How medical bills are turning families into beggars

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Diana Mwalili’s life as a happy mother and businesswoman was turned upside down by a simple cough.

In 2013, her four-month-old baby Angel caught a cough and fever that did not improve despite the medication clinicians at Kayole Dispensary prescribed.

Baby Angel began having convulsions as the fever persisted and a desperate Ms Mwalili took her to Mama Lucy Hospital.

“She was placed under a resuscitator, a machine used to help babies in distress to breathe. One of the nurses even told me that my baby had passed on, but the intervention by a senior medical officer, who was called to assist in the emergency, saved my baby from an early death,” recalls Ms Mwalili.

An unconscious Angel was referred to Kenyatta National Hospital ( KNH), where doctors worked round the clock for three agonising days to save her life.

She regained consciousness, but the close brush with death did not spare her delicate body.

Baby Angel developed bilateral front hypoxic-ischemic encephalopathy or HIE, one of the most common types of brain damage caused by oxygen loss.

It is a spinal infection that has since made it impossible for her to sit up, stand, walk or feed herself.

Diana Mwalili

Diana Mwalili with her daughter Angel Rebecca, 5, during her interview at Nation Centre. Angel suffers from hypoxic ischaemic encephalopathy (HIE) that has made it impossible for her to sit up straight, walk or eat on her own. Her mother has lost all her savings due to treating the condition. PHOTO | DENNIS ONSONGO | NATION MEDIA GROUP

“Angel is on a special diet. Her food must be mashed before she eats because she cannot swallow solid food. She also cannot be left alone for long periods and requires constant care,” Ms Mwalili says.

Her once thriving eatery in Kayole One Estate collapsed and she was evicted for failure to pay house rent.

She is no longer able to update her National Hospital Insurance Fund (NHIF) contributions for her daughter’s medical care, and now depends on sympathetic neighbours, who are temporarily accommodating her.

Mzee Amadi Lihindi, 93, is listlessly staring into a bleak future as he shuffles into the Nation Centre assisted by his friend Adnan Barisa for this interview.

His daughter Gladys Amadi is admitted to the Nairobi Women’s Hospital with multiple complications including cerebral venous sinus thrombosis (CVST).

The condition occurs when a blood clot forms in the brain’s venous sinuses. The clot then prevents blood from draining out of the brain.

As a result, blood cells may break and leak blood into the brain tissues, resulting in bleeding, also referred to as haemorrhaging.

Gladys suffered a haemorrhage, and has been in constant pain since.

“This means I must also receive medication for the frequent headaches I experience nowadays,” the mother of two, who sounded exhausted, told DN2 on phone.

To add to her woes, she suffered a clot in the right leg or deep venous thrombosis, which also requires medication to manage.

Her bill at Nairobi Women’s Hospital currently stands at over Sh785,000, with no cash in sight for an MRI scan that is required before doctors can begin to treat her leg’s deep vein thrombosis in addition to the clot in the brain.

“I have NHIF cover, but the hospital tells me that my condition is not covered by the national health insurer,” a despondent Gladys says.

DVT aside, Gladys also suffers from gastritis, which requires antacid medication. Her children are currently under the care of her ageing and sickly father.

The old man is haunted by the sight of his wife and four children’s graves in his homestead, making his frequent trips from Mbale, Vihiga County to visit his daughter in hospital, an emotional affair.

medical bills

Amadi Lihindi, whose daughter Gladys Amadi is admitted at Nairobi Women’s Hospital. Mr Lihindi is unable to pay his daughter’s medical bill, which has risen to Sh785,000. Many Kenyan families have been impoverished due to huge medical bills. PHOTO | EVANS HABIL | NATION MEDIA GROUP

“My small compound is already dotted with graves. At my age, I do not think I can survive the loss of another child,” Mr Lihindi says.

He also suffers from high blood pressure and painful joints due to age, making the task of caring for his five grandchildren an uphill task .

Richard Musyoka is a worried man as he stares at the long list of items on his wife’s medical bills. His wife, Jane Kugui, has been in and out of hospitals since May last year.

“We were not sure what was ailing her until doctors at KNH diagnosed it as acute myeloid leukaemia last August,” he said.

Since then, Jane has been battling the condition in which rogue or abnormal white blood cells crowd the bone marrow, interfering with its ability to produce red blood cells. These cells carry oxygen in the body, among other functions.

The online content consultant decided to transfer his wife to MP Shah Hospital, on the advice of medics, who told him the success rate of treating patients with AML at the referral facility was higher.

After a chemotherapy session using a technique known as seven plus three, she was wheeled from the isolation ward to the general ward.

“Dr Joseph Maina, who is our physician and haematologist, told me the technique has a success rate of 70 per cent, meaning that 30 per cent of the cases will fail to result in the cancer’s remission of the target area.

“Unfortunately for my wife, the first round did not succeed, meaning she has to undergo another round as soon as she is physically strong,” Mr Musyoka said.

During her stay at the isolation ward, he took his two year old son for a visit.

“It was hard for me to hold back tears as my son met his mother who had to wear a mask because she was still in isolation and vulnerable to infection. With her face covered in that mask, our son did not recognise her,” a pensive Musyoka told DN2.

The family is grappling with a Sh1.9 million medical bill that must be paid before she is released from hospital.

“We need to clear the bill, after which my wife will undergo a period of recuperation at home, to regain her energy before medics subject her to another induction chemotherapy session to bring the cancer into remission. Only then can we consider other options like bone marrow transplant,” he said.

Fundraisers to offset medical bills among affected families are becoming more commonplace, with many WhatsApp and Facebook groups dedicated to the cause being formed daily all over the country.

Mr Musyoka is planning a fundraiser, which will be held later this week.

For most of his adult life, journalist Raymond Owiti has battled with a brain tumour that causes him to experience seizures.

“Although I was too young to remember, I was told by a relative, who witnessed the events that our house help used to bang my head against the wall whenever I annoyed her or made a mistake,” he told DN2.

The condition has affected him several times, leading him into life threatening situations.

“One time, I almost fell off the balcony of a building while in college. Quick action by a friend who was with me at the time saved me. He grabbed me and held on as I convulsed on the edge of the building, saving me from a deadly fall,” he recounts.

Raymond’s condition has not spared him in the course of his work.

“Another time, I had a seizure at the desk in a newsroom of a local media house as I worked on a story. Colleagues scrambled to get away from me as I toppled over, falling to the floor in the grip of another seizure.

Fortunately, my friend, TV anchor Lofty Mtambo came to my rescue, and organised for me to be taken to hospital,” he recalled.

Raymond requires Sh3 million for an operation in India’s Manipal Hospital to remove the tumour. He will need to be accompanied by a relative, whose accommodation costs must be factored.

“We do not have any money and are depending on well-wishers to offset our expenses,” he told DN2.

The above cases are only few of the many cases of enormous medical bills that are turning many Kenyans into paupers.

Families end up selling cars, houses, land and other property to offset the huge medical bills incurred by their loved ones in hospital.

In many cases, the patients eventually succumb to the illness, leaving their families with even more grief to bear.

According to the Ministry of Health statistics published in 2016, an estimated one million Kenyans are driven into poverty every year due to unaffordable medical bills or what it terms “catastrophic health expenditure”.

With the increasing cases of non-communicable diseases such as cancer and heart disease, most Kenyans are simply a medical bill away from poverty.

Costly health bills are set to worsen the prospects of hapless, cash-strapped Kenyans in a country with at least 17.4 million people living below Sh92.4 per day, according to 2018 World Bank data on poverty rates.

Calculated using 2011 Purchasing Power Parity conversion factors, the paltry amount is more than twice below the amount for the International Poverty Line set at Sh191.33 per person per day.

With this amount, the average Kenyan will mostly concentrate on purchasing basic needs, often choosing to forego necessary medical care, which results in diseases such as cancer and heart ailments getting diagnosed at advanced, difficult-to-treat stages.

The proportion is 36.8 per cent of the total population, which indicates a drop in poverty numbers over the last 14 years.

In 2005, there were 21.19 million Kenyans living below the poverty line.

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