Kenya is facing a double burden of communicable and non-communicable diseases. Clustering of infections (such as HIV or TB) and noncommunicable diseases such as diabetes or hypertension is now common. This is putting pressure on the overstretched healthcare system.
In spite of this, many individuals with noncommunicable diseases remain undiagnosed for a number of reasons. These include unfamiliarity with symptoms, lack of testing equipment, and costs associated with the tests.
Recent statistics show that just over half a million adults were living with diabetes in Kenya in 2019. About 40% were unaware of their condition. Deaths from cancer are estimated at 7% while cardiovascular diseases account for 13%.
Overall, almost half of hospital admissions and about 55% of deaths in Kenya are associated with noncommunicable diseases.
This leaves countries like Kenya in a particularly vulnerable position when it comes to the severity of COVID-19. Globally, evidence shows people with underlying medical conditions such as cardiovascular disease, hypertension, diabetes or cancers are at a higher risk of COVID-19.
Is the health system in Kenya prepared?
Even before the COVID-19 pandemic reached Kenya, access to chronic care, especially for noncommunicable diseases, was challenging. This is worse for patients with more than one chronic disease.
Kenya’s health system is fragmented and largely designed to manage individual diseases rather than managing patients with multiple diseases. This is partly due to health system challenges such as staff shortages, inadequate or dysfunctional medical equipment, drug stock-outs and unskilled providers.
Unlike HIV, tuberculosis and malaria, access to care for most noncommunicable diseases such as diabetes is a major problem especially among the poor. Findings from our study at Mbagathi district hospital in Nairobi revealed some of these challenges.
A 52-year-old female patient said:
My HIV/AIDS care is provided free of charge but other diseases such as diabetes I pay for.
Another 58-year-old male patient said:
Every time I use KSh.1500 (US$15); consultation fee is KSh.300 ($3); I buy drugs for three months and that costs KSh.300 ($3).
During the COVID-19 pandemic, access to care may be even more difficult due to overwhelmed health systems, lockdown and curfews as well as fear of infections. Currently, preparations are being made to prevent or manage COVID-19 cases. But little is said about protocols to manage patients with chronic conditions.
It’s important to strengthen the healthcare system in Kenya to offer integrated care that addresses not only the COVID-19 pandemic but also chronic illnesses.
Management of COVID-19 should take account of other conditions. The current funding such as the $50 million provided by the World Bank should provide horizontal treatment and care. It should address all conditions rather than only prioritising COVID-19 cases.
Integrating care means that individuals could get access to testing and medical care for COVID-19 as well as other conditions such as diabetes or hypertension.
The Kenyan government must also provide healthcare workers with adequate personal protective equipment and address staff shortages by hiring more unemployed doctors and nurses.
And healthcare providers with chronic conditions must be relieved from being at the frontline in managing COVID-19 cases. If this is not possible, providers must be well protected to avoid being infected.
Collaborating with communities and local administrations will help in reporting and tracking cases or deaths, and citizens who defy government laws. Community health workers can sensitise community members and individuals at risk of COVID-19 on preventive measures.
Finally, the police force in Kenya should be made aware that, even during the COVID-19 pandemic, patients with chronic diseases need constant engagement with hospitals. Lockdowns or curfew measures should be sensitive to these populations.
Econet Wireless hiked data prices by up to 225 percent overnight Tuesday – sparking anger from hard-up Zimbabweans.
The increase in data costs could not have come at a worse time for Econet customers who are in the middle of a coronavirus-induced lockdown that has forced many to conduct business online, including universities and private schools.
There was no explanation for the sharp price increase, but in a letter to its suppliers on April 20, Econet said it was experiencing "difficult trading conditions" occasioned by a "harsh economic environment and the compounded effects of the Covid-19 pandemic."
"As Econet, we operate in a regulated industry where our tariffs are significantly trailing the upward movement in our operational costs, threatening the viability of our business," wrote Econet chief supply chain officer, Sharon Marufu, in the memo.
"We, therefore, need to take drastic measures now to safeguard the business and ensure we remain viable so that we are able to continue offering our services to our customers and to retain our suppliers."
Ironically, Econet was asking its suppliers to slash their prices by 20 percent. The suppliers targeted in the memo included companies providing fuel, trucks, shop space for Econet's retail outlets, and land for base stations.
Zimbabweans reacted with anger to the latest increase on social media, and the hashtag #EconetMustFall was trending on Tuesday morning.
"Everyone is depending on data for work and school and you just chock-slam us with a Z$1,300. Nonsense. Adjust down," one Econet customer wrote on Twitter, quoting the new price of the monthly ‘Private Wifi' which went up from Z$400 for 25GB.
"Lack of serious competition enables Econet to do as they please. The barriers to entry in the telecommunications industry means that we are doomed for a long, long while as consumers and we can't do anything about it," added Paul Nyabando on Twitter.
The popular Private Wifi bundle also sees 50GB go up to Z$2,000 – more than a third of a doctor's salary.
Econet customers also complained that the price increase was effected before midnight, between 10 and 11PM – denying many a chance to buy data at the old prices.
Last month, the Zimbabwe government agreed with bakers, millers and other businesses to cut the prices of basic goods, including bread and sugar, to levels before the country entered a coronavirus lockdown on March 30 amid soaring inflation.
Annual inflation has hit 676.39 percent, one of the highest rates in the world, as a currency that was re-introduced last year weakens amid acute shortages of foreign currency, food and hospitals short of medicines.
Vice President Kembo Mohadi said price increases seen since March 30 were "speculative and unjustified."
Mobile phone companies are regulated by the Postal and Telecommunications Regulatory Authority (POTRAZ), which must approve any price increase.
South Africa on Wednesday confirmed that Madagascar had requested assistance with scientific research on Artemisia – the herb used in the production of COVID-Organics.
Addressing the issue, Health Minister Zweli Mkhize said South Africa had agreed that its scientists will only assist with analysis of the herb.
“We received a call from the government of Madagascar, who asked for help with scientific research. Our scientists would be able to assist with this research. We will only get involved in a scientific analysis of the herb. We are not at that point yet,” Mkhize tweeted.
The now controversial herb has been donated by the Malagasy government to a number of African countries amongst them: Equatorial Guinea, Republic of Congo and Guinea-Bissau – the latter received a consignment meant for the ECOWAS region.
The African Union, AU, have confirmed that they are in talks with Madagascar over COVID-Organics, the island nation’s purported herbal cure for COVID-19.
A May 4 statement by the AU said it was in contact with Antananarivo “through its embassy in Addis Ababa, with a view to obtain technical data regarding the safety and efficiency of a herbal remedy, recently announced by Madagascar for the reported prevention and treatment of COVID19.”
AU and Malagasy diplomats have held meetings in Addis Ababa with the view to getting necessary information regarding the remedy.
“Once furnished with the details, the Union, through the Africa Centres for Disease Control and Prevention (Africa CDC), will review the scientific data gathered so far on the safety and efficacy of the COVID-19 Organics.
“This review will be based on global technical and ethical norms to garner the necessary scientific evidence regarding the performance of the tonic,” an AU statement further disclosed.
Meanwhile, the World Health Organization, WHO; have reiterated its caution against people putting their faith in herbal remedies that have not been scientifically tested.
In a statement, WHO said despite supporting all efforts – including traditional medicines – in search for treatments, it was important that any purported treatments be thoroughly tested.
In his last address, President Rajoelina said Madagascar was building a factory to scale up production. He also said the cure was to undergo clinical trials and that aside the drinks, injection options were being pursued. Over half-dozen African countries have expressed interest in it.
Credit: VILLAGE REPORTER