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Unravelling link between diabetes and coronavirus

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Fear, distress and anxiety is what best describes the feelings Newton Ngugi has been having for the past four months. As a diabetic, one of the groups of people at risk, he can boast about all the diabetes management lessons he has acquired from his doctor and support group for the past six years.

Not knowing what the future holds, the 25-year-old has proven to be resilient amidst all the anxiety, “I have been trying to stay calm and make sure I am okay, especially since there has been a lot of misguided information regarding us and Covid-19,” he says.

Stuck in a dilemma of whether to go to hospital or not, Ngugi has had to come up with ways of self management that has seen him not visit a hospital or develop diabetes complications since the pandemic hit Kenya.

“Most of us are afraid of going to the hospital even for regular check-up, because we have been told we are vulnerable. But even if we go, we are most likely to be attended to after hours of waiting by different doctors because most diabetes centres are still closed and the focus is on coronavirus,” he says.

For Ngugi, the coronavirus ca me wit h layoffs that affected him. Consequently, he lost his health insurance cover that rendered him unable to buy his medication.

“Although I don’t have a source of income, one thing I am really happy about is the support groups that have been my comfort place. They have been a shoulder to lean on throughout the pandemic and also comforted me when I felt so low. Especially since it is important to manage ones stress with diabetes,” he says.

According to International Diabetes Federation Atlas, just over half a million adults were living with diabetes in Kenya in 2019. This total is estimated to triple over the next 25 years. However, a high number of Kenyans with diabetes, an estimated 40 per cent, are unaware of their condition, putting them at a higher mortality risk when infected with Covid-19.

Ngugi is one of the many people living with diabetes who have been consumed by the fear hovering among diabetic patients. Although he has developed ways of

managing the illness, it is still important to ensure that he goes for his regular check- up.

Unmasking diabetes

Dr Jacob Shabani, Chair, Department of Family Medicine at Aga Khan University Hospital, Nairobi, says various studies have documented that diabetic people have greater risk of death from Covid-19 infection.

“But while there is some truth in this, it’s important to note that, it is mainly uncontrolled diabetes that lowers the patient’s immunity. This happens because with prolonged periods of high blood sugars, white blood cells, responsible for producing immunoglobulins [antibody that neutralise pathogens such as bacteria and viruses), get damaged by excess glucose and fail to multiply adequately to make immune elements,” he says.

Therefore, he highlights, one has to ensure the body is well prepared to fight the disease, through regular appointments, avoiding self diabetes management and ensuring they have a telemedicine component so that their care can continue.

Dr Shabani adds that patients turning out to be Covid-19 positive and develop severe complications are those who are already diabetic, or were not aware they had diabetes, so their sugar control has worsened. He explains further that some death cases in patients with Covid-19 occur when they get diabetes complications such as diabetes ketoacidosis [when the blood sugar is very high and acidic substances called ketones build up to dangerous levels in your body) or low blood sugars that they end up with increased acidity and complications.

The pandemic, the doctor says, will worsen diabetics’ control of their condition and unmask people who had diabetes and didn’t know.

“With these revelations, it is important to get your sugar checked and be aware of your diabetes status. This will avoid late discovery and prevent complications. At Aga Khan University Hospital, we keep our regular services open to take care of our patients who have diabetes, hypertension and other chronic illnesses.

We remind them on how they can safely obtain care, get medications renewed and get check-ups to ensure they achieve the control they desire. We have also made sure that we keep a record of the people with these chronic illnesses and we make an effort to call those who have not come for their care as expected and remind them to keep their appointments,” he says.

He advises people with chronic illnesses not to just refill their medications and treat symptoms without advice from their regular doctor because they might not know whether they are controlling their sugar or not and in that way, put themselves at risk. He also says they should stay at home and avoid unnecessary gatherings; however, they should visit their regular doctor or at least contact them telephonically.

“Patients with chronic disease will mitigate against their vulnerability if they keep their physical distance, avoid overcrowding, always wear a mask if they have to go out. They should also wash their hands regularly with soap and water or alcohol based sanitisers,” he adds.

Dr Catherine Kanari, Clinic lead, Amref health Africa, says diabetes is a known risk factor for developing severe Covid-19 complications, adding that people with the condition are more vulnerable in the society.

Although most adults with diabetes fear going for their regular checkups, Kanari emphasises on them for they ensure sugar levels are stable just in case one contracts the coronavirus. Failure to which, she highlights diabetics could be prone to developing other diabetes complications such as blindness or heart attack or stroke that may result in death.

Kanari further says that despite the virus being relatively new for health workers, study indicate it damages insulin producing cells, which are important for regulating blood sugar levels leading to rapid health deterioration.

Access to home care

“Although most diabetic people are vulnerable, further studies indicate that the virus might also trigger diabetes. Therefore, ensuring you follow the World health Organisation [WHO] Guidelines of staying safe and staying home to prevent transmission,” says Kanari.

In addition, people with diabetes are most likely to be vulnerable because when the body doesn’t make enough insulin to break down sugar, it uses ketons, which is an alternative source of fuel that is quite complex for a body with low immunity to process.

“One way we can deal with this and win the battle is by ensuring we enlighten people on the importance of management of diabetes and the importance of taking care of themselves and regularly checking their sugar levels. If a patient is able to access a glucometre and check their sugar levels by themselves, the better because then they would have avoided the whole process of going to the hospital and putting themselves at risk,” she says.

Furthermore, the government need to quantify and make data of people who are vulnerable more accessible in order to ensure that diabetic patients and even patients with other chronic illnesses access better home based health care hence reducing mortality rate of people living with this diseases.

NEWTON NGUGI

Most of us are afraid of going to the hospital even for regular check-up, because we have been told we are vulnerable. But even if we go, we are most likely to be attended to after hours of waiting by different doctors…

DR CATHERINE KANARI

One way we can deal with this and win the battle is by ensuring we enlighten people on the importance of management of diabetes and the importance of taking care of themselves and regularly checking their sugar levels

DR JACOB SHABANI

It is mainly uncontrolled diabetes that lowers the patient’s immunity. With prolonged periods of high blood sugars, white blood cells… get damaged by excess glucose and fail to multiply adequately to make immune elements.

Effects of diabetes

Stroke
Lower limb amputation
Nerve damage
Blindness
Kidney failure
Heart attack
Increased risk of premature death (before age 70)

Effects of gestational diabetes

Pre-eclampsia or eclampsia

Overweight babies
Congenital malformations

Complications during childbirth Stillbirth

Death of mother
Increased risk of obesity in children

Increased risk of type 2 diabetes in children

Pregnancy risk
Older age at pregnancy
Excessive weight gain
Lack of exercise/ physical activity
Gestational diabetes during previous pregnancy

Unhealthy diet

Management of Diabetes
Medication
Diet, exercise
Regular screening and treatment for complications

Blood glucose, cholesterol and blood pressure control Stopping smoking

TYPE2
The proportion of people with type 2 diabetes is increasing in most countries TYPE1
More than 1.1 million children and adolescents are living with type 1 diabetes 79PC of adults with diabetes were living in low- and middleincome countries

By PD

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Health

Nairobi woman hopes to give birth, leave bedsitter 4 years after husband kicked her out

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Gasherry Bendito has always been on the move. Her life revolves around thinking of the next step.

Nairobi woman hopes to give birth, leave bedsitter 4 years after husband kicked her out

Gasherry and her mother. Photo: Gasherry Bendito
Source: Facebook

As she plots about her next move, the beauty gets caught up in wishful thinking and dreaming of a more permanent way to live.

Four years ago, the struggling woman was kicked out of her marital home by the man she gave her heart and soul to.

When married, Gasherry could not bear children and that drove her partner insane. So, he saw it fit to get rid of her.

That meant she had to recalibrate and start from square A. This squeezed her between a rock and a hard place.

In just four years, the lady’s life proved to be a living hell as she struggled to find a decent job and a place to lay her head.

Nairobi woman hopes to give birth, leave bedsitter 4 years after husband kicked her out

The lady’s tiny room. Photo: Gasherry Bendito
Source: Facebook

“From losing my job, to being thrown out, to becoming a domestic worker, to being hosted by a colleague, and finally living in a hostel,” she narrated in a Facebook post sighted by TUKO.co.ke.

All along, Gasherry held onto unused baby clothes she had bought in the past as she waited for the fruit of the womb.

While crushing at her tiny bedsitter sufficiently decorated with a small bed, the hopeful woman still believed that one day she will get to hold her own bundle of joy.

Nairobi woman hopes to give birth, leave bedsitter 4 years after husband kicked her out

Gasherry could not have kids and that irked her estranged husband. Photo: Gasherry Bendito
Source: Facebook

The netizen told social media users she has been unable to get rid of the infant clothes because at the back of her mind, motherhood is her biggest goal in life.

“I have this bag full of baby clothes from 2014 when I was getting ready to have a baby. Almost seven years down the line and I am still holding on to it. I move with it everywhere I go,” she added.

Nairobi woman hopes to give birth, leave bedsitter 4 years after husband kicked her out

She has stored baby clothes for seven years. Photo: Gasherry Bendito
Source: Facebook

In other related news, a woman left many in tears after disclosing the pain she has been through for lack of children in her marriage.

The lady, identified as Margaret Wanjiru, opened up about her torturous 25 years journey on Monday, April 27.

Speaking to Kikuyu Diaspora TV, Wanjiru revealed life was not easy for her even in the first years of her marriage.

According to her, she married the love of her life in 1993 after two years of dating and after a few years in marriage without a child, her mother-in-law started insulting and mistreating her.

“I met the love of my life and after dating for two years, we moved in together in 1993 and this is when things started going south. At home, everyone was on our case since we did not have a child. Fights from my mother-in-law became intense. There is no pain like being married and you have money but no child,” she said.

by Tuko

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Health

Appeal for support to establish a free cancer screening center in Kenya

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BY JACKLINE N. MWATI

Kenya Cancer Care Foundation is a community-based organisation focusing on offering free cervical and breast cancer screening to all women in Kenya, starting with a pilot program in Gatundu North Sub-County in Kiambu County.

We also offer free prostate cancer screening to all men from 45 years and above as well as provision of  free HPV vaccine to all the Girls from the age of 10-12 years.

We strive to have a cancer free nation.

To support this project, kindly send you donation to the phone number provided in in the flyer. You can also call us and we will be happy to answer any questions.

The KENYA CANCER CARE FOUNDATION® is a subsidiary project of the Maryhelp Mission Rehabilitation and Counselling center. The project was founded in the year 2016 to cater for free cancer screening and ensuring there is proper referrals.

Its main goal is to ensure there is an equitable distribution of FREE cervical, breast and prostate cancer services to all the Men/women of reproductive age insured or un-insured. It also ensures all the girls 10-12 years are vaccinated against HPV [Human papilloma virus] .

We believe in the modality and the methodology that no man/woman should die of prostate, breast and cervical cancer since it’s a disease that is treatable and manageable if early screening, vaccination and correct diagnosis techniques are instituted.

Practically if all the men/women are screened regularly for prostate, cervical and breast cancer then it’s evident that any form of cancer will be detected early and proper therapy instituted. Meanwhile we are currently working with several cancer institutes for the treatment and diagnostic procedures as part of our referrals. We are advocating for these tests to be FREE to all and mandatory to our population. This will ensure we achieve our mission by giving these expensive tests to those who cannot afford them. On achieving this,

We are in our initial phase towards the construction of our cancer diagnostic and treatment hospital along Thika-Mang’u road.

  It’s quite important to note that Kiambu County is only served by one cancer referral Centre that is Kenyatta University Hospital. There should be a MODEL structure put in place to have at least one cancer screening and diagnostic Centre in every Sub County.

The Centre will cater for early screening and early treatment according to the WHO protocol. One of this model pilot project is the one that we are proposing to have in Gatundu North then the same will be duplicated in Githunguri then we shall roll out this project to other counties in Kenya. It’s important to emphasize on the role of cancer screening as a pilot project.

 More details to follow…

 

 

 

 

 

 

 

 

 

 

 

1.4STATED MISSION:

Advocates and supports Cancer prevention through vaccination and early screening.

To make a positive difference in the lives of those affected by prostate, cervical and breast cancer.

Aids in providing screening, vaccination, treatment, after-care, educational materials, and patient/family assistance and information.

                                                                                                                     

 

1.5VISION:

“To stop cancer before it starts”. Early, regular screening, early treatment with good prognosis.

Embarking on the best oncological care on our proposed state-of-the-art-cancer hospital and use the Centre as a facility for cancer training and research.

 

 

1.6MODUS OPERANDI:

The project initial phase will start at Gatundu-North Sub County. The project will be conducted through the use of the EVA System. This is a digital colposcope for enhanced visualization of the cervix. The EVA software provides secure online data management, image filters and annotations, and a telegynecology platform. All the cervical images captured will be evaluated and decisions made if they are positive or negative for cancer. The data obtained will be stored in a smart card and all patient information/data will be stored there in a PIN code secured smart card.Also in case the Smart card is misplaced, then the finger prints will be used in case of otherwise. The patient will be followed using this smart card and an automatic tele-reminder of her next schedule will be automated. There shall be no treatment of any medical condition NOT unless the smart card is revealed and showed as a prove of cervical /breast cancer screening [or finger print method to access the patients data].Then all the female children in that family will be followed for HPV vaccination for the scheduled vaccination doses and the smart card indicating that shall be issued.

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Why I chose to have my breast cut off

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Lucy Njeri vividly recalls the horrors she underwent on the day she received the test results showing she had breast cancer.

“It took me by surprise,” Lucy says. “Emotionally, I went down. I tried to clear my tears, since I was still in the office, but immediately I left the gate, I broke down and cried. I was all by myself. I was not ready for it.”

The result indicated she had ductal carcinoma [cancer that starts in cells that line the milk ducts), grade 1. The news hit her like a ton of bricks. And so she sat at the gate to her workplace, wrapped in colossal agony, struggling to come to terms with her new, sorry predicament. She was still nursing emotional bruises sustained by her mothers lengthy battle with throat cancer. Now here she was, physically sick from a similarly debilitating malady.

Just then, a complete stranger, touched by the sight of a lonesome lady crying her heart out, approached to help.

“This passer-by tapped my back and asked me, ‘is it okay’? I shook my head, and gave her my results. She read and told me it was go ing to be okay. She asked if she could call my mum. I told her no, she cannot call anyone in my family, since everyone was sick emotionally,” she explains.

Thus had begun Lucy’s long battle with breast cancer, a journey which, for many people, is beset with uncertainties and excruciating consequences on a person’s material and emotional well being. For Lucy at least, she had a shoulder to lean on right from the onset, and this assuaged pangs of grief that had belligerently gripped the mother of three on that fateful day.

Lucy’s newly found comforter cut short her journey, offered to buy her a meal and they walked to a nearby restaurant. But Lucy couldn’t eat. She cried her heart out the whole afternoon. She later gave the Samaritan the phone contact of one of her relatives, who came to pick her up.

“At night, I could not digest what I had read”, Lucy narrates, fighting back tears. “The next thing in my mind was committing suicide. I had seen anguish and pain my mum was going through. I was not ready for it.”

As luck would have it, Lucy wouldn’t hang herself that night. She didn’t find a place to hang herself in the house. But she cried the whole night.

On waking up the next morning, her uncle candidly advised her to brace for the new reality. It was time to summon her inner strength, and face her condition head-on.

“My uncle told me to face the lion, and fight it,” she adds. The words served to buoy her through the turmoil. But another calamity lay ahead – nurses were on strike, and her hospital couldn’t take her in. Her doctor advised her to seek surgery elsewhere. After weighing her options, Lucy settled on Kenyatta National Hospital, where she was booked for surgery.

“I had my breast removed,” she says.

Just before the mastectomy, a medic had counselled Lucy to be positive about the consequences. There are people without breasts out there, the medic told her. They are surviving, and they’re okay. So, there is nothing to worry about. Life has to go on.

With these words, Lucy mustered the courage to go through it. And she bubbles with joy, noting hers was a choice between living with one breast or dying to maintain the image. She chose life.

“I have seen people who resist treatment,
who say their breast(s) cannot be removed, and we lose them. I’d rather not have the breast, and be alive. I am lucky to have one. I have seen people who don’t have both, and they’re still there. Since then, I look at life from a different perspective”.

Thankfully, Lucy’s NHIF covered her treatment. This included six chemotherapies, radiotherapy, follow-up treatment and hormonal therapy.

Constant support This was a tough time for Lucy’s three children, who underwent manifold emotional excursions in these trying moments. They wondered at spike in visitors to their home. They’d been told their mother was sick, but couldn’t quite relate with the sickness. Lucy requested help from a friend who broke down the news to her children, while assuring them that mum would be okay. She recalls the news was particularly devastating to her daughter.

Now a fully recovered and ebullient cancer survivor, Lucy recounts her journey through the malaise with appreciation for galaxy of magnanimous supporters who held her hand through the predicament.

Right from the benevolent stranger who took her time to comfort Lucy in her low moments at the gate, to her circle of friends that helped her raise money for biopsy, her relatives, her husband and children, and neighbours, some of who would do her laundry, look after her children and even provided foodstuff and paid house rent in the bleak moments. There was even a matatu crew that would wait for her early in the morning on the days she went for treatment. And of tremendous importance to her journey, have been the healthcare providers who handled her condition.

“There are people you can’t even pay,” Lucy says. “I got a lot of help from neighbours and friends and even strangers.”

Her journey encapsulates the importance of a support network in the healing process of a breast cancer patient. As the world celebrates the Breast Cancer Awareness month, a call is made upon everyone to lend a helping hand and a supportive shoulder for those caught up in the throes of this exacting malady, a malady that deals long-lasting blows on the purses and hearts of hundreds of households it afflicts.

by PD.co.ke

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