<p><span style="font-family: helvetica;">Just the other day I sat in clinic and watched a grown woman 
break down in tears. She tried her level best, but the stream of tears kept on 
flowing. While I did my best to hold back my tears and console her, my heart 
was breaking on the inside. Her insurance cover was exhausted and she had no 
other source of income to cater for her continued chemotherapy. This is 
unfortunately not a new scenario in clinics all over the country.</span></p><p><span style="font-family: helvetica;">I reflected upon the fact that as we battle the COVID-19 
pandemic, the health issues of our other patients with acute illnesses and 
chronic illnesses such as cancer, diabetes and heart failure to name a few have 
not stopped. Cancer patients still have the same fears and questions: what 
stage is my cancer? Is my cancer curable? What treatments do I need? What are 
the side effects of treatment? Will my cancer come back? Will I be in pain? How 
much will my treatment cost?</span></p><p><span style="font-family: helvetica;">In addition, cancer patients and indeed patients with other 
medical conditions are watching the news and hearing that they are at higher 
risk of getting complications from COVID-19. Therefore, they now have new fears 
and concerns. They worry about their safety to come for reviews and treatments. 
How their immune system will respond if they get infected with COVID-19? Transport 
is more expensive and harder to get. Some imported medications are taking 
longer to come in. And with the recent lockdown of four counties, some patients 
may be cut off from their regular doctors.</span></p><p><span style="font-family: helvetica;">As my colleague and friend, Dr Andrew Odhiambo, so aptly 
described it in a recent Facebook post, it is estimated that approximately 700 
people have lost their lives to esophageal cancer in the first quarter of 2020. 
This is if we are to go by estimates of GLOBOCAN 2018 where 3000 people lost 
their lives to esophageal cancer. This figure is likely to be higher and this 
is only one cancer type. Imagine if the Cabinet Secretary for Health held a 
press conference every day giving us the daily figures of the number of cancer 
cases and deaths.</span></p><p><span style="font-family: helvetica;">The problem with chronic diseases is that patients struggle 
with their diseases for long periods and the deaths do not have such a shock 
factor as a pandemic like COVID 19. Make no mistake, this pandemic is a serious 
health emergency that demands all necessary steps being taken. It is however 
very important not to forget all the other medical conditions that patients are 
struggling with and the resources and improvements they need to be healthy and 
productive members of the society.</span></p><p><span style="font-family: helvetica;">Cancer diagnosis and treatments are expensive and take long 
to complete. While we applaud efforts of National Health Insurance Fund for 
greatly assisting patients access care, a lot is still left to the individual 
patient and family members to cater for. This will hold true for other chronic diseases 
such as patients with kidney failure requiring dialysis or immune suppression 
drugs after kidney transplant. Apart from cost, access to treatments such as 
radiotherapy is also limited to Nairobi and Eldoret.</span></p><p><span style="font-family: helvetica;">While we stay home to save lives, keep our distance from 
others (a metre at the least), wear our masks and wash our hands with soap or 
sanitize with 70% alcohol to reduce the spread of COVID19, let’s remember to 
pray and support our other patients with other diseases whose statistics you 
will not see day to day but they are there in large numbers and still need care 
and support.
</span></p> 
 
<p><span style="font-family: helvetica;"><strong><em>By Dr Sitna Mwanzi, Consultant Medical Oncologist at Aga 
Khan University Hospital and Chair, Kenya Society of Haematology and Oncology 
(KESHO)</em></strong>
</span></p>