Don’t neglect those with underlying illnesses

Kenya is facing a double burden of communicable and non-communicable diseases.

Clustering of infections such as HIV or TB and non-communicable diseases, such as diabetes or hypertension, is now common. This is putting pressure on the overstretched healthcare system.

In spite of this, many individuals with non-communicable diseases remain undiagnosed for a number of reasons. These include unfamiliarity with symptoms, lack of testing equipment, and costs associated with the tests.

Recent statistics show that just over half a million adults were living with diabetes in Kenya in 2019. About 40 per cent were unaware of their condition.

Deaths from cancer are estimated at seven per cent while cardiovascular diseases account for 13 per cent. Overall, almost half of hospital admissions and about 55 per cent of deaths in Kenya are associated with non-communicable diseases.

This leaves countries like Kenya in a particularly vulnerable position when it comes to the severity of Covid-19.

Globally, evidence shows people with underlying medical conditions - such as cardiovascular disease, hypertension, diabetes or cancers - are at a higher risk of Covid-19.

Kenya’s health system is fragmented and largely designed to manage individual diseases rather than patients with multiple diseases.

This is partly due to health system challenges such as staff shortages, inadequate or dysfunctional medical equipment, drug stock-outs and unskilled providers.

Unlike HIV, tuberculosis and malaria, access to care for most non-communicable diseases is a major problem, especially among the poor. Findings from our study at Mbagathi District Hospital in Nairobi revealed some of these challenges.

During the Covid-19 pandemic, access to care may be even more difficult due to overwhelmed health systems, lockdowns and curfews, as well as fear of infections.

Currently, preparations are being made to prevent or manage Covid-19 cases but little is said about protocols to manage patients with chronic conditions.

Management of Covid-19 should take account of other conditions and funding should provide horizontal treatment and care. It should address all conditions rather than only prioritising Covid-19 cases.

The government must also provide healthcare workers with adequate personal protective equipment and address staff shortages, while those with chronic conditions must be relieved from the frontline.

Collaborating with communities and local administrations will help in reporting and tracking cases or deaths and citizens who defy government laws.

Community health workers can sensitise individuals, while the police should be made aware that, even during this pandemic, patients with chronic diseases need constant engagement with hospitals.

The writer is a PhD candidate and associate researcher, Developmental Pathways for Health Research Unit, University of the Witwatersrand