Alarm as hustlers suffer lifestyle diseases linked to the rich

Some 372,000 Kenyans from low-income households have tested positive for diabetes and hypertension in the last four months, health authorities have revealed.

Of these, 106,000 patients have been referred for further screening for diabetes following tests of 5,510,000 people across the country.

Another 272,000 were found to have hypertension after tests of 3,890,000.

This is according to the latest data from the electronic community health information system (eCHIS), which sends diagnostic data directly from households visited by community health promoters (CHPs).

CHPs are largely deployed at the grassroots targeting low-income households for instance in informal settlements.

According to the World Health Organisation (WHO), diabetes, a chronic, metabolic disease, is characterised by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.

“The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin,” State Department for Public Health and Professional Standards Principal Secretary, Mary Muthoni, said last week.

In the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels,” the global health regulator explains.  

Last week, Magdalene Mukabwa, 38, limped while wreathing in endless bouts of pain at a health facility in Ileho, Kakamega County.

The pain was coming from a wound on her left foot that had for six months been eating away her two toes apart from refusing to heal.

“The smell was pungent and so awful, like a dead decomposing rat or something to the point that my children fled from even sitting next to me, “she opens up as tears race down her cheeks.

In an interview, the widowed mother of five told Nation that she first visited local chemists, who sold her some white powder to apply in between her toes, then washed down antibiotics and painkillers one brand after another but nothing got her out of her mystery.

On Friday last week, an attendant at one of the chemists that Ms Magdalene has been frequenting recommended Sh200 blood sugar tests.

“I did not have any money so I went home but because I couldn’t bear the numbing pain anymore I decided to drag myself to a health facility and just beg for help, “she discloses.

She says that doctors who had opted to admit her and then do proper tests on Monday evening showed up bearing bad news that shook her to the core.

“Your leg from the knee downwards has to go, all of it,” they said.

“Go where? “Ms Magdalene asked before it dawned on her that she was staring at an amputation.

She was informed that she had diabetes.

Ms Magdalene is just one in 372,000 Kenyans from low-income households, who have been diagnosed with diabetes and hypertension, in the last four months.

In November last year in Iten, Elgeyo Marakwet during the World Diabetes Day commemoration, then Health CS Susan Nakhumicha disclosed that more than 2.1 million Kenyans had been diagnosed with diabetes with only 40 per cent being on treatment at the time while 87% did not know the status of their blood sugar.

“350,000 Kenyans with diabetes are not able to access treatment due to the high cost of treatment and access to medication,” she highlighted while noting that the government was banking on CHPs to conduct screening at the community level and refer the patients to health facilities for treatment.

“Everyone is encouraged to eat a healthy diet with less refined sugar, low sugar and fats, and plenty of fruits and physical exercise. As Kenyans, we also need to stop tobacco use and binge drinking,” said the former CS.

“We are concerned that for every 1000,14 people are diagnosed with diabetes. At the county referral hospital, we are registering over 400 new cases,” Governor Wisely Rotich said.

The latest data from MoH further indicates that 266,000 Kenyans were referred to health facilities across the country for further assessment and management after 3,890,000 people were screened for hypertension in the same duration.

“7,730,000 households have been registered in e-CHIS against a country target of 12,500,000 households (61% of households registered).

Of these, 5,490,000 households have been re-visited by CHPs for routine community health services,” PS Mary Muthoni from the state department told Nation in an interview while dissecting the findings of their latest status report.

“213,000 pregnant women have been identified and 88,800 of the identified women were referred to the link facility for antenatal services.

For Child health, 4,330,000 under 5-year children have been assessed for common childhood illnesses including malnutrition, diarrhea, malaria, and pneumonia,” she highlighted.

In May this year, 30,000 Kenyans with high sugars and 64,000 with high blood pressure were recommended for facility-based healthcare by CHPs.

PS Muthoni explained that a year after President William Ruto launched the CHP programme, over 1.9 million Kenyans have been screened for diabetes, while 1.4 million have been checked for hypertension, thus helping locals from low-household incomes get a much earlier diagnosis thereby saving lives.  

At the moment, Kenya has 107,831 CHPs according to the health ministry.

“The national government provided 100,000 CHP kits, medicines, and supplies as well as 100,000 smartphones to enable CHPs to use e-CHIS for service delivery at the households.

The President also allocated resources for payment of stipends to 100,000 CHPs and in the latest cycle of payments this month, 45 counties received national government stipends for up to May 2024 except Mandera and Mombasa,” PS Muthoni told Nation.

She however admitted that there are still several challenges considering all 47 counties use e-CHIS.

First, the low number of CHPs trained in basic modules is affecting the quality of community health services.

Another challenge as per PS Muthoni is the long distance covered by some CHPs.

“Inadequate support supervision for CHPs by community health administrators (CHAs and inadequate budget allocation for prevention and health promotion at the county level are among the issues we are grappling with, “she noted.

The health ministry suggests to county governments several steps to be taken so that the CHP program flourishes.  

“Provide CHAs with support on oversight and mentoring to all CHPs, ensure that each community health unit has a designated full-time CHA to supervise the CHPs (1 CHA:10CHPs), social accountability by all parties involved at all levels using score cards as well as training of CHPs to ensure standardized and quality community health services,” MoH recommends in its status report.

They further call for performance monitoring of the CHP programme implementation monitoring actions and conducting dialogue days.