COVID-19 Creates Double Burden for Young Kenyan Cancer Patients
Fears of contracting COVID-19 and stay-at-home orders impact everyone, but children being treated for cancer in Kenya now face an unimaginable double burden. AMPATH Oncology’s Burkitt and Lymphoma Program (BLP), working in partnership with Takeda Pharmaceuticals, helps to ease some of that burden for patients and their families through innovative interventions and solutions.
Survivorship meeting at AMPATH with Takeda fellows (2018)
BLP is a care program initiated in 2017 in response to low survival rates (30-40 percent) of lymphoma patients in sub-Saharan Africa. Lymphomas are highly curable with survival rates of more than 90 percent in high-income countries. “Late presentation with advanced stage disease is prevalent for a majority of our patients, contributing to the poor outcome,” said Dr. Peace Mbengei, program manager for BLP. Burkitt lymphoma occurs frequently in sub-Saharan Africa, especially where malaria is present.
Lack of awareness and financial obstacles to care such as transportation costs, insurance payments and treatment costs were already identified as the key barriers to providing cancer care in western Kenya according to Mbengei. To mitigate these barriers for pediatric lymphoma patients and their families, the program offers transport reimbursement, NHIF (National Hospital Insurance Fund) payments and chemotherapy.
During COVID-19 these existing barriers were heightened by both fear of the virus and mitigation strategies intended to stop the spread. “The biggest challenge is poor treatment compliance amongst our patients, who are more worried about contracting COVID-19 than completing their chemotherapy,” said Dr. Mbengei. Additionally, transportation became more limited and more expensive and many families who lost their means of earning an income also face food insecurity.
Because of the increased challenges to patients caused by COVID-19, Takeda redirected some of the capacity building funds to help address these specific needs. “Therefore, in addition to our routine patient support, BLP is providing family stipends to cover food expenses and we have increased the amount of transport reimbursement we offer to cater for the price hikes. Staff welfare has also been considered, with purchase of PPEs (personal protective equipment),” said Mbengei. The team is also increasing calls to patients to remind them of their scheduled treatments.
Lecticia Papai, mother of a lymphoma patient, is grateful for the increased support. “I would like to appreciate BLP for the kind of support it has donated to my son in the form of transport and NHIF coverage because I am a single mother of poor background. Without it, I could not have been able to support his treatment. Thank you for standing with me,” Papai said.
”BLP has touched many lives beyond words,” added Lorna Akinyi, clinical research nurse with the program. “From aiding in diagnostics, treatment, NHIF payment and survivorship programs for our patients to a source of income for our staff. Takeda is treasured and appreciated to the core,” Akinyi said. “Thank you!”
Other key components of the BLP program have also had to adjust to the restrictions created by the pandemic. Phone calls have replaced face-to-face support groups and some outreach and survivorship activities have been postponed to observe social distancing.
Education of health care workers through bi-monthly virtual learning sessions on the ECHO platform and quarterly community awareness campaigns on lymphomas are also essential parts of the BLP effort and promote early referrals for treatment. Mbengei said one positive consequence of the COVID-19 restrictions is the growth of the ECHO sessions with more attendees participating in the online training.
“Increased survival is always our goal,” concluded Mbengei.
Lymphoma awareness campaign in Mfangano Island, Homa Bay County (photo taken before COVID-19)