By Kelvin Mokaya, @EduardoKelvinho
Image Courtesy: www.fotolia.com
Non-communicable diseases (NCDs) are the leading cause of death globally and diabetes mellitus is the 4th main contributor. It is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, action or both. The World Health Organization (WHO) estimates that the prevalence of diabetes in Kenya is at 3.3% and predicts a rise to 4.5% by 2025.
“It was in late 2002 when I started falling ill. I thought I had malaria and I went to the pharmacy and bought antimalarial drugs. I took the drugs but I didn’t improve, so I decided to go to the hospital. I was told that I had amoeba and typhoid and I was given medicines but even after taking those medicines my health kept on deteriorating. I had the diabetes symptoms but I didn’t know that I could be developing diabetes.
In February 2003, my friend who is a dentist asked me to go to her place so that she could take me to a specialist. She took me to a diabetes and kidney specialist who diagnosed me immediately with diabetes after I told him how I was feeling. He just pricked my finger and tested my blood sugar and confirmed that indeed I had type 1 diabetes at that time I was 20yrs old when I was diagnosed.
I was put on Humulin 70/30 thrice a day for the first 2 weeks and then twice per day after that. It was not easy at first to inject myself but at least my doctor friend guided me through the process until I learnt how to do it by myself. It was not easy at first to accept that I was going to live with the condition for the rest of my life, but with time I accepted it and since then I can’t complain much. I thank God that when I got pregnant in July 2012, I didn’t have any complications through the pregnancy. Now my daughter is 2yrs and 4months old.
However, treatment is expensive and I have to pay out of my pocket. The annual tests are very expensive. I haven’t gone for those tests for 3 years now. Insulin is still expensive in Kenya. You can find it in government hospitals or in pharmacies. In government hospitals it’s a bit cheaper compared to pharmacies. There are people who can’t afford insulin. I wish our Kenyan government could provide it for free. ”
Like Susan says, the high cost and low availability of insulin in Kenya with inadequate patient follow up contributes to poor management. Although the Kenyan government subsidizes insulin to reduce the price for patients, supplies frequently run out and there is miscommunication between local depositories and central medical stores to restock.
Diabetes requires long-term follow up, with uninterrupted access to medication and specialist care. Many health workers lack adequate knowledge and training thus exposing diabetics to suboptimal management. Many health facilities do not routinely screen for hyperglycaemia.
The current disease burden indicates a need for more resources for prevention and health promotion, with primary healthcare taking greater responsibility for chronic diseases. Effective primary care should lower hospital admissions and reduce overall cost. The WHO recommends changes in financing and delivery of services for chronic conditions within Kenya and other sub-Saharan African countries. Funding needs to be reassessed and allocated appropriately, with a greater proportion to NCDs especially diabetes. A lower financial burden on individuals by increasing public funding should:
- Reduce poverty,
- Increase treatment compliance,
- Improve diabetic control and
- Reduce complications, thus
- Reducing further burden on healthcare services.
The burden of diabetes has been recognized. Kenya is addressing the need for improvements through the launch of The National Diabetes Strategy. This aims to prevent or delay the development of diabetes, improve the quality of life by reducing complications and premature mortality. Key interventions prioritize prevention, early detection and control. Hospital diabetic clinics have been established in some of the counties but access remains a challenge due to long distances of travel. Success of such strategies is dependent on their sustainability and local ownership. To date there has been little evaluation of the strategy so policy makers cannot make informed suggestions for improvements.
For Susan and other young people to have access to the highest attainable standard of health, there is need to increase access to diagnostic, therapeutic and palliative care. All this begins with increased budgetary allocation to Non-Communicable Diseases.
The author is a Youth Advocate with NAYA.
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