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How money, power determine services in public cancer wards

Florine Kamiri voluntire nurse take blood pressure of Agness Wawire at Masinde Muliro University Science and Technology in Kakamega during Free breast, cervical and prostate screening and treatment. Some of the areas they focus on are reflexology,counseling, physical therapy and movement, body massage, lymphatic drainage, nutrition therapy and meditation and breath work. The County government in conjunction with Faraja cancer support trust, Nakumat and others were the sponsors. BY DUNCAN OCHOLLA

Shock, fear, and anger – that is how doctors and parents described their experiences at the Kenyatta and Moi referral hospitals’ children’s cancer wards.

In a rare tell-it-all by parents and doctors, the experiences can only be described as traumatic.

At Kenyatta National Referral Hospital, attending doctors say money presents the biggest challenge to families with children suffering from cancer. Few families survive the experience as a harmonious unit.

Blood cancer treatment goes on for about six months but whatever the outcome, the money challenge to families remains a threat for a long time afterwards.

“Money or lack of it brings a bad odour around here,” reads a report prepared by the hospital’s health workers led by Roselyne Anyango Okumu of the Cancer Treatment Centre.

Ms Okumu and colleagues, in a study sponsored by the hospital and published in the current issue of the Asia-Pacific Journal of Oncology Nursing, investigated the experiences of parents with cancer patients at the facility.

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The study involved 62 of 72 parents with child cancer patients undergoing leukaemia treatment at KNH in 2015 and sought to find the link between family finances and psychological experiences among the parents.

Apart from the direct impact on the sick child, the cancer strains family bonds and is especially hard on those with limited means.

The team recorded the kind of emotional upheavals the parents suffer. Marital tension, the reports show, was highest among families with problems paying medical bills. This was more so with families earning less than Sh10,000 a month.

“The inability to pay medical bills creates tension in marital relationships,” reads the report.

The study found that such families spend between 50 and 90 per cent of their earnings on the sick child’s bills or related expenses.

A similar investigation at the Moi Teaching and Referral Hospital showed that money was the deciding factor on which child gets treated.

69 per cent of the 104 interviewed health care workers who deal with paediatric cancers at Moi said the quality of care improves when a patient has prosperous and highly educated parents. The workers, including doctors, owned up to providing preferential treatment and giving more attention and elaborate and accurate information when dealing with children from rich families.

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The was study carried out by a team from Moi Teaching and Referral Hospital, VU University Medical Center of the Netherlands, and Indiana University, US.

Most health workers said they provide more elaborate explanations and attention to prosperous parents.

“Many of the health care providers, 51 per cent, reported that they have more respect, pay more frequent visits, and spent more time per visit on children from prosperous and highly-educated parents,” reads the report.

Moi hospital, like Kenyatta, has two models of service provision: the public and private systems. The private system is more expensive.

Some parents recounted harrowing experiences because they could not afford better care. “A child can stay for a month before being given chemotherapy due to lack of blood for transfusion,” reported a parent.

Most health workers agreed that the quality of care improved a patient’s chances of cure or survival.

 

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