Lest we forget other life-threatening chronic diseases

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.

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?

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.

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.

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.

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.

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.

By Dr Sitna Mwanzi, Consultant Medical Oncologist at Aga Khan University Hospital and Chair, Kenya Society of Haematology and Oncology (KESHO)