Patient recounts fight with unusual cancer of the blood

Thursday, February 22nd, 2024 00:15 | By
Beatrice Afande and her children at their house in Ponda Mali, Nakuru town, during an interview. PHOTO/KNA
Beatrice Afande and her children at their house in Ponda Mali, Nakuru town, during an interview. PHOTO/KNA

For the past two years, Beatrice Afande has known no peace or comfort.

Languishing in misery and poverty, her chest heaves with emotion as she struggles to string together a sentence during a conversation with two neighbours who have just called on her at the single-roomed, mud-walled structure in the sprawling Ponda Mali estate in Nakuru town where she calls home.

In February 2023, she was diagnosed with Acute Myeloid Leukemia (AML), a type of cancer that affects blood and bone marrow. Afande, 31, does not have money for treatment, even as her situation worsens. She depends on well-wishers for food, drugs, rent, and transport for routine hospital visits.

It all started in July 2022 when she suspected something was amiss after she initially started experiencing fever, stomach cramps, migraines, and joint pains.

She started managing her condition with painkillers, believing it was just a normal discomfort and that self-medication would return her to normalcy.

But that was not to be. The agony persisted as she now also felt fatigued and lost weight.
As the aches got more severe and could not be numbed by painkillers, a neighbour convinced her to seek professional opinion from physicians at the Nakuru Level 5 Teaching and Referral Hospital.

A doctor at the facility conducted some tests and precribed some medication and within a week the pain disappeared.

But the doctor suggested a haemogram (or blood count) on her blood components, including the red blood cells, white blood cells, and platelets.

The first test revealed she had a low count of all the components. The doctor was worried about the results and asked her to wait for a week before she took another test. But there was no improvement when she took the second test.

Doctors attributed the possible causes of her low blood cell count to a viral infection, bone marrow cancer, or certain tumours.

“They took a sample of my bone marrow to test for any of these possibilities, and what came out was the worst revelation in my life ever,” she recounts ruefully.

According to Afande, it was after visiting the hospital with hopes of being cured of the ‘mysterious ailment’ that physicians finally diagnosed the cancer.

“It was hard. I was shattered, broken, and in shock. It is the most devastating news women from low-income settlements like me can receive.” She wanted to keep the diagnosis a secret from her 14-year-old son Malcolm Otieno and her 11-year-old daughter Elsie Adhiambo, as she was aware of how grave the illness was.

“I did not want to break the news to them, but the doctors first took them through counselling and then explained everything to them. It has been hard for my children, who have since both dropped out of school due to lack of fees,” she laments.

Exactly a year after the diagnosis, Afande has not started treatment because she has no money. She does not have National Hospital Insurance Fund cover and depends on friends, well-wishers, and relatives.
Due to lack of money, she has also been unable to have another sample of her bone marrow analysed to determine whether a bone marrow transplant is needed or not. Managing AML, she adds, is very expensive, especially with the numerous blood transfusions that one needs.

Given the option of health care or food, health has become a luxury in Afande’s household. For her son, who wrote his Kenya Certificate of Primary Education (KCPE) examination last year, he would be at Naivasha Boys, where he secured admission to Form-One.

However, that is not the case as he is yet to be admitted due to lack of school fees.
Otieno sat his KCPE at Angalo Primary School and scored 308 marks. He has since been juggling between taking care of his younger sibling and fending for his ailing mother.

Afande explains that she needs about Sh60,000 alone to have some tests at the Nakuru Teaching and Referral Hospital, even before the start of chemotherapy.

According to the National Cancer Control Programme, treatment in Kenya ranges from Sh175,000 to Sh800,000, where there is no need for an operation.

According to Prof Othieno Abinya, a consultant oncologist, AML occurs when the bone marrow, the factory that produces all blood cells, ceases to function properly.

Instead of the normal production and development of white cells, red cells, and platelets, a wrong ‘seedling cell’ which has failed to develop into a functional cell multiplies in large numbers, and while still in an immature state, fills out the bone marrow, eventually spilling out into the blood.

These abnormal cells eventually phase out normal cellular components of the bone marrow, and when that happens, the patient will experience symptoms such as tiredness, recurrent infections, and weakness due to marked reduction of white blood cells and bleeding or unexplained bruising due to diminished levels of platelets.

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