Twenty-two cancer patients who braved the morning cold at 6am on Tuesday for scheduled radiotherapy at two hospitals were required to pay cash or miss out on the critical treatment.
The patients had been relying on the National Health Insurance Fund (NHIF) to pay for the treatment, but the new Social Health Insurance Fund (SHIF), run by the Social Health Authority (SHA), was not operational despite being re-registered on October 1.
Patients were stranded at Kenyatta University Teaching, Referral & Research Hospital (KUTRRH) and Nairobi West Hospital as the chaos of the country's transition from NHIF to SHIF on October 1 unfolded in hospitals across the country.
The Nation learnt from hospital administrators that the new SHIF system is yet to be activated by the government, but the Ministry of Health appears to be focused only on increasing subscriptions, which stood at 2,019,588 as of September 29, 2024.
“We have just been told to register patients and make sure they join SHA; no further directions on things like billing,” a senior hospital administrator told Nation .
“My name is Maryanne Wanjiku*(38). I live along Kangundo road and was up early at 5am to beat traffic so that I could start my 11th radiotherapy session that had been scheduled for 8am. But when I got here, they told me to pay Sh3,600 or go home,” a woman battling stage 3 cancer told the Nation on Tuesday.
“If I miss this session it means I will have to start all over again. It’s so frustrating and unfair, especially because I do not have any money apart from my fare back home. This horrible disease has robbed me of almost everything," she added as tears ran down her cheeks.
“I have already undergone surgery and they have chopped off one of my breasts. I don’t want to lose another. Unlike KUTRRH, KNH doesn’t have a pet scan, which is why many cancer patients throng here.”
Ms Wanjiku* has had a mastectomy, a breast cancer surgery in which the entire breast is removed to reduce the risk of the cancer spreading.
Ms Wanjiku is just one of 15 patients who visited KUTRRH on October 1 when the government rolled out SHA. Seven other patients went to Nairobi West Hospital.
“I have been sitting at the reception since 6am. In fact, the receptionist, a lady, found me here, went and consulted her manager before coming back to tell me either I pay in cash for radiotherapy or go home,” said David Ochieng* (50), another patient who spoke to the Nation .
He said he was also supposed to collect Sh4,000 medication, but he is now unable to.
“They told me NHIF has stopped working and that I should go and register outside where they have placed a registration desk. I did not waste time because I thought after joining SHA, I would comfortably access treatment at no cost. I was wrong,” he said.
Defeated, Mr Otieno resolved to use Fuliza (a Safaricom overdraft service).
“My Fuliza limit is Sh8,000 and because I have no money I decided to borrow from there because if I miss the radiotherapy and medication it means I have to start the treatment process all over again,” he told the Nation .
Speaking to the Nation in a telephone interview, KUTRRH Chief Executive Officer Ahmed Dagane said they had sent home patients who wanted to use their NHIF cards for treatment.
“We are however working to resolve their issues. I have instructed all managers of various departments to recall all the patients they have sent away and will be issuing a memo in an hours’ time to that effect. I was not on the ground when it happened, but now I am,” he said.
Mr Dagane said they have received instructions from SHA Acting CEO Elijah Wachira and Public Health and Professional Standards PS Mary Muthoni not to send any patients away.
“I am now at the hospital supervising patient care after chairing an executive meeting to prepare for this rollout and henceforth the directive from the Health ministry is being implemented, which means no patient coming for treatment will be asked to pay or turned away,” Mr Dagane said.
“I have also personally intervened on radiotherapy and talked to all the managers to ensure that they comply with the health ministry directive.”
At Nairobi West Hospital, cancer patients queuing for treatment wore sullen faces.
“I was here by 9am after boarding a bus from Kakamega because I can’t afford to miss my scheduled chemotherapy sessions. However, I have been told to pay in cash or go home,” Mr Titus Anzatse*, another stage 3 cancer patient who waited, then lost hope and left.
“This is a reminder that our facility is an accredited National Health Insurance Fund (NHIF) Cancer treatment centre in Kenya. We accept NHIF coverage for Chemotherapy, Radiation therapy, Surgery, and Cancer diagnosis procedures such as Biopsy, CT/MRI/PET-CT scans, etc. Co-payment is also accepted once the coverage is exhausted,” Nairobi West Hospital says in an official social media post.
While responding to questions from the Nation on Tuesday, Nairobi West Hospital said that they were sending away cancer patients who rely on NHIF.
“The Nairobi West Hospital is in the process of commencing integration with the new SHIF introduced by the Kenyan government. As we transition from the NHIF to SHIF, initial challenges are expected. We are finalising our contract arrangements with SHIF and are committed to a smooth integration,” the administration said in an official response.
“We acknowledge that some of our clients may experience difficulties with billing as we adapt to this new framework. Please rest assured that we are actively addressing these issues to ensure that every patient continues to receive the high-quality medical care they deserve,” they added.
Before the Nation left KUTRRH, we confirmed, through CEO Dagane, that Ms Wanjiku had returned for her radiotherapy session and was not charged a cent.
