Why poverty is as good as death sentence for cancer patients

It takes a keen eye to notice that Josephine Njoki’s hands are not symmetrical. Her right hand is actually bigger.

Her body structure, however, hides this well, the same way she struggles to hide her pain, which she only discloses to close confidants, or to those she knows may offer help.

For three years the 66-year-old has never returned to hospital to complete her cancer treatment. She has no money, she says.

To move from Kariobangi North to Kenyatta National Hospital, Ms Njoki says she needs at least Sh500 for fare and lunch.

“Hiyo yote nitatoa wapi na niko pekee yangu? (where will I get all that money, yet I'm all alone),” she poses.

Njoki’s troubles began in 2012 when she lost her only son. Due to depression, she says, she lost a lot of weight and that is how she noticed a lump in her right breast as she was showering.

She went to a clinic, but was referred to the Kenyatta National Hospital. Since her case was termed very urgent, the whole breast was removed on July 28, 2012.

She paid the Sh159,000 hospital bill with her savings and with the help of well-wishers. Njoki (pictured) had no insurance, as she retired from Nairobi City County in 2007.

“Even my own relatives thought I would die. In fact, we are still fighting in court over land that was taken from me when I was sick,” she said.

But after paying the hospital bill she was left with no money to proceed for chemo and radiotherapy.

“I had stayed home for a whole year without treatment,” she recalls.

However, in early 2014, some missionaries paid for eight cycles of chemotherapy and 25 sessions of radiotherapy at Sh500 each. She also had to undergo eight chemotherapy cycles each at a cost of Sh2,500.

“But as soon as treatment was over in December 2014, I got no more support. It was presumed that I am well since those therapies were the only remaining part of my cancer treatment,” Njoki says.

Since 2015, she has never visited the hospital for check-ups to establish whether the cancer treatment worked.

“I am old. I live with my granddaughter (an orphan) and she depends on me. I used to prepare chips in my area, for sale but with this swollen hand I cannot do any heavy work,” she says.

Better equipped

Poverty, according to Mukuhi Ng’ang’a from Aga Khan Hospital, makes it difficult for cancer patients from poor neighbourhoods to access treatment.

Most poor people, notes Dr Ng’ang’a, cannot afford treatment in private facilities, which are better equipped.

“So why can’t we do the same (have better equipment) for government facilities? It has become a case of if you have money you can easily receive quality care. We are not doing well in terms of cancer care. If I get a patient today, and a biopsy is done and a month later there is no action, something needs to be done,” said Dr Ng’ang’a.

The lack of quality equipment is demonstrated by the plight of Ann Muthoni, who was diagnosed with breast cancer last May. However, by the time Muthoni, 52, was diagnosed, she had  spent almost Sh50,000 on tests, including X-rays and scans.

This was after a spell of treatment at Thika Level Five hospital, where she was being treated for pneumonia that would not respond to drugs.

At one point, she had to borrow Sh13,500, and wait for two weeks before the biopsy tests were done.

“I was told if I wanted it done faster, I should visit a private facility. I did not have that kind of money,” she says.

And even after it was confirmed that she had breast cancer, she was still told to do more X-rays to confirm that the cancer had not spread to the areas around her liver, chest and kidney.

“I need around Sh150,000 to have my breast removed, as per the doctor’s orders. I am a widow, where will such an amount come from,” she poses.