Eric must set aside Sh12,000 every month to buy insulin and other drugs
As an impressionable young man straight from form four, January of 2006 was my first month in "freedom".
But then, I started getting continually thirsty and would suffer frequent headaches, which I attributed to the hot and dry weather.
Eventually, I checked into hospital because of high fever, believing I had contracted malaria. But the lab results were negative.
The doctor suggested that from my symptoms, he should test for diabetes.
The results showed that my sugar levels were a high of 33, while a normal person’s sugar levels are between 4.5 to 6.5. I could hardly tell what awaited me.
I was admitted at the high dependency unit of the Aga Khan Hospital in Nairobi for three days as doctors struggled to lower my dangerously high blood sugar, and later spent two days recovering in the general ward and learning how to use the diabetic pen to inject myself.
I had joined the more than 1.8 million young Kenyans living with diabetes.
There are two major forms of of the disease. Type 1 diabetes is characterised by a lack of insulin production; the cause is unknown and it cannot be prevented.
I was diagnosed with the far more common type 2, which accounts for about 90 per cent of all diabetes globally. Often preventable, it results from the body's ineffective use of insulin.
The doctors slowly explained that I would need daily insulin injections for life. Otherwise, over time, the diabetes could damage the heart, blood vessels, eyes, kidneys and nerves, causing chronic problems and early death. I was heartbroken.
Over time, I have come to understand what this really means. While other young people have to only contend and even share monthly food and rent bills, I spend more.
I inject myself with insulin four times a day, three times with Humalog insulin before meals and before I sleep, with Lantus insulin.
A packet of Humalog insulin containing five cartridges costs Sh4,750 and lasts for a month, while a single cartridge costs Sh950 and only lasts for a week.
A single cartridge of Lantus insulin, which I use once after supper, lasts for a week and costs Sh1600.
I also buy 50 diabetes strips to monitor blood sugar levels before meals and two hours after meals. The fifty strips cost me Sh1600 and last eight days. But at least I do not have to test the sugar levels daily.
When I was diagnosed in 2006, I started attending diabetic clinics at a private hospital and this cost Sh2,500, later rising to Sh3,200 per visit.
At some point I abandoned the clinics because of the cost but I later found a different private hospital that charges Sh1,500 per visit.
That means every month I must set aside Sh12,000 for my health.
When these costs become nearly unmanageable, I sit back and wonder how the hundreds of thousands of other diabetic Kenyans cope.
I recently sought to hear from Eva Muchemi, the executive director of the Diabetes Management and Information Centre (DMI).
Muchemi says that through the National Non-Communicable Diseases Strategies, the Kenyan government can seek funding to lower the costs of treating and managing diabetes.
DMI provides education and training to people with diabetes, health care providers, the general public and other stakeholders involved in the disease on its management and prevention.
They also organise awareness activities in schools, community and social groups and companies
They also help procure insulin for young people under the age of 18 years with type 1 diabetes who can't afford it.
I realised that the high cost of managing diabetes also bothers them.
"The prices of insulin are quite erratic depending on where one gets theirs from. Insulin is treated commercially whereby pharmacies are in business to make money and thus the cost can go beyond what most people can afford. Some pharmacies can sell the insulin from Sh1500 to Sh2500 per vile and you that people can't just live on just one vile. That is a stiff cost to a lot of Kenyans considering what they earn," Muchemi told me.
"Nowadays, there is insulin in some pharmacies coming from the project called 'Base of the Pyramid' which is supposed to be sold at Sh500, which is still a lot. When we had the national government controlling the hospitals, insulin was being sold at Sh200. We're hoping that with the county governments and devolved systems of health, we will have insulin being sold at Sh200. Young people below the age of 21 years should be given insulin at no cost since they aren't earning anything yet. Since insulin is a life saving drug like the anti-retrovirals (ARVs) and the TB drugs, insulin should also be considered to be for free, since for diabetics, costs are not the only for the drugs. There are tests that require to be done. One needs to buy strips on a regular basis to check their sugar levels, one needs to eat a healthy diet. Hence for the parents it becomes an uphill task which needs to be lessened. In other cases you may find that insulin is affordable but inaccessible or accessible but expensive. The two need to go together, where insulin is affordable and accessible," she said.
Some reports say steps to prevent diabetes in Kenya and lower the cost of management are probably being taken, such as the recent collaboration between the Ministry of Health and Kenyatta National Hospital in the management of hands-on training to medical students about diabetes prevention, care and treatment methods.
The government's National Medium Term Plan and National Health Strategic Plan (2014-2018), which focuses on the prevention and control of non-communicable diseases, also offers some hope.
Internationally, the World Health Organisation is establishing diabetes initiatives for other countries through its Global Action Plan for the Prevention and Control of NCDs (2013-2020).
Its focal point is on the termination of the growth in obesity and diabetes as well as reducing 25 percent of diabetes deaths by 2025.
In Kenya, diabetes is more prevalent in urban areas, which is attributed to people’s lifestyle changes such as decreased physical activity, increased smoking and alcohol intake.
Unhealthy diets have also contributed to the prevalence of the condition with people eating more foods with higher calories, sugars, saturated fats and salt while the intake of fruits and vegetables has reduced.
This has led to the increase in people who are overweight and obese, thus increasing their risk of premature death and disabilities from non-communicable diseases that reduce the quality of life.
But I understand, like for my case, the exact cause of type 2 diabetes and what triggers it is still unknown, but with the rapid increase in the number of people diagnosed with this condition over the past few years, new research and theories are developing.
However, there is low awareness of the condition in Kenya despite the fact that the World Diabetes Day is usually marked on November 14.
What troubles me most is the daily risk many diabetic people face simply because they cannot access the life-saving insulin or quality health care.