can prevent up to 70 or 80 per cent of cardiac diseases that occur in our communities by addressing key risk factors like hypertension, diabetes, and obesity." These risk factors are often linked to lifestyle choices. Dr Nafula-Kisaka points out, "Sedentary lifestyles, unhealthy diets, alcohol consumption, and tobacco use are major contributors to cardiovascular disease." Recent health studies have shed light on the growing cardiovascular health crisis in Kenya. A 2022 study published in the East African Medical Journal found that urbanisation and changing dietary habits have increased CVD risk factors among young adults in Nairobi. Another study from the Kenya Medical Research Institute (KEMRI) in 2023 revealed that only 22 per cent of Kenyans with hypertension are on treatment, highlighting a significant gap in disease management. "We want people to put their hearts at the forefront of their decisions and how they live their lives. Use heart for action. Stop smoking, exercise, eat a healthy diet, and stay away from excessive alcohol," Dr Nafula-Kisaka says. For Millicent, the message is personal and urgent. "I encourage people to take the signs seriously," she says. "You know your body well. When you have those signs - swelling of the legs, chest pains, sudden weight loss - seek medical attention."

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