Challenge

THE CHALLENGE

Some patients undergoing treatment in the Gipap program live very far away from the treatment center in Nairobi. The cost of their regular travel and monitoring is very high thus causing them to fail to access this life saving treatment, most of the time causing an undesirable failure of treatment.

Teresa Iwoton lives in a village near Loima, a small dusty town half a day’s journey from Lodwar in Turkana County. This single mother with no formal employment, has to make this journey that takes her Three days and nights on the road to reach Nairobi City in order to access the Gipap clinic. This monthly pilgrimage is a must for her to get a chance for close monitoring, since she is on second line treatment for CML. Prior to being changed from Glivec, which is the first line treatment for CML, she would attend clinics every three months like most of the other patients. Often times she would fail to make the trip to Nairobi, and miss the three-monthly refills of her doses. This meant that she stays without treatment for sometimes until she can afford to travel to the hospital.

There are quite a number of patients, who, like Teresa, have to go for months without this chronic life-saving treatment.

This is because they find it hard to make the trip to Nairobi and back due to the high transport cost. Failure to take the medicines as prescribed, may result in failure of treatment. In some cases, this is remedied by a change of treatment to second line. In other cases, the results may not be so good and it might mean losing the patient altogether.

Janet Lodomo and Lillian Ametan are two other patients who live in the arid and unforgiving North of Kenya. They too, like Teresa, depend on well-wishers to afford their regular travels to Nairobi for treatment. According to the Doctors, up to 20% (about 250) of all patients usually struggle to make the trip to Nairobi for treatment, and most of them fall off the treatment program. There are three treatment centres, KNH, The Nairobi Hospital & Aga Khan Hospital, Nairobi and one Dispensing centre – The Nairobi Hospital pharmacy). 

There are quite a number of patients, who, like Teresa, have to go for months without this chronic life-saving treatment.

Perhaps one way to ease the suffering of all these patients is to open many more centers across the Country. The Gipap program requires that such a center is run free of charge to the patients; from nursing care, consultation and dispensing the medicines. This also include managing the medicines stocks. It is therefore not an easy venture for many health establishments to arrange. The Nairobi Hospital has dedicated its cancer center; both facilities and nursing staff, has provided pharmacy staff to man the registration and bookings desk, and a dedicated pharmacy to serve patients who attend a fortnightly joint clinic. This clinic is made complete by the volunteer oncologists who give their time to make the clinic successful.

While travelling to the treatment center is obviously the greatest need, Gipap patients also face challenges in getting monitoring tests done. These tests help to inform whether the treatment is effective, and where its not, the dose is adjusted, or the medicine changed or stopped altogether.

The ‘New normal’ occasioned by the emergence of Covid19 has also brought along with it a new set of challenges for our patients and cancer patients in general. Most of these patients are already weakened by the vagaries of therapy (both physically and economically) and therefore giving them a higher than average chance to contract infectious diseases. We therefore need to help them acquire basic Personal Protective Equipment. (Masks and hand sanitizers)

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