• Two partners have now struck a deal with a US-based manufacturer of stents to acquire them at subsidised prices and train medics in the same.
• At least 12,000 oesophageal cancer cases are diagnosed in Kenya every year.
Image: Boston Scientific
For people with end-stage throat cancer, mealtimes are terrifying moments.
This is because as the tumour grows, it progressively blocks the food pipe. Eating bite-sized food feels like one is choking, or like something is stuck in the throat or the chest.
To help the patient, doctors often insert a tube or (stent) in the oesophagus to keep it open to allow food and liquids to pass through into the stomach.
However, the self-expandable stents are routinely unavailable in Kenya, not even in referral hospitals.
Researchers say 90 per cent of oesophagus cancer patients in Kenya are diagnosed late and without the stents, they die prematurely of malnutrition.
Two partners have now struck a deal with a US-based manufacturer of stents to acquire them at subsidised prices and train medics in the same.
The collaboration brings together the Clinton Health Access Initiative, African Oesophageal Cancer Consortium (AfrECC) and manufacturer Boston Scientific Corporation.
“Boston Scientific Corporation announced its commitment to launching an access programme to provide oesophageal SEMS (self-expanding metal stents) to patients in Tanzania, Kenya, Malawi, and Zambia at a subsidised price,” AfrECC says in a report it published in the Global Oncology journal.
Currently, the overall cost of stent placement is about Sh40,000 inclusive of import and procedure-related expenses. Stents are usually 12 to 14 centimetres long and about two centimetres wide.
AfrECC, which collaborates with Tenwek Hospital in Bomet, said Kenya has an age-standardised incidence of 8.3 per 100,000 people. This means at least 12,000 oesophageal cancer cases are diagnosed in Kenya every year. It is commonest in the Rift Valley, especially in Keiyo, Uasin Gishu and Nandi.
Dr Shaheen Sayed, a pathologist at Aga Khan University Hospital, recently theorised the incidence could be linked to volcanic soils, tobacco chewing or smoking and the traditional fermented milk (mursik), which contains ash.
AfrECC said squamous cell carcinoma is the dominant subtype in Kenya, normally caused by heavy alcohol consumption and smoking, but other risk factors have been documented as well.
The authors say the stents can be used as the sole therapy or in combination with chemotherapy and radiation, with low rates of procedure-related and long-term complications.
“Tenwek Hospital, a faith-based community hospital in Kenya, became a high-volume referral centre for patients with oesophageal cancer due to its ability to source SEMS at low cost,” they say.
Experience at Tenwek showed that patients who got stents improved immediately, faced comparatively less financial burden, and were managed on an outpatient basis.
The authors say 80 per cent of all oesophagus cancer patients in Kenya could potentially benefit from stent placement, and live a better life without surgery.
The partners published their experience to demonstrate how such collaboration can improve the supply chain for high-priority medical devices.