Did you know that sitting next to a room where a patient is undergoing an X-ray can actually be harmful to you?
Did you also know that even just walking past a room where the procedure is taking place can be dangerous to your health?
Well, this, according to health experts, is the case if you are exposed to uncontrolled doses of radiation, which can lead to cancer.
To complicate matters, in most cases, it is impossible to definitively attribute cancer to radiation exposure that occurred years or even decades earlier.
As the country’s population grows, coupled with the government’s ambitious programme to offer quality and affordable health services to virtually every citizen, the demand for ultrasounds of 2D, 3D, and 4D systems and CT scans has been on the rise.
This demand has seen the Government invest in modern technology to reduce patients’ exposure to dangerous radiation in hospitals.
But are the patients seeking imaging services in facilities with unqualified radiologists, or who are qualified but simply do not take safety measures when performing the routine?
As one way of dealing with the problem and ensuring better health care, the government is installing Computed Tomography (CT) scan
machines that are free from exposure to dangerous levels of radiation.
TAMING THE RISK
Just like other X-ray imaging exams, CT scans expose you briefly to a small, targeted amount of ionising radiation, which helps create an image of structures inside your body.
The CT scans provide more detailed images of more types of tissue than traditional X-rays do, which allows your doctor to detect and locate many medical conditions.
What is produced is detailed, three-dimensional images that enable doctors to see things previously visible only through a biopsy or surgery.
Health PS Peter Tum says the modern machines being installed at various county hospitals have been fixed with a gadget that taps radiation to minimise the exposure risk to the patient, specialists and anyone working in an adjacent room or even walking near the scan machine.
Some radiographers and radiologists had sought an assurance on the safety of medics who will be operating the new machines.
Health CS Sicily Kariuki has also assured the specialists of the safety of the new machines, saying the technology being used is far much better than what the country has been relying on.
“The safety and level of accuracy of this equipment, in terms of diagnostics and subsequent treatment, is better than what we have had before,” Kariuki said recently.
Commissioning a CT scan centre in Lamu
on
November 17, she said the machines will complement universal health care (UHC) programmes by the government.
“The government is committed to improving health services to all Kenyans by installing 37 CT scan machines in 16 counties. The machines will help hospitals deal with renal medical emergencies and reduce referrals,” the CS said.
BACKED BY RESEARCH
According to a study by Beaumont Health System, a not-for-profit health organisation in southeast Michigan, the use of advanced CT scanning equipment is helping to address the important concern of patient exposure to radiation.
The research, published in the
Journal of Cardiovascular Computed Tomography, found that the use of advanced CT scanning equipment is helping to address the concern by clinicians that the growing use of CT scans could be placing patients at a higher lifetime risk of cancer from radiation exposure.
The study, of 2,085 patients at nine centers in the US and Middle East, found that using newer generation, dual-source CT scanners significantly reduced radiation exposure for patients when compared with first generation, 64-slice, single-source scanners or first generation, dual-source CT scanners.
Patient radiation exposure was reduced by 61 per cent with the newer scanners, with no significant difference in image quality for patients having CT scans for coronary artery disease, pulmonary embolism or aortic disease.
US Food and Drug Administration says radiation dose from CT procedures varies from patient to patient. The particular radiation dose will depend on the size of the body part examined, the type of procedure, and the type of CT equipment and its operation. This, according to health experts, is a technology that was not available with the use of earlier equipment.
According to the Health ministry, radiology department, on top of acquiring the CT
scanners to improve on CT scan services, the government is transforming how radiation safety monitoring is done in the public sector.
A senior ministry official,
who did not want to be named, said:
“Traditionally, film-based technology was used for radiation monitoring. But with the newer, more powerful digital CT scan equipment being installed, there is a need to change to Thermo-luminescent Dosimeters (TLDs). These dosimeters will monitor radiation levels for the healthcare workers, and assess background and environmental radiation leakage within the radiology departments.”
TLDs are wearable devises that measure ionising radiation exposure levels from radiation-emitting devices like general X-ray units and CT scanners.
To boost professionalism in dealing with the new equipment, 30 radiographers and radiologists jetted back to the country from China last month after receiving a month-long training.
They were trained in basic operations, post-processing images, archiving and filming, and positioning patients. They also underwent a mentorship course under the supervision of specialists from China and Europe, in partnership with Megascope Healthcare.
UNIVERSAL CARE
During the 58th World Health Assembly of 2005, WHO member states committed to provide affordable universal coverage and access for all citizens on the basis of equity and solidarity.
Early this year, President Uhuru Kenyatta pledged UHC as part of the Big Four agenda over the next four years.
“For Kenya to achieve universal health coverage, we need high-quality services for health promotion, prevention, treatment, rehabilitation, palliation and financial risk protection,” he said.
Uhuru said accurate diagnosis is the first step in developing an individualised treatment plan, and it is guided by laboratory tests and imaging.
“From the current developments in the world, CT-scan images are classified as basic diagnostic equipment,” he said.
The President is expected to officially launch the national UHC pilot phase
on December 13,
in Kisumu county. Four counties —
Nyeri, Isiolo, Machakos and Kisumu — have been picked for the piloting. The pilot phase of the programme will run for six months. Thereafter, the government will roll out the full programme, if it proves to be successful.
In 2014, the government carried out an assessment of all the hospitals and found out that most of them did not have the capacity to make diagnosis using CT scan machines.
Where the CT scan machines were available, they were old, of low capacity and were not being serviced and maintained as per the standard operating requirements.
“The goal of UHC is to improve access and availability of quality health services. The CT scanners being installed will ensure that this important diagnostic tool is available and affordable to most Kenyans, without travelling to Nairobi, where CT scanners were previously found,” PS Tum said recently.
According to the National Hospital Insurance Fund's annual report, CT scan services were ranked number 12 in terms of its health expenditure during the financial years 2016-17 and 2017-18, at Sh285,069,617 and Sh311,512,561 respectively.
“This is an indication of a need for this crucial service. With the increasing burden of cancer and road accidents, these machines will greatly transform operations in public health facilities and help the local population reduce expenses on medical care as well as reduce distances covered to access imaging services,” the PS said.
Data from the Health ministry shows that about 10,000 Kenyans travel abroad annually for medical treatment and spend at least Sh10 billion over the same period.
Last year, 116 patients suffering from non-communicable diseases travelled to India between January and March. Cancer patients accounted for 57.8 per cent of the patients, while 16.8 per cent were those suffering from renal disease, 7.8 per cent had cardiovascular disease and 3.4 per cent had skeletal disorders.
The ministry blamed this on inadequate specialists and specialised medical equipment, high cost of treatment and the long waiting period for cancer treatment and kidney transplants.
Figures from 2016 to
March 2018
indicate that over 31.5 per cent of Kenyans sought cancer treatment 31.5, 16.8 per cent chronic kidney disease, while heart disease accounted for 9.19 per cent. Ninety-eight percent of the patients sought medical attention in India, while the rest visited South Africa, Turkey, Italy, USA, UK and Russia.
Tum added that besides the CT scanners project, the Health ministry
is putting up centralised X-ray and CT scan reporting centres.
“This will allow reporting of CT scans from far-flung health facilities, where there may be no capability of reading or interpreting the scans. This will also enable doctors to discuss and guide diagnosis of patients by specialists who may be found in Nairobi or outside the country,” he said.