It all began with a toothache in June 2022. Then a tumour followed. By August this year, the tumour had ballooned, pushing Mary Awino’s teeth and tongue out of the mouth.
She struggles to drink milk, her only food, and only swallows after a cocktail of painkillers. “I am in a lot of pain,” that is all she could say.
Awino, 35, was a salonist in Nyamira before the tumour, now confirmed to be cancerous, got her bedridden. Her husband, Morris Omondi, 38, was a mason but has become her full-time carer.
The two moved to Nairobi in October last year to seek treatment at the Kenyatta National Hospital. They now live with Solomon Omolo, Omondi’s elder brother, in his one-room house in Dandora’s phase 5.
“We have become beggars,” Omolo says on behalf of his brother. “We are begging for treatment. We are begging for medicines,” he says.
The two step-brothers, who share one father, are united in trying to save Awino's life. Solomon sent his family to live upcountry to accommodate his brother. He goes out each day, to beg, hustle, and do anything that can give him money.
On the other hand, his brother Omondi stays in the house caring for his bed-ridden wife.
“There is no hope if they stay in Nyamira. But here they might get treatment. I lived in a two-room house but we moved to one room because life is unbearable. My brother and his wife sleep on the bed because she is in pain but I sleep on the floor,” Omolo says.
Awino needs about Sh500 daily for painkillers and food.
Omondi explains the problem started in June 2022, as a persistent toothache and swelling. “We went to Nyamira district hospital. They gave her medicines and injections but there was no change so they referred us to Kisii County Hospital for better treatment,” he says.
“The Kisii County Hospital took a biopsy to Kenya Medical Research Institute laboratories for tests. The results came, they showed it is cancerous tumour. The doctors in Kisii said the tumour could be removed through surgery at Kenyatta National Hospital or Moi Teaching and Referral Hospital.”
The couple came to KNH in October 2022, but oncologists advised chemotherapy first to reduce the growth before it is removed.
“We did three rounds of chemo until April when we ran out of money,” Omondi says.
The National Health Insurance Fund covered the chemo.
The couple was also asked to buy implants or metal plates that would be used to fix Awino's jaws once the growth is excised. A quotation seen by Star shows the implants cost Sh250,000 and are not covered by the NHIF.
The brothers estimate they need about Sh300,000 on the lower side.
“Every time we go to KNH they ask us to do three CT scans for which we pay Sh8,000 cash. It is a lot of money. The growth is growing bigger,” Omondi says.
The couple has a small child who is still breastfeeding. Their two other children live upcountry but do not go to school.
Awino's condition has significantly deteriorated. The once vibrant and hardworking mother can now only drink milk due to the tumour's size and the excruciating pain she experiences daily.
The toll on Omondi is immense. As a mason, he could earn Sh500 a day at a construction site. But being Awino's full-time caregiver means he cannot leave her bedside.
The two brothers’ hopes now lie in the generosity of kind-hearted individuals or organisations willing to extend a helping hand. They are in desperate need of funds to cover the surgery cost, purchase the metal plates, and continue essential treatments.
NHIF officials told the Star the fund pays a maximum of Sh600,000 for the treatment of cancer in a year for a patient.
The cancer care package entails up to 10 chemotherapy sessions, oral and injectable anti-cancer drugs, inpatient and outpatient oncology services, 20 sessions for radiotherapy and up to two sessions for brachytherapy for advanced cancer, per year.
NHIF covers six sessions for the first-line treatment for up to Sh25,000 per session, four sessions for second-and third-line treatment for up to Sh150,000 per session and 20 sessions of radiotherapy at Sh3,600 per session.
“However, the fund does not cover implants such as metal plates bought from third-party suppliers,” the official said.
Last year, former NHIF CEO Peter Kamunyo said in 2021 the fund spent a total of Sh3.8 billion on cancer treatment alone.
This accounted for six per cent of the total expenditure on claims that year.
Forty per cent of the amount went to chemotherapy, 23 per cent on surgeries with the remaining amount being distributed to other cancer treatment processes such as radiotherapy and imaging.
In total, NHIF catered for 47,000 cancer patients that year, Kamunyo said.
The high cost of treating non-communicable diseases has confined many Kenyans into poverty.
"One million Kenyans end up in poverty every year due to catastrophic health spending,” Kamunyo said at that time.
Civil society groups note that despite NHIF covering chemo and radiotherapy, cancer patients still pay a lot out of pocket.
The experts from the Kenya Network of Cancer Organisations and the Center for Public Health Development noted that up to 70 per cent of cancer cases are detected late due to costly diagnostic services.
“If we have the NHIF paying for cancer diagnostics then that will change the health-seeking behaviour of Kenyans since they know they will be sent to the lab for proper diagnostics,” KENCO director Evan Mapelu told a media roundtable by Pfizer.
It is estimated that up to 90 per cent of cancer patients in Kenya rely on the NHIF cover to be able to afford the treatment.