According to Kenya Renal Association (KRA), about four million Kenyans are suffering from chronic kidney disease with less than 10,000 of them on dialysis. Further reports estimate that 4.8 million Kenyans will be suffering from kidney disease by the year 2030.
Currently, an increased number of patients have been diagnosed with kidney problems and injuries in various health care facilities worldwide. This is according to a physician at Kenyatta National Hospital, Dr Owuor (not his actual name) who believes that the country currently has about two million people who need to undergo kidney transplant (Okeyo, 2017). Cautioning that the figure is only an approximate, Dr. Owuor observes that the numbers are likely to be higher and more people are likely to be diagnosed with kidney failure. This is because of extensive use of unsafe herbal medicine and drugs that are in high circulation all over the country. While people do not fully trust the medicines sold cheaply along the streets without need for any tests or professional advice, Dr Owuor reveals that increased cost of living in the last five years, rising cases of unemployment for educated youths as well as ease access of herbal drugs all over the country are factors likely to cause a spike in the number of people needing kidney transplant in the next five to ten years.
According to another physician at MP Shah Nairobi, the number of people seeking kidney transplant annually is about 100 and 150 every year in one health care facility. Since there is more than one hospital capable of handling such procedures, Dr. Tawil (also not real name) revealed that on average, the number of kidney transplant surgeries performed annually could be about 500-700. The figures are expected to be higher as while some cases are handled internally, there are those patients who opt to receive the kidney transplant services outside the country. This has been the case in the past and while a good number of physicians within the region have been able to handle these procedures successfully in the last five to ten years, some patients still demonstrate their lack of confidence in these doctors or opt for less wait period hence seeking the health assistance abroad in regions like India, South Africa, and Israel (Omulo, 2018).
Percentage Covered by Insurance
Doctors at MP Shah and KNH attribute the recent developments in kidney transplant surgeries and proper management of related renal illnesses to increased government involvement in the operations of the ministry of health. In 2000, referrals hospitals and teaching colleges introduced dialysis programs a situation that saw more patients get help faster while increasing chances of survival. Recently, the National Hospital Insurance Fund (NHIF) also increased the number of cases they would pay for under their cover and this included payment of dialysis (Ubaya, 2018). While this cover hardly pays for all the procedures, Dr Tawil laments that without it, the situation would be worse especially for the patients seeking medical assistance at a private health care facility.
NHIF is accessible to all Kenyans and in fact for government officials, the medical cover is compulsory hence a good number of patients seeking medical care have coverage. NHIF is not however the only medical cover accepted in the health care industries with regards to kidney transplant surgeries and dialysis. Other private players in health care insurance have been able to offer assistance but according to Dr Owuor, they hardly provide full coverage and most patients strain financially while seeking the treatment procedures. Medical insurance covers pay for about 30% of treatment needed with regards to kidney treatment and management and the rest is paid from out of pocket (Ubaya, 2018).
A talk with a physician at Murugu herbal clinic showed that patients unable to afford dialysis and kidney transplant have been seeking for medical assistance from herbal clinicians. While there are good, professional, and certified herbal points in Nairobi, quacks are on the rise and unsuspecting patients have been falling victims to medical fraudsters every day. As a result, in attempts to get cheaper health care they have ended up worsening their medical conditions and later death. This is the main reason why legit herbal clinics like Murugu have been unable to fully gain the trust of their patients in the region or the whole country at large (Murugu Clinic, 2019).
It is not very hard to locate herbal medical points within Nairobi or any other county. Every day sale-traders hawk their drugs along the streets, in buses, within buildings and places of work as they try to make their services known. Further, with the increased number of smartphone users and digital marketing in Kenya in the last three years, a single search on the internet is likely to yield a good number of Facebook and twitter pages for salespersons, herbal clinics or doctors offering herbal services for various ailments including leukemia, kidney and liver.
Considering kidney transplants and dialysis are costly whether an individual is seeking care abroad or not, a search on the internet revealed that many people try the social media as a source of fund. Facebook, Twitter, Instagram, and WhatsApp are the main sites where legit and con-men have been posting their messages seeking for financial aid from Kenyans. It is not uncommon to also find individuals asking for financial aids from Television programs, during news bulletin and media advertisements. Other additional crowdfunding mechanisms include using of forms for pledges, holding fund-raising events, holding fund raisers at Christian gathering centers, and even using forms to ask for donations from door to door or along the streets of Nairobi. However, the most common options are social media and media platforms (Ubaya, 2018).
More than 10,000 Kenyans seek treatment in India for complex diseases annually according to statistics from the National Health Insurance Fund (NHIF). Besides the low cost, most Kenyans admire the speed with which diagnosis and treatment is done in India. Opting to go to India should ordinarily be expensive considering the airfare, accommodation and treatment, but ironically, patients have found this far cheaper than seeking treatment in Kenya.
John, now 40-year-old, has been suffering from renal conditions since he was 16 years old. He is a small bodies man and a person can be forgiven to confuse him for a 12-year old. He has been attending MP Shah for dialysis for seven years now and he has had 6 surgeries so far. Before he sought treatment from MP Shah, he was among those who relied on KNH for all his renal treatment and as Dr Tawil reports, the wait used to be too long that at one point, John’s family traveled to India for treatment. A doctor at KNH referred them to a specialist in India and recommended for a kidney transplant. Unfortunately for John, his body rejected the two kidneys he received there as well as the other four he has since received at KNH and MP Shah. The process of receiving kidney and undergoing surgery in India is faster compared to Kenya. While the cost is not too much, chances diminish when a patient does not have adequate funds to cover the expenses. In Kenya, the list of patients waiting for kidney transplant surgeries is always long and most, without family members to donate kidneys for them, they stay on the queues for even longer than three years. John has been through the treatment process in Kenya and India and reporting on his behalf, his current doctor revealed that the expenses have rendered John’s family poor.
Things may be different in future as the NHIF has signed memorandums of understanding with some medical facilities in India such as the Apollo Navi Mumbai. Some doctors from Kenya are getting trained in India, while doctors from India do fellowships in Kenya in order to build capacity locally.
Kenya Renal Association https://kenyarenal.org/
Murugu Clinic. (2019, April 17). Murugu Clinic. Retrieved from https://muruguclinic.com/kidney-transplants
Okeyo, V. (2017, July 3). World Kidney Day. Daily Nation, p. 3.
Omulo, C. (2018, March 6). Mbagathi Hospital to perform kidney transplant from next week. Daily Nation, p. 8.
Ubaya, L. (2018, September 27). NHIF asked to improve cover for kidney transplants. The Star, p. 18.