Why healthcare is such an important issue
Herima Mwakima’s prudent financial plans have been turned upside down by two medical emergencies.
The Kenyan single mother was working in Dubai as a nanny and was on her way to saving money to improve the lives of her two teenagers.
But then her younger brother fell ill and a few months later she fell ill. He had acute kidney disease and needed dialysis and was diagnosed with chronic fibroids – painful growths on his uterus.
Life is precarious in a country where there is a lack of affordable health care. A twist of fate can destroy everything someone has worked hard for.
Mrs Mwakima was clearly in pain as we talked in a dimly lit room at her sister’s house in Likoni – a suburb of Kenya’s coastal city of Mombasa.
The 45-year-old looked tired and washed out and as she spoke she rested her head in one hand.
She explained that she had to come back from Dubai to help her brother, Sylass, using the money she had saved for her children. Other relatives contributed and the family land was sold. After all, that was what families were for, she said.
Sylass Mwakima sat down beside her and listened. Her grateful smile broke through as she spoke.
Collect money together
It’s a familiar story because most Kenyans don’t have easy access to healthcare.
Nearly four out of five citizens have no health coverage.
Twenty percent of the population is affiliated with the National Health Insurance Fund (NHIF) and 1% can pay for private health care.
Others have to try to live with various health problems or scrape together money from meager resources, which can push them deeper into poverty. Failing that, they rely on the kindness of family, friends and sometimes strangers in the now familiar crowdfunding campaigns.
Until now, membership of the NHIF was not compulsory, but this should change by the end of the year, if the new president and the government – which is due to be elected on August 9 – stick to it. to the plans of the outgoing administration.
NHIF membership is part of the job offer for many jobs in the formal sector. The monthly fee of 500 Kenyan shillings ($4.20; £3.50) covers hospital care for members and their dependents – although medication costs more.
Despite plans to make membership compulsory, the government has not explained how affordable this will be for many whose low wages are swallowed up by paying for food and rent.
Ms Mwakima said joining the NHIF was unaffordable and making payment compulsory would not change that.
Maybe she could find 200 shillings a month, she suggested. But first she had to get back to work and that was not possible without fibroid surgery.
“It’s very hard for me because it hurts, [there is] lots of heavy bleeding. So I can’t do anything because I just feel weak,” she said softly.
She decided to ask members of her community for financial help.
Leading presidential candidates William Ruto and Raila Odinga have policies they hope will address the health problem Ms Mwakima and others have faced.
Mr Ruto said he would reduce the monthly NHIF contribution to 300 shillings ($2.50) per household.
Mr. Odinga set out to create what was called Babacare – after his nickname “Baba”. He said that would mean affordable, accessible and quality health care.
The former Prime Minister also wants to create a fund for emergency care.
But any change, even if she had the means, would of course come too late for Ms. Mwakima.
“I just trust God [that] I could get help and my situation could become normal. [Then] I’m going to start struggling or hustling my life,” she said.
Goodbye, she leaned against a concrete column in the family shop, smiling through the pain, with her brother standing beside her.
A week later, I learned that she had managed to raise the funds and that she had had the operation.
“It went well. Thank God,” she said in a brief WhatsApp message.
Now, maybe she can start helping her children achieve their dreams again, because their future is always her priority.