Every first Saturday of the month, Grace Wambui, a breast cancer patient living in Kawangware, comes all the way to Liana Hospital in Kangemi to receive food supplies and cash to assist in going for physiotherapy at Kenyatta National Hospital.
This food package has sustained her family for the last 10 months since the outbreak of Covid-19 pandemic.
Grace and many other cancer patients from Ushindi survivors group in the urban low-income settlements such as Kangemi and its neighbouring informal settlements and villages of Kawangware, Riruta, Dagoretti, Waithaka, Kikuyu, Mwamwito, Gathiga and Gachie, patiently wait for Jane Frances Angalia, a survivor of the rare triple negative breast cancer, to bring them food supplies.
“The chemotherapy compromises the immunity of a cancer patient and one requires a good diet. That’s why I went out of my way to look for food during the Covid-19 period for the patients to ensure their immunity isn’t compromised,” says Angalia, founder of Cancer Information Support Network and the secretary of the Cancer Survivors Association of Kenya.
The burden of cancer continues to rise globally, with statistics showing that nearly 18.1 million new cases were reported and approximately 9.6 million people died from the disease in 2018. This means that out of six deaths that occur in the world, one is due to cancer. Here in Kenya, statistics from National Cancer Institute (NCI) indicate that every year, there are around 28,000 new reported cases of cancer with at least 22,000 lives lost. Women are most affected as breast cancer still ranks the highest with 37.4 per cent prevalence rate followed by cervical cancer at 23.7 per cent.
Majority of the cases are reported among low and middle-income families who have no means of catering for the expensive treatment and drugs. The burden has become heavier following the outbreak of the pandemic as most of these patients have lost their means of earning a livelihood, which makes them vulnerable.
Roselyn Simiyu, 59, a breast cancer patient is grateful for the support she has received during the pandemic. She was diagnosed with cancer in 2018 and within this period, she has gone through six chemotherapy session, a surgery to remove her breast and 15 radiotherapy sessions.
It has not been an easy path and her family has had to chip in to pay for the expensive treatment. The Covid-19 period affected her financially as she was doing menial jobs for people and now, most of them are not inviting people into their homes to do small chores for fear of the virus. She currently has to go through physiotherapy every Monday and sometimes she misses sessions due to lack of funds. Since her close friends and relatives see her ailment as a burden, most of them shun her and this group is the only refuge she and her daughter, 33, who was diagnosed with cervical cancer, have.
“The support group has really assisted me during this period. We have a WhatsApp group where we share our problems and when I lost my son this year, the group visited me and offered me support during this time. I am thankful for what I have learnt and the food that I receive,” she says.
The pandemic also saw restrictions in hospitals, which affected cancer patients from receiving treatment.
For the past six years, the organisation has been taking care of cancer patients, encouraging them to go for screening, providing information on the disease. During the pandemic, it has been assisting vulnerable cancer patients with food, National Health Insurance Fund monthly payments and medication.
“People were told to keep off the hospital and some of these patients were receiving chemo. When you start treatment especially chemo and stop, the cancer cells could continue growing. We spoke against this and we are glad that the government changed,” Angalia says.
What drives Angalia to do this is the fact that six years ago, she was diagnosed with triple negative breast cancer, which was at stage 3 B, a fatal stage. At the time, she was a lecturer at Jomo Kenyatta University of Science and Technology and even her salary couldn’t cater for the expensive treatment. Through support and contributions from family, friends as well as her church family, Angalia was successfully went through treatment.
“It was a traumatising moment for me and I really thought that I was going to die because most of the people who had cancer had passed away. The cost of treatment was expensive at that time as I was required to pay Sh5 million to be treated within the country and Sh3 million abroad. Even if I sold my land, I still wouldn’t be able to get the cash for treatment. I promised God that when when I get better, I would support cancer patients to go through the treatment process with grace and dignity. That is why I assist them during this tough period,” she says.
So far, she has assisted over 500 patients get access to food and National Hospital Insurance Fund (NHIF) monthly charges.
While the NHIF was created to assist low-income families access cheaper health care in line with the World Health Organisation’s Universal health coverage goals, since its introduction it has struggled to ensure that it lives up to its mandate with the growing health care needs of the Kenyan population. According to the Ministry of Health in 2019, the national insurance programme covered only 11 per cent of Kenyans. This leaves majority of the population, which is around 89 per cent without the subsidised health plan. In addition, the current NHIF care package only caters for a cancer patient’s 10 chemotherapy sessions, oral as well as injectable anti-cancers drugs, inpatient and outpatient oncology services, 20 sessions for radiotherapy, and up to two sessions for Brachytherapy for advanced cancer, per year. It also covers six sessions for the first line treatment for up to Sh25,000 per session, four sessions for the second and third line treatment for up to Sh150,000 per session and 20 sessions of radiotherapy at Sh3,600 per session. Biopsy is covered under the surgical package while radiology is also done during the diagnosis stage, and this includes MRIs, ultrasounds, or CT scan and PET scan. Still this is not enough and cancer patients are crying out for more assistance due to the high costs.
“Before NHIF we were paying Sh500 per month, but now we have to pay Sh6, 000 per year before they can access treatment. My wish is that all our treatment could be catered for by NHIF because sometimes we are told that our funds have been exhausted, which makes it difficult to plan financially for treatment. While I am glad that I have received treatment, there are some of my friends who have no access to treatment and have died before receiving it,” says Dorcas Abwala, one of the beneficiaries of the programme.
Food is not the only thing that cancer patients gain from the meetings organised by Angalia. The patients encourage each other and sometimes experts who train them on how take care of themselves, boost their self-esteem and start businesses come to talk to them. Other times doctors come in and gives them expert advice.
One of the experts includes Dr. Edwin Kimathi, proprietor and CEO of Liana medical centre where the group holds its meetings. One of the main challenges the group initially faced was finding a safe venue to hold meetings, but Dr. Kimathi agreed to host them in his hospital’s compound.
“I was approached by Angalia when Covid-19 started since there was a lot of fear because of the pandemic and some of the patients could not access basic services. I thought that I could offer them some space and educate them about cancer and steps to take to ensure they don’t get infected by Covid-19. Majority of the residents are low income earners who cannot access such services with some lacking a steady source of income hence the food supplies are important,” says Dr. Kimathi.
The other challenge they face is the influx of people who are not cancer survivors who flock their meeting to get food supplies. The fact that the meetings are conducted in an area where majority of the families have been adversely affected by the pandemic, makes it a difficult process to ensure that the right people get access to their supplies.
“To solve this issue we have records and every person signs once they get their supplies. We also don’t hype the meetings so that we don’t attract crowds. However, even with this, we still have people sending their children to request for food, which is sometimes a challenging situation as our supplies are not enough for everyone,” says Angalia.
For a month, Angalia requires at least Sh6,000 for every cancer patient to cater for his or her supplies. In the first months of the pandemic, many people came out in large numbers to support the project and with time, the number has grown.
“I am grateful for politicians and some corporates such as Safaricom who have chipped in to assist with the project. However, it has not been an easy task convincing donors to come on board,” she notes.
Even as Angalia tries to bring on board experts to talk to the cancer patients on being economically independent, she still requires funds to assist the members start businesses so that they can become self-reliant.