• Dionisia went for 30 radiotherapy sessions at MP Shah Hospital in Nairobi and completed them in June 2019.
• The National Cancer Institute says Embu, where Dionisia comes from, has one of the highest rates of breast cancer in Kenya.
A tiny lump on her right breast is all it took to turn Dionisia Mugo's life around and also separate her friends.
Her confidants had assured her that the lump was too small to amount to anything. So she ignored it until August 2018 when, during a routine check-up, a scan of the lump was done and the doctor recommended a biopsy.
The results changed her life completely.
“The cancer diagnosis hit me like a thunderbolt,” Mugo recalls. “We had no history of cancer in my family, so it was very unexpected. Though the doctor tried to encourage me it was treatable, I was lost in despair. I saw death, literally. I worried about what would happen to my children without me.
In its Globocan 2018 report, the World Health Organisation’s International Agency for Research on Cancer reported that 47,887 Kenyans get cancer every year and 32,987 die from the disease.
The disease is hard to treat in its advanced stages. It’s also expensive to treat, hence, for many Kenyans, a cancer diagnosis is akin to a death sentence.
For Dionisia, who works as an administrator at an NGO in Embu town, the treatment was painful, debilitating and costly.
Her friends fled. Losing her breast, hair, weight and skin tone drained her.
BREAKING THE NEWS
Dionisia's first dilemma after the diagnosis was how to break the traumatising news to those close to her.
Her husband and her work colleagues were all shocked to the core. She feared to disclose the sad news to her daughter, mother and sisters.
Before treatment could begin, Dionisia was tested to establish the extent of the spread of the disease. The tests alone cost Sh70,000. Another round of the same tests was done for confirmation.
The operation to amputate her breast lasted five hours. Dionisia counts on the financial and moral support of friends and family for the success in treatment.
“Friends and family members escorted me to the theatre. They stayed during the operation. When I came out of the theatre, a dear part of me — the breast — was gone forever, and in its place a catheter that would remain with me for two weeks. It was hell. My friends' support was godsent,” she says.
Further tests established the cancer had affected five leaf nodes and was in stage three. However, it had not reached the bones. She was told to prepare for chemotherapy.
The National Cancer Institute says Embu, where Dionisia comes from, has one of the highest rates of breast cancer in Kenya.
Other counties with high rates of this type of cancer are Nairobi, Meru, Mombasa, Kiambu and Nakuru.
The institute CEO Alfred Karagu called for increased funding to the struggling institute to enable it to carry its huge mandate in cancer research and prevention.
“There is no payroll for the National Cancer Institute. We are working with a team of six deployed by the ministry. For three years, I have been running the institute alone,” Karagu told MPs in July last year.
Dionisia went for eight chemotherapy sessions in 2018, whose side-effects she describes as excruciatingly painful and triggering vomiting.
“On reaching home, I did not even know where I was. I could not do anything by myself. I had memory lapses. On the fourth day, I received an injection to boost white blood cells that would help fight opportunistic injections. My pain eased,” she says.
After her fourth chemo, her body was temporarily paralysed and on touching the ground, she would feel as though her feet were being pricked. On the cold floor, chilling impulses would rush over her body.
She says the first six chemotherapy sessions cost Sh50,000 each, of which NHIF would offset Sh25,000. Medical consultation would consume another Sh4,200. More tests costing Sh20,000 would establish if the drugs work.
She bore the full cost of the last two sessions.
She went for 30 radiotherapy sessions at MP Shah Hospital in Nairobi and completed them in June 2019.
Prof Nicholas Abinya, the University of Nairobi's head of haematology/oncology programme, says there are three types of cancer treatment: surgery, radiotherapy, and chemotherapy.
He recently told the Star the drugs used during chemotherapy vary, depending on the type and stage of cancer as well as the patient’s age and health.
"Drugs used to treat cancer can be very dangerous and toxic. An expert needs to assess thoroughly whether a patient's body can take in chemo and survive by checking the patients' performance status," he said.
The treatments in most cases are combined, depending on the type of cancer.
"If surgery and chemotherapy are administered to the wrong patient, they die," Abinya told the Star recently.
FREE AT LAST
Last year, Dionisia won her battle against cancer, but she takes a drug every day costing Sh2,000 monthly and an injection every three months that costs Sh20,000.
She is also on a special diet that is rich in fruits and vegetables and must avoid meat, unless the occasional white meat.
“Cancer treatment is so expensive. I was lucky I have an NHIF in addition to the job medical cover. I, however, exhausted them and had to do with contributions from colleagues, family and friends. The government should make it affordable and accessible to all Kenyans,” she says.
Dionisia has formed a support group, bringing together cancer patients in her locality, where she encourages them that the diagnosis is not a death sentence.
She also advocates for regular screening, especially for breast cancer and cancer of the cervix.
Her lowest moments in fighting the disease were when many of her friends deserted her as well as losing her breast and her hair.
She had to wear a wig but it was so hot that after two months, she gave up on it and had the pain of people enquiring why she had clean-shaven.
“My friends abandoned me as they feared I would request them for financial assistance or help in the house in cleaning up. I’m grateful to God that I have friends who stood with me. My employer, colleagues and family have been on my side,” she says.
One of the friends is Catherine Wanja, a primary school teacher who was her classmate at Kyeni Girls High School in Embu.
Wanja says they stood with her financially and morally, but she counts on medical insurance for lessening the medical burden, wondering how it would have been for an unemployed Kenyan without any cover.
“Some Kenyans cannot afford even the Sh500 NHIF monthly premium. This is something our leaders must address. We need to have working cancer treatment centres at all level 5 hospitals. Cancer treatment should be provided free,” she says.
Dionisia's last born, Ann Murugi, who completed form four last year at Nthagaiya Secondary School in Embu, has been telephoning her mother every day to remind her to take her drugs.
According to the Ministry of Health, Kenya last year gained 10 new cancer treatment centres across the country.
Before that, Kenyatta National and Moi Teaching and Referral hospitals were the only public facilities offering cancer treatment.
"We have set up 10 chemotherapy centres across the country in Mombasa, Garissa, Nakuru, Kisumu, Kakamega, Longisa, Machakos, Embu, Nyeri and Embu, in addition to three centres of excellence at KNH, MTRH and KUTRH," Health CS Sicily Kariuki told the Star recently.
The 10 centres, built by the county governments with technical support from the ministry, had been promised by President Uhuru Kenyatta last year.
"Three radiotherapy centres are currently under construction in Mombasa, Nakuru and Garissa to be completed by May 2020," Kariuki said.
Karimi says these centres are godsent as the key to defeating cancer is early diagnosis and treatment.
Edited by T Jalio