By Habil Onyango
When Dorah Anyango, 56, took her ailing husband to Moi Teaching and Referral Hospital in Eldoret for medication, she never knew her life would change forever.
A resident of Wi Obiero village within Homa Bay County, had for long been living her normal life and ongoing with her normal activities without noticing any serious medical complication.
The mother of six, however, had been experiencing some headaches, a matter which she never took seriously since she could access over-the-counter medications that used to reduce the pain and had never thought of going for a checkup.
Her late husband, who had been suffering from colon cancer, was referred to MTRH, and she accompanied him after his condition worsened.
One day at the hospital, Anyango found herself in one of the wards after she collapsed, not knowing the actual cause after being rushed by the emergency team
“When I came back to my senses, I found myself admitted to another ward, which was different from where my husband was. I could not remember what actually transpired,” she said.
To her surprise, the Doctors narrated to her the ordeal and informed her that she had collapsed due to hypertension, which might have been caused by the illness of her husband, who later passed on.
“I used to suffer from headaches on regular occasions back at home, but never took it seriously since I could afford pain killer drugs which temporarily relieved pain, not knowing that I had some underlying medical conditions.”
“Due to the challenges we were undergoing as a family, sometimes of were stressed up, but I never thought this could lead to hypertension since I never even bothered to go for medical checkups, but I used to depend on pain killers whenever I felt unwell,” she said
“I was really surprised when the doctors informed me that I had high blood pressure since it had never even run through my mind or thought of suffering from such a disease,” she said.
“I thought that my world had come to an end following the revelation; however, after cancelling and being informed that the condition is manageable, I came to reality and accepted the condition before being enrolled on medication”, she said.
Back at home, the patient started buying the drugs at a local private health facility until 2022, when she could no longer afford them due to the high prices.
“We were exhausted after the passing of my husband in 2011, and with the support of well-wishers and family members, I was only able to buy the drugs until 2022 when I stopped due to lack of finances,” she said.
Her condition, however, worsened after defaulting.
However, one evening, good luck knocked on her door when one of her friends directed her to seek medication at Nyalkinyi health centre, where free hypertension services and drugs are being provided.
According to Anyango, ever since she got enrolled at the facility, she has been living a healthy life since she has been getting free hypertension drugs, thanks to the support from Médecins Sans Frontières (MSF), an International NGO based in Homa Bay.
According to the Ministry of Health, globally, three out of every ten individuals are living with hypertension; however, in Kenya, the prevalence rate is 24 per cent.
About 78 per cent of people diagnosed with the disease are not on treatment, and for those on treatment, only 3 per cent have achieved blood pressure control, according to the STEPS survey 2015.
According to the Kenya Health Facility Assessment, 2018, approximately 44 per cent of health facilities in Kenya are not able to diagnose and treat hypertension.
According to MOH, hypertension, along with other NCDs like Diabetes, Hypertension, Asthma, Epilepsy and chronic obstructive Pulmonary Disease, among others, account for up to 39 in every 100 deaths in Kenya.
However, in Homa Bay, MSF is currently offering free medical services to patients suffering from the NCDs at Nyakinyi and Marindi Sub-County Hospitals within Homa Bay Town Sub-County.
Hypertension, or High blood pressure, is a condition where the heart pumps blood around the body with greater force than normal, and it is a common lifelong disorder that many people develop when they grow older.
According to the MSF Programs Coordinator, Anne Bruckenhoff, they came up with the initiative in 2019 following an internal review in the inpatient department at the Homa Bay County Teaching and Referral Hospital, which showed that one in every five deaths occurred from chronic diseases.
She said, according to the review, it was noted that among patients with chronic diseases in the County, four in every five deaths occurred in the first 24 hours of admission.
“Following these findings, in 2021 MSF implemented a decentralised, simplified model of care for chronic diseases in Nyalkinyi and Marindi health centres within Homa Bay Sub County,” she said.
“This was a way to reduce the deaths and complications associated with chronic diseases, which enables the patients to be treated for their disease in smaller facilities closer to where they live,” she said
According to the coordinator, the decentralisation of care also includes an established referral framework for a continuum of care from these health facilities to the Homa Bay Teaching and Referral Hospital.
Bruckenhoff revealed that together with the Ministry of Health, they are currently supporting 1,394 patients at Nyalkinyi and Marindi health centres.
“At the moment, our organisation is providing support to 870 patients at Marindi and another 524 at Nyalkinyi Health facilities, and the number continues to increase,” she said.
“We know many people remain undiagnosed, untreated and unaware of the dangers brewing within them. Hypertension is a silent killer, and everyone is urged to take the initiative and get a check-up so that they can know their condition,” she said.
Apart from offering free medication to the hypertension patients, MSF has also supported the MOH by training Health workers to be able to conduct screening, diagnose and manage the condition effectively.
They have also been facilitating regular follow-ups, offering counselling services to patients and community outreach to keep the patients engaged in the care.
The organisation has also been creating awareness to let people understand blood pressure control.
“Our effort has led to many people now coming out for regular checkups, not only on the hypertension but other NCDs,” she said.
The coordinator, however, revealed that despite the strides they have made in tackling the disease, there are several challenges.
She said that the unavailability of anti-hypertension medication and, lack of enough lifesaving drugs have hindered their efforts to serve the patients diligently.
Access to health care, she said, is limited, especially in the rural areas, due to the distance they need to cover and the transport costs they need to access the two facilities, which are the only ones offering free hypertension services in the entire Homa Bay.
Lack of awareness has also affected the locals since many people still lack the information needed to understand why regular blood pressure checkups are important, which can enable them to seek support.
The coordinator, however, called on different stakeholders, the MOH, Health policy makers, and partners, to prioritise hypertension as a serious health issue.
She advised them to invest in diagnostic tools, especially at the Primary care level and also to supply medications to all medical facilities across the country.
She further called for the training of more health workers on proper management of the chronic diseases, advising, “Hypertension may be silent but the damages it causes is not, act early, measure your blood pressure regularly, control it effectively and help all the community live longer.”
“Hypertension is a silent killer disease; however, with proper care and medication, it is manageable,” she said.
Salome Akinyi from Rongo Constituency, who has been receiving her drugs in Homa Bay, however, said that hypertension is manageable and she has lived with it for over seven years since she was diagnosed with it.
She urged those who have not gone for the checkups to do so to enable them to know their conditions.
“If I had not gone for checkups and enrolled in drugs, I would not be alive by now,” she said.
“To those who are suffering from the disease, the best way to live longer is to enrol for the drugs, take your drugs in time and live a healthy life as directed by the doctors,” she added.
Mboya TJ, a resident of Komollo village, Homabay Town, who was diagnosed with the condition three years ago, however, challenged the County Government to allocate some funds so that they can be easily available in various health facilities within the County.
He said several patients are dying silently since they cannot afford to purchase the drugs, and due to the long distance from the two health facilities established by MSF to access medication.
“The County Government through the MOH should put into the budget allocation for hypertension drugs to enable the sick to access them at closer facilities,” he said.
“They should not assume that MSF are helping the patients; they should also chip in and offer checkups, and offer drugs to patients freely,” he added.
In an effort for a long-term plan, Mboya revealed that they have already formed a Community Based Organisation within Homa Bay Town Sub County, which provides psychological, social and economic support to its members who are suffering from hypertension.
He cited that MSF, being a private and international NGO, might decide to leave the Country at any time, and this might leave their lives in jeopardy since it is the only one caring for the hypertension patients.
“We came up with the group to offer our member psychological, social and even economic support for instance even one of our members might lack money to buy drugs we can organize for a fundraiser and assist him or her to get the essentials even for two or three days to be able to continue with her or his life as usual,” he said.
He, however, advised hypertension patients to join the organisation to help in solving unforeseen circumstances that might affect them in future.
Homa Bay Public Health Officer, who coordinates health promotion and education, Kennedy Omollo, however, assured the residents that the County Government has enough Community Health Providers who are capable of offering check-up services to the locals.
“We have enough well-trained CHP in all parts of the County who are creating awareness and offering various services, including hypertension checkups,” he said.
The Officer, however, advised the locals that early detection and control of blood pressure can keep them healthy.
“Hypertension does not cause symptoms, and this means that most people who have the condition do not feel sick and may not be aware they have it, and this can only be revealed through a checkup,” he said.
He, however, advised that for one to control hypertension, he or she should stop smoking, check the weight by avoiding being overweight, reduce taking too much salt and fats regularly, avoid taking a lot of alcohol, avoid stress and always exercise.
Currently, MSF, whose County office is based in Homa Bay Town, is the only organisation that offers free NCD treatment with only two facilities in the entire Homa Bay County.
