By Samwel Doe Ouma @samweldoe
The prohibitive cost of medical care for cardiovascular conditions and challenges in finding a heart donor complicates treatment for patients requiring heart transplants.
According to Dr. Ephantus Maree, head of Non-Communicable Diseases (NCD) prevention and control unit at the Ministry of Health, variety of barriers including high cost of drugs and insurance payer restrictions has contributed to high mortality rates of preventable cardiovascular deaths.
“In Kenya, CVDs accounts for about 25 per cent of all hospital admissions and 13 per cent of all deaths in Kenya often linked to unhealthy lifestyle and eating habits,” Dr Maree said.
Dr. Murage, Kenyatta National Hospital Head of Cardiology said because of lack of specialized facilities and specialists to handle complex cardiology conditions like heart transplants many patients are forced to seek care abroad.
He adds that cardiovascular conditions are not fully covered by the National Hospital Insurance Fund (NHIF) with immunosuppressant and devices left out.
“Cardiovascular medications cost should be capped and health devices be made affordable by zero-rating its taxes,” Dr Murage said.
Seven-year-old Nathaniel Mburu afflicted by a congenital heart condition from his first breath has over time his heart abnormalities has damaged his lungs and is slowly choking the air out of him.
With his complex congenital heart condition Nathaniel needs a heart and lung transplants to live but because of lack of donors and facilities to do transplant he has been forced to seek transplantation services abroad.
According to his Mother Eline Maswai, Nathaniel needs specialized medical care throughout his life. “He has already endured six heart surgeries, two being open heart surgery and catheterization procedures all of which have drained the family’s resources.
“Cost of heart medications in chronic conditions is too expensive for example Nathaniel is required to take a daily medication three times with tablet costing Sh700 per drug, which totals to Sh2100 daily,” she said, adding that “it is out of reach to many families.”
The Health Act 2017, provides for establishment of National Blood Transfusion Services and Human Organs Transplantation, to create a regulatory framework that would govern how organs can be transplanted in Kenya.
According to section 81 (1) of the Health Act, 2017 Kenya system of organ donation is opt-in. A competent person “opts-in”, that is, through a will or an oral expression in the presence of at least two competent witnesses, a person opts to be a donor upon their death.
The law gives Health Secretary authority to order harvest of unclaimed and untraced cardevers.
It also stipulates that any transplant of tissues must be done in a duly authorized health facility and witnessed and approved by a medical practitioner.
Despite drastic progress made in interventional medical technologies to treat cardiac ailments in Kenya, the facility of heart transplantation for most of the congenital and complex cardiovascular diseases is still a distant dream for over 45 million people.
With the non-availability of such facilities in Kenya, many people suffering from heart diseases such as cardiomyopathy, congenital heart defects and other cardiac ailments like Nathaniel, are compelled to depend upon medical facilities outside Kenya.
None of the government hospitals and even the premier private hospitals in Kenya offers or has introduced heart transplant facility at their establishments despite wide range of about 100-plus different malformations” of the heart and coronary arteries that can occur in babies.
Congenital heart problems are the most common birth defects, Thousands of infants suffer defects so severe that they require complex, high-risk operations – sometimes several over a period of years.