HEALTH OF AFRICANS – PART 2
By Charlotte Ahmadu
From the Project Leader;
Tragedy happens to everyone. I suppose it is what makes us human- that we feel pain, loss and a pinch of shock at the unexpected. But perhaps, what makes us superhuman is how we choose to respond to what befalls us.
Human beings are extremely resilient. But there’s just so much stretching that the rubber band can allow before it breaks, permanently.
If you’ve gotten used to my ramblings, you might have figured out what I’m talking about- mental health. Too often we focus on how our body feels while our mind is crying and shouting for help.
And so dear reader, if I may, might I beckon you to think about how you take care of your mind. What do you do to ensure good mental health? Who do you see to help you with the adverse effects that life’s stretching has brought upon your delicate mind?
Many sensitive stories lie ahead and so I hope that as you read the healthcare stories of people who mean something to someone, that you take care to comfort and heal your mind when it weeps for them.
Story Five: A Sit-down with Mr Itoro
Background: Mr Itoro doesn’t have health insurance… it’s been a pinch.
Que: Good evening sir.
Ans: (smiles) Good evening ma
Que: How would you like to be addressed, sir?
Ans: You can call me Mr Itoro
Que: If you’re amenable, I’d like to ask you what you think about health insurance.
Ans: (Hmm) For me it’s a way to guarantee that I keep healthy.
Que: So, Mr Itoro, you don’t have health insurance; how have you been staying healthy?
Ans: I’m very careful about what I eat- I ensure my food is healthy and my water is uncontaminated. I live in a clean, sanitary environment.
Que: Very impressive sir. I just want to guarantee that this interview is confidential and so you can feel comfortable to tell me everything.
Ans: OK good, I think I feel much better now that I know this.
Que: Have you faced any major illnesses?
Ans: (Hmm) I have had a tough struggle with Hepatitis B and I am so scared about it.
Que: What about it scares you?
Ans: This illness killed my brother because it was already too late by the time it was noticed. The doctors gave him unrelated treatments because they couldn’t discover the reason for his sickness. But the bitter truth is that we still lost him by the time they made the correct diagnosis, that is why I am very scared that I too may die from this illness.
Que: My condolences on your loss sir, I really understand what it feels like to have a sickness another person close to you had but didn’t survive it. I want to assure you that this virus is treatable. It’s not an illness that doesn’t have a cure. Your case has been detected early and that’s already a good prognosis.
Ans: Yes, it is under control. But I have a family and so many responsibilities. I can’t afford to die on them. They need me.
Que: How has this affected your finances? I can imagine treatments have not been cheap.
Ans: It has really been hell for my family and we’re no longer as well off as before. We’re barely managing right now but I thank God that I’m still here to survive.
Que: I believe that you will survive this, sir. So how have you been able to afford health care out of pocket?
Ans: Well, because we had good savings, we’ve been able to cover the expenses so far.
Story Six: Biographical Account of Catastrophic Health Expenditure
Background: A case of breast cancer and no funds for treatment
Mrs M.I who has asked to stay anonymous has no health insurance. Everything pertaining to her medical bills and healthcare costs has to be out-of-pocket. She’s Christian and lives by faith that her health will continue to remain well, hoping for the best, but never expecting the worst.
Fourteen months ago, she found a hard lump on her left breast. Alarmed, she went to the hospital to see a doctor. They ran all sorts of tests… tests whose expenses dwindled the little she had set aside to pay for any medical bills. The hospital couldn’t seem to give her answers, all they asked for was more money to conduct more tests. Her business began to feel the blunt edge of her health tragedy. Soon after, she was put on chemotherapy- the medication resulted in hair loss; a medication whose name she was never told. Soon after, the money well dried and so she resorted to alternative medicine and began to buy miracle oral and topical herbs that the charlatans swore would heal all her ailments. When asked if she knew the names of what she had bought- she shook her head.
2018, the lump has only gotten bigger- now it’s covered more than half of her left breast. Her left axillary lymph nodes have swollen painfully and she can’t sleep well in the night because it throbs too much. The doctors have suggested mastectomy but she’s turned it down because of the social implications that people put on women with only one breast.
Now, looking like a mere shadow of her past self (drastic weight loss), she’s extremely worried and anxious about her future and her only child.
Without any help to pay for her hospital visits, medication and even the possibility of surgery, she’s become impoverished and her family members are not in debt because they all tried to lend a helping hand to ease her medical condition.
She really wishes that she had insurance- something that would assure her and her son’s future which seems so uncertain and bleak right now.
Life for Mrs M.I has never been the same since she got sick.
Fast-forward: 1st week of January 2019
It is with the saddest regret that we announce the death of Mrs M.I. May her soul rest in peace.
Story Seven: Biographical Account of Catastrophic Health Expenditure
Background: Diabetes gone terribly wrong
Mr Killian is a teenager. Only nineteen but already missing some of his limbs. Four years ago, as a high school senior, he was diagnosed with Type 1 Diabetes Mellitus. His parents are subsistent farmers and their main food group are the carbohydrate plants they grow and harvest. He has four siblings and very little money.
When he was diagnosed, he was put on insulin and asked to take Metformin and Glibenclamide daily. At first, it was alright, but soon, his chronic condition became unaffordable for his parents to keep up with. He soon stopped taking the drugs and started alternative therapies, drinking herbal preparations.
They seemed to work… for a while. His blood glucose levels were fine until he started losing weight overnight, the tip of his index finger became gangrenous and eventually fell off. All hell broke loose soon after.
He was admitted to the hospital and diagnosed with tuberculosis, pneumonia and inter-digital scabies. When we interviewed him, he was lying on his hospital bed, looking so very much worse for the wear… a chronically ill patient with little hope for survival.
His family and friends don’t visit much. They would like to, but they’re unable to pay for his hospital bills, lab tests and prescribed medications. It’s almost as if he’s just waiting for death to come.
When we asked him what having health insurance would mean to him, his exact words were, “Health insurance would mean that I won’t have to worry so much when I get sick.” None of our eyes was dry as we left his hospital bed.
Story Eight: Biographical
Background: An unexpected syndrome and unexpected medical bills
10 years ago when 14-year old Minnie lost her family in a traffic accident, life became very hard for her family. As the eldest child, she knew she would have to step up and be strong and capable of her two younger siblings, as her mother took on the role as the family breadwinner.
“Combining my studies with helping my mummy in her business, taking care of my siblings and the house has been a lot of work. But I have no choice… I’m just sad that I got so sick.”
Four months ago, Mmenie noticed that something wasn’t quite right- her legs, abdomen and face took on some swelling that only seemed to worsen over time. Her urine volume drastically reduced and she began to have a lot of trouble with her breathing.
She was taken to see a doctor, diagnosed with Nephrotic Syndrome and immediately put on aggressive therapy. Her mother’s petty business took a sharp hit from her medical expenses. With no health insurance, affordability would soon become impossible.
With contributions from religious organisations, loans from friends and family and her mother’s meagre savings, they are barely managing to keep up with her medical bills.
Mmenie is only fourteen years old. She’s missed a lot of classes and will continue to miss them until she’s discharged from the hospital. She awaits that day eagerly.
When asked how she stays healthy, she grinned and replied, “I just eat my mother’s food.”
Story Nine: Biographical
Background: Dialysis, HIV positive and no health insurance
Mrs Iniemem is a trader, breadwinner, widow and mother of 3. In the past when heard about the chronic condition HIV/AIDS, she didn’t give it much thought. Life was happening, and that wouldn’t happen to her. A year ago, she was diagnosed as seropositive. Since then, she has taken her health status seriously and has astringently followed the doctor’s advice, “I was counselled on my medical condition and on the importance of strictly following my medication therapy.”
She doesn’t have health insurance but luckily, has been able to assess free antiretrovirals (she doesn’t know the names of her drugs) through an American foundation that provides these drugs for free to HIV positive patients. That took off a huge burden financially, but the side effects she’s been feeling has reduced her quality of life: regular headaches, mental disturbances; she had to switch her medications when it got worse.
With that by the side, she started experiencing symptoms of chronic kidney disease- bilateral leg swelling, decreased urine volume, etc. With her kidneys failing, she was given a blood transfusion and put on dialysis.
Affording this new turn of events has been very difficult for her and her family. Her elder brothers stepped in to pay for a large proportion of her medical bills and the little that’s left from her trading, she uses it to take care of her children. Things have been very difficult since her husband died and she got sick.
We asked her how she stays healthy and she was very specific with her answer: I don’t drink alcohol anymore, I don’t smoke, I eat healthy foods, I don’t share sharp objects with anybody, I always go for dialysis and take my kidney medications. It’s very tasking, but I try to keep up.
Story Ten: Interview with Mr S.D
Background: Mr S.D has a lifelong illness. Now living and studying abroad, his health prospects are much improved
- What are some of the most memorable illnesses that you’ve had? And what interventions were made?
Ans: All my life I’ve only ever faced one type of illness (well all illnesses come at me only in this form)- that is- body pains. My limbs start hurting really badly and it feels like the pain is crawling deep in my muscles, trying to tear it from my bone.
Body pains are how my body notifies me that something is wrong and that has everything to do with me being a person living with sickle cell anaemia. Any illness- be it malaria or anaemia, always starts with me having body pains. I remember a time when I couldn’t move. I was in excruciating pain and my arms and legs were very stiff. My mother had to put me on her back and carry me to the hospital. It was very terrible.
I use traditional medicine for prophylaxis- once I start getting these symptoms, I use Moringa leaves (washed, shredded and boiled in water). My doctor suggested this to me and it has worked for me. Then I go to the hospital for tests so that they can determine what the problem is this time and treat me accordingly.
- I can imagine these pain attacks would be very unanticipated, but how do you attempt to stay healthy?
Ans: Well, firstly I get to know my body system and how it works- what is and what is not healthy for it. I try to recognize early symptoms and start treatment early. I also avoid anything that I know affects my health including food and strenuous activities. As much as possible, I avoid stress and when it’s unavoidable which is almost every day of university life, I take the supplements suggested to me by my physician. Oh and I drink a lot of water.
- How do you plan towards your future health? In other words, how do you make plans concerning the probability of future illnesses?
Ans: I make sure all my medicines are available and always within reach. Also, anything I would need for an emergency trip to the hospital is always packed. I have emergency health information and contacts on my phone in the case the crises arise outside of the home where people don’t know who I am so that whoever helps me can know what to do and who to call.
- What does the burden of your medical bills look like?
Ans: I wouldn’t know actually, my parents have always paid my bills. And they don’t tell me how much they spend. But up until last year, I fell sick very often so I might say it was a little more than what the average person would pay.
- Could you guess a yearly figure?
Ans: I really can’t. But most of the time, I get a discount because my doctors have been treating me for a very long time and they have known my parents for a very long time too. One of them is family, so that helps.
- How has your family been able to afford your healthcare?
Ans: Between buying my supplements, medicines and my routine check-ups, I’d say it’s not been easy for my parents. But they don’t talk about it and they have never complained.
- How do you deal with unplanned illnesses?
Ans: It depends on how and when it starts and the intensity. But most times I’m prepared for it, I’ve had too many surprise breakdowns to not be always prepared for the unexpected. I’ve heard many times that one is not supposed to plan for an illness, but It’s become a part of my daily routine to make sure that I’m ready for anything.
- Tell me about your healthcare abroad, how has it been different for you?
Ans: I live and study in Cyprus now, and I travelled with a lot of my usual supplements and medicines, enough to last till I get home for holidays. I wasn’t quite sure how affordable medication would be out of my country.
I was fine for a whole semester before I had my first crisis in the summer. I went to the hospital and was treated without paying anything. I have student health insurance and so the city general hospital provided me with free care. My friends took care of me during that time. Since then, I’ve had only three other episodes that took me to the hospital.
I try to take preventive measures, avoiding things I know will trigger illnesses like stress, though it can be unavoidable sometimes there are countermeasures for those times.
Literally, in everything I do, I take my health into consideration because being ill seriously affects my studies and I can’t afford to backtrack.
- B) How long did you spend in the hospital?
Ans: Spent around 2 weeks. Drips were administered to counter dehydration and analgesic medications were given for the pains and my general wellbeing. Later on, the doctor recommended being given a blood transfusion because I had lost too much blood, he also said that I could take my blood supplements but transfusion would get me back on my feet faster.
- What does having health insurance now, mean to you?
Ans: It means a lot to me because I am a person who needs regular check-ups, medications and interventions, to stay healthy and also to treat health crises once in a while. It has helped to cut down the costs for my healthcare.
- How would you rate the healthcare system in your birth country compared to your current country of residence?
Ans: Private hospitals in Nigeria are almost the same as the public hospitals here, the only difference I’ve noticed is a lack of healthcare equipment in my country, so I’d give them an 8 out of 10. Public hospitals in my country are very problematic, in terms of healthcare, I’d give them a 4 out of 10.
- B) Would having access to better healthcare services be one of the top three reasons why you would want to permanently live outside Africa?
Ans: Top three, no; probably top 7.
From Project Team Member
There is no one who wishes a bad situation upon themselves, but life dishes out portions of the less-than-ideal without our prompting or permission. From the stories we have shared with you, this observation is clearly evident. Different medical conditions have resulted in health expenditures that have been proved detrimental to family finances in one way or the other. Most cases progress into individuals being fraught by penury, probably due to having borrowed under heavy interest rates.
Catastrophic health expenditures, simply put, are out-of-pocket payments made by individuals, but usually families, to cover their health expenses, such that these overshoots a manageable proportion of their income to further impoverish the family. Bearing in mind that rationing limited resources for basic needs is already an uphill task for most families in the sub-Saharan, without the addition of extra healthcare burdens.
Maybe, just maybe if there were health insurance packages, designed to keep poverty-due-to-bad-health from being the norm, these healthcare stories we have brought to you would have ended in a different way. Perhaps with less anxious tears and more hope for the future.
So what can we take out of this? Africans need health insurance. Not the talk of it or bogus promises on election campaign trails, Africans need the reality of health assurance by health insurance. We shouldn’t be terrified when we get sick. We shouldn’t feel hopeless when there is a cure for our ailment. Health expenses should not be the reason why the mortality rate persists in deteriorating.
Yours in Faith,