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The hidden costs that make home-based care financially overwhelming

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When Jerotich Seii (pictured) and Eva Mutua opted for home-based care after testing positive for Covid-19, they did not foresee the expenses they would rack up in treating the disease. For the days they were in self-isolation, doctor’s consultation fees, drugs, subsequent Covid-19 tests, personal protective equipment and multiple other hidden costs emerged, leaving a huge dent in their pockets. Jerotich tested positive on July 22, at a private laboratory run by International Organisation for Migration (IOM) in Nairobi, nearly a week after she self-isolated on experiencing Covid-19 symptoms.

“The IOM lab technicians told me they would forward my results to Ministry of Health,” Jerotich told The Standard. Days after testing positive, no one from the Ministry of Health got in touch to offer guidance or prescribe home-based care, prompting Seii’s conscious decision to self-isolate. She did this under the direction of her doctor and with the support of her family and house help.

“I read the Ministry of Health and World Health Organisation (WHO) guidelines and went into home-based care,” Jerotich told The Standard in a phone interview. Eva, on the other hand, tested positive after returning to Nairobi from Pretoria, South Africa, where she had travelled for treatment and got stuck due to Covid-19 related travel restrictions.

Tested negative Before leaving Pretoria, Eva (pictured) had tested negative for Covid-19 at a Lancet laboratory in South Africa.

“I had been in self-quarantine because I had been in South Africa for four months, where I had gone for treatment before getting caught up in the lockdown,” she told The Standard.

After writing to the Kenya Medical Practitioners and Dentists Board and certifying that she had met all requirements, Eva was allowed to quarantine at home.

“What I was reading in the press was scary. There were reports that public quarantine facilities were not clean, and that in private facilities there was no guarantee that one would be quarantined for only 14 days,” she says on her decision to self-isolate. It was during this quarantine period that she developed Covid-19 symptoms. “Between June 28 and 29, about 10 days after my flight to Kenya, my ears started itching and my doctor told me to get an antihistamine, but those were the first signs that I had contracted the virus, along with the accompanying symptoms of fatigue and a headache,” Eva told The Standard.

While she was initially set to be tested on July 2, upon the expiry of her 14-day quarantine, she only managed to test on July 7, that is 19 days after going into self-quarantine. The next day the results came back positive. Over the next few weeks after testing positive, Jerotich and Eva separately watched with alarm as their expenses soared.

Jerotich says she spent more than Sh60,000 on the initial and subsequent tests for herself, her husband and her house help. “The cost of home-based care is very high because you pay for everything yourself,” she says. She has a fourth test in a month’s time, after her last test on August 14 came back positive. Eva, on the other hand, reveals a long list of expenses she has incurred.

“I spent Sh30,000 for the 40 days I was in isolation,” she says.Other expenses during home-care arose from doctor consultations that were mostly done over the phone. The Health ministry’s guidelines for home-based care require that the patient be in touch with a doctor.

Sh30,000 on consultancy

Jerotich and Eva reckon they spent at least Sh30,000 each on over-the-phone consultations from the time they went into self-quarantine.They had no option-no one from the Health ministry checked on their progress at home.

“I received my first call from the ministry on the 23rd day since first falling ill. Before that, it was up to me to sort myself out. Even when they called, they didn’t help much,” Jerotich said. “I got a call from the case worker assigned to me by the Ministry of Health. He was just calling to check up on me and see how I was doing,” says Eva. At home, the two had to buy antibiotics, malaria drugs, anti-histamines, anti-inflammatory drugs, cough medication, zinc and multivitamins.

Since they had to enhance their diets, they also ended up spending more on food. Eva’s weekly grocery shopping doubled from Sh2,500 to more than Sh5,000. Home-based care, they say, is not for everyone. “It works for people like me: single, with my own bathroom and house help, but can you imagine someone who lives with six children in a one-bedroom house in Kibera (slums),” says Eva.

Even having a person on standby to care for a Covid-19 patient at home does not come easy.  For Jerotich, she made an arrangement with her husband to be on standby in case her condition worsened or she needed to be taken to a hospital.

Eva on the other hand, requested her house-help to move in and formed a WhatsApp support group. Not everyone has such privileges, she says.

Jerotich and Eva have been discharged from self-isolation They now hope that their respective insurance companies will reimburse the money they spent during home-based care. Above all, they hope the government will step in to support poor patients self-isolating at home.

Source: Standard.co.ke

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Health

NMS apologises for Pumwani child birth fiasco, takes actions

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All the four hospitals in the capital, which are run by the Nairobi County government, will now be manned by officers from the National Police Service to prevent disruption of services.

The Nairobi Metropolitan Services (NMS) announced this on Saturday after making several changes at Pumwani Maternity Hospital following an incident on September 13 in which a woman gave birth at the gate.

In a statement, NMS’ Director of Health Services, Dr Josephine Kibaru-Mbae, explained that the woman was denied entry into the facility.

Dr Kibaru-Mbae noted that the incident took place two days after nurses began a legal go-slow but added that essential services were still being offered.

“The security guard denied the patient access to the premises in a very unfortunate incident [but] a nurse from the maternity ward was notified,” she said, adding the medic rushed to the scene and helped with the delivery and the patient’s admission.

Apology

The agency apologised for the incident and said that going forward, officers from the NPS will augment provision of security at the four main county hospitals.

The other three are Mbagathi, Mama Lucy Kibaki and Mutuini.

“We take this opportunity to apologise to all Kenyans and mothers in particular for this unfortunate incident,” Dr Kibaru-Mbae said.

She assured the safety of the mother and child, saying they were both well and were discharged on Friday.

“NMS commends the nurses who quickly assisted the patient,” she said, adding Pumwani’s security team was changed and a customer care desk set up.

“NMS commits to train front office staff in all its facilities,” she added.

This is not the first time Pumwani has been in the limelight for the wrong reasons. Cases of mothers delivering outside the wards as well as those of child theft have been rife at the health facility.

by nation.africa

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Health

All about subdural hematoma, condition Nameless’ dad has been suffering from

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Kenyan artiste Nameless has revealed that his dad has been ailing from a condition known as Subdural Hematoma in medical terms.

A subdural hematoma is a collection of blood outside the brain. It occurs when there is a head injury.

The bleeding is under the skull and outside the brain, not in the brain itself. As blood pools, however, it puts more pressure on the brain.

In the case of Nameless dad, the condition had led to clots in the head which in turn were causing minor strokes.

Below are things to learn about the condition.

There are different symptoms to Subdural hematoma and some include

  • Confusion
  • Headache
  • Change in behavior
  • Dizziness
  • Nausea and vomiting
  • Lethargy or excessive drowsiness
  • Weakness
  • Apathy
  • Seizures

The symptoms in subdural hematoma patients are not standard, it varies from one patient to another.

The conditions that influence the symptoms one has when battling subdural hematoma include

  • The size of the hematoma
  • Age of the patient
  • Other underlying medical conditions

Hematoma is majorly caused by a head injury, such as from a fall, motor vehicle collision, or an assault.

The sudden blow to the head tears blood vessels that run along the surface of the brain.

A subdural hematoma can be diagnosed using imaging tests, such as a CT or MRI scan.

Your doctor may also give you a physical examination to check your heart rate and blood pressure for evidence of internal bleeding.

An acute subdural hematoma can only be treated in an operating room.

A surgical procedure called a craniotomy may be used to remove a large subdural hematoma.

It’s normally used to treat acute subdural hematomas. In this procedure, your surgeon removes a part of your skull in order to access the clot or hematoma.

They then use suction and irrigation to remove it.

Results of hematoma may include

  • brain herniation, which puts pressure on your brain and can cause a coma or death
  • seizures
  • permanent muscle weakness or numbness.

By Mpasho.co.ke

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Health

Couple’s triumph after testing positive

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At the beginning of July this year, Geoffrey Alemba, a protocol officer in an international organisation in Nairobi was suffering from severe fever. He did not think much of it, hence he suffered through it for two more nights before seeking treatment on July 3 upon his wife, Sylvie’s insistence. The tests showed he had an acute bacterial infection. He was put on medication and went back home. By Monday July 5, the symptoms worsened , with a backache setting in.

When he began exhibiting Covid-19 symptoms such as nausea and dry throat he decided to seek treatment on July 8, with Sylvie offering to drive him to the hospital. His wife stayed with him as the doctors conducted a battery of tests, ranging from CT Scans to blood tests.

The last test was the nose swab whose results were expected to come out in 24 hours. Geoffrey was admitted and put on isolation, while Sylvie drove home, only to be arrested on her way there for staying out past curfew hours. After a tense twenty- four hours wait, Geoffrey was diagnosed positive.

Death sentence

“I remember breaking down after receiving the diagnosis. All I could remember immediately the doctor stepped out was the constant mention of death and Covid-19 in the same breath. It felt like a death sentence,” Geoffrey explains.

Geoffrey was also in shock as he had been careful both at work and at home. He was the guy who would always have a mask on, and was a vocal advocate for social distancing measures, putting on masks, hand washing and using sanitisers.

He called his wife immediately after his diagnosis and urged her to get tested. Sylvie tested positive, but with no symptoms.

After two days, his symptoms worsened, which necessitated him to be put on oxygen for four days. His doctor told him he was being treated for pneumonia and was put on drip for 10 of the 12 days he was admitted due to loss of appetite.

His body responded well to treatment and he stabilised enough for the second Covid test to be done before being released from hospital. The test came out positive and they opted for home-based care.

Sylvie had to prove that their home was fit to accommodate an ailing patient without posing a risk to other people, as per the Ministry of Health home care guidelines.

Discharged

Sylvie rearranged their second bedroom and bathroom into his quarantine quarters, bought paper plates and cups to prevent cross infection and he was discharged armed with multi-vitamins and an inhaler.

“First of all, if it wasn’t for God, it would have been worse. I thank him for life and for Sylvie. Sylvie has been supportive. She would cook for me masked and wearing gloves, place the food and drinks for me in disposable plates and cups, and gave me emotional support via phone through it all,” Geoffrey enthuses.

Geoffrey just finished using his inhaler two weeks ago, though he is still on multivitamins for an immunity boost. Four tests later, he has tested negative twice and is back to work. After five tests, his wife is also negative and back to work too.

“People at the office have been supportive. I cannot say I have been stigmatised on that end. Our landlord and neighbours have also been kind and supportive. Of course, there is that fear that you can almost feel emanating from friends. There is also this one incident which I find more hilarious than hurtful. I had parked my car in a place where the guard knows me. He came to check the car and on seeing me, quickly pulled up his mask, which had been lying on his chin and took off without a word,” he further elaborates.

Alemba is still a passionate advocate for people to practice the MOH guidelines for Covid-19 prevention. He is testament to the fact that Covid is real; he has a sizeable dent in his finances to show for it. He talks of the need to care for others as one can be asymptomatic and easily spread it to others. He talks with reverence of the doctors and nurses who walked him to recovery.

“Seeing the nurses sweating and still smiling in their PPEs as they took care of us was quite humbling. One nurse told us of how the neighbour’s children run away from her whenever they spot her since they know she works with Covid patients.

“Knowing that there are all these people who stand between the ailing and certain death is quite sobering. If for no other reason, they should inspire you to be better just so you do not unnecessarily risk their lives. This whole experience has made me be want to be kinder and to be gentle towards other people and their experiences. You never know what someone has gone through. Even when they share it, you may not grasp its full depth or breadth,” he concludes.

By PD.co.ke

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