Response from the public

Kui Muthigani

SOLDIER ON DOCTORS!!!!
by Margaret Ayienda on Saturday, December 10, 2011 at 9:11pm

My first unfortunate and very personal encounter with the public health system was about two years ago.This is the time my mother was diagnosed with cancer,cervical cancer to be precise.I must say it was a long heart rending journey that has and will always be etched in my life.

We first consulted a gynaecologist at the KNH doctors plaza who then referred as to an oncologist immediately,who in turn told as that a sample of the growth was needed for accurate diagnosis and staging of the cancer to enable her to know what course of treatment to prescribe.It was a simple procedure,she said,and it only required that my mom be put under for about 30 minutes and it would cost some Ksh.5000 at KNH compared to private hospitals which would charge at least Ksh.20000.

We opted to for a private hospital due to the urgency and the procedure was done and we got the results in 5 days.The pathology report confirmed our worst fears and here began our never-ending trips to KNH.It was a stage 3 highly aggressive cancer.The oncologist ruled out a hysterectomy and chemotherapy citing it would be in vain because it had already spread to the surrounding areas and mom was to frail.The only option left was radiotherapy everyday for six weeks.

The radiotherapy sessions cost Ksh.330 per session at KNH compared to an average of Ksh.1200 at other private hospitals.Therefore we settled for KNH because the other hospitals were beyond our reach.We were given an appointment time of 8.00a.m everyday.Little did we know that it would translate to 12pm onwards.We would be at KNH by 6.00am but find at least 20 patients already in the waiting room..This was due to the long queues at the radiology department.The technicians would come in at 8.30am.Hitherto,i still shudder at the thought of that waiting room.Most patients were critical,with all types of cancers and worst of all the smell was sickening,nauseating to any healthy person.The washrooms were not any better and any sane person would have to go there with gumboots so as not to pick an infection.

More often than not,we were required to carry our own gloves because the radiology technicians always said they were out of stock.It was either you buy the gloves or if you are the caregiver,undress your patient and ensure the diseased part is exposed under the machine before they put in on.After each session was complete,the caregiver would be called upon to dress the patient and wipe the surface with a disinfectant.I recall, that with time i had to force mom to wear adult diapers simply because one of the side effects of radiotherapy,diarrhoea would not let up.I did this for her and myself to avoid infections from the washrooms because she had uncontrollable diarrhoea and could soil herself anytime of day.

After a gruelling one week of radiotherapy,the oncologist stopped mom's sessions since she had become too weak due to a dangerously low hb of 6.She consequently ordered a full blood count,fine needle aspiration of the inguinal nodes and a doppler because her thigh was swollen such that she couldnt walk.All these tests were carried out in different parts of KNH as i discovered that day.You can imagine my frustration having to take someone who cant walk even 50metres to the farthest ends of Knh for these tests.I got a 'good samaritan' (cleaner) who volunteered to get me a wheelchair for Ksh.50 so that i could take my patient for the various tests.We became' good friends' with this cleaner as he would provide me with the wheelchair everyday,of course at a fee,as eventually mum coudnt walk.

Results which were due the next day got lost.They had supposedly been sent to the prescribing doctor who in turn said she had not seen them.I was only given the doppler results that day.So i concluded they were lost and crossed over to the privatley run lab at doctors plaza where i got tangible results within an hour.Afterwards i came to discover that they would take blood for testing while in fact the blood count machine was faulty and non-functional most of the time!

Within those six weeks of radiotherapy mom got 4 blood transfusions of two pints each, definitley not at KNH.Our thinking was if the blood count machine wasnt working,what other machines were not working?How do they test blood types and anything else to do with blood?I dont know, but at that time we were unwilling to take the risk of a wrong blood type being administered.All this while,the oncologist would change mom's medication at will due to the adverse and worsening side effects.Up to date i still remember all the 15 types of medications by name. Amazingly,I only got two in the KNH pharmacy,immodium and morphine, the rest were out of stock.Surprisingly the prices of even the 'out of stock' medications would be pinned on the wall!Why even bother,i would wonder.All these medicatons would cost at least Ksh.1000 per day owing to the high retail prices in town.

Mom completed the radiotherapy sessions successfully as the growth had shrunk substantially.But more was yet to come since she was still in immense pain.So our oncologist,not one to give up easily, prescribed a procedure called brachytherapy, but on the other hand she was quick to inform us that the machine at KNH had not worked for at least 1year.This procedure,she said,was strictly for pain management in mom's case.Other private hospitals that had the machine charged at least Ksh.200,000 for the 24hour procedure.Frankly,my family was financially,emotionally and psychologically drained.But what were we to do?We would go to the end of the earth if it meant mom would be pain-free.The oncologist suggested Mulago hospital in Uganda which did the procedure at way less than its kenyan counterparts.This,i can say was the worst time for mom because she starved herself for 2 days prior to the trip reason being she didn't want to soil herself during the trip.Nothing or no one was able to convince her to eat but she would still take her pain medication,which in essence made her crazy.She even refused to put on the adult diapers during the journey and God was on our side because she didn't soil herself in the course of the 12-hour bus ride.To cut a long story short,we went and had the procedure done then resumed our ever endless visits to KNH.It was downhill from there as she developed kidney failure and subsequently general organ failure.

Mom succumbed to her illness two months after the brachytherapy procedure,that is six months after the diagnosis.

In my opinion,anyone who has never had a critical patient at a public hospital should zip it!!They should not under any circumstance, condemn the doctors intimating that they are selfish.You who has never seen the walls of a public hospital,have no moral authority to criticise.The working conditions at this public hospitals are deplorable,to say the least.The basics like gloves and disinfectants are lacking.Patients lose their lives due to treatable diseases like malaria.These doctors have a right to work under a conducive working enviroment,they are no more human than you or i.

And doctors out there bravo!I can say you are doing a damn fine job with the little that has been availed.Thank you for fighting for the right to better healthcare,thank you for fighting for our children and thankyou for fighting for us all.