By Bedah Mengo
NAIROBI, Dec. 21 (Xinhua) -- Living in Korogocho, a slum district on the east of Kenya's capital Nairobi, Bernard Macharia, who is hypertensive and diabetic, does his best to manage the disease.
Macharia, 60, strives to take his medicine, eat recommended foods and live a healthy lifestyle, which are crucial in the management of hypertension and diabetes.
"Each day I ensure that I walk around the slum for several hours to exercise. The doctor attributed my condition to sedentary lifestyle that I was living, which saw my body size increase disposing me to hypertension," he explained recently in an interview.
But for Macharia and tens of other people living with diabetes and hypertension in the slum, walking around to exercise is the easiest part.
The toughest part, which, however, is the most crucial in the management of the disease, remains out of reach. This is accessing drugs.
The patients cannot afford the drugs that hold the key to their survival due to high costs. Individually, one needs about 23 U.S. dollars a month to access the drugs, but through support groups, where members contribute money and buy in bulk, the cost drops to four dollars. However, this is still unaffordable to many residents.
But soon, Macharia and other patients living with the diseases will be able to access drugs affordably due to research.
Researchers in the East African nation are working on a model that would help patients access drugs for as low as two dollars a year.
The project dubbed Sustainable Model for Cardiovascular Health by Adjusting Lifestyle and Treatment with Economic Perspective seeks to bring the cost of treating and managing diabetes to affordable level, as it has happened with HIV/Aids.
"Management of diabetes and hypertension is crucial in winning the war against the diseases. War against HIV/Aids has been successful because of accessibility of drugs. This is what should happen with diabetes and hypertension," said Dr Steven Van de Vijver, a medical doctor and senior research officer at African Population and Health Research Center (APHRC) in Nairobi.
Van de Vijver said that they have done analysis and found out that the cost of managing diabetes and hypertension can drop to one or two dollars a year for 35,000 people.
The model that is being tested in Korogocho slums involves screening all people aged 35 years and above, who are at high risk of contracting diabetes and hypertension
Those found to have the diseases are referred to a health clinic in the slum and later put into support groups.
"This starts with community workers visiting residents at their homes where they screen them for the two diseases. The health workers ask questions on lifestyle, which include if they smoke, drink alcohol or exercise before he screens them for the two diseases. Residents who are found with high sugar level and blood pressure are referred to a clinic in the slum," said Van de Vijver.
The doctor, who is one of the principal researches, is working with 48 community health workers and a population of 35,000 residents.
"We organize the patients into groups so that they can buy drugs in bulk. They are supposed to attend group meetings regularly where they also learn about nutrition," he noted.
The main reason of being in support groups is to contribute money to buy drugs at a subsidized cost and encourage each other to attend clinics.
"In the model, we have that if more than 80 percent of people in a group attend clinic, the cost of drugs, which is currently two dollars per month, having dropped from three dollars, goes to about a dollar and a half. This creates peer pressure so that members of a group can encourage each other to attend clinics for prices of drugs to come down," said the medical doctor, adding that the strength of the model is in working with groups.
Van de Vijver noted that the concept was arrived at after researchers found out most people were not attending clinics and taking medicines due to high costs.
"While developing the model, we worked with Boston Consulting Group, a global consultant firm. We did the cost of treating the two diseases, which included payment of community health workers and nurses and found it can come down to one or two dollars per year," explained Van de Vijver.
The model is becoming a success in the slum where it is being tested. "We have seen the number of patients attending groups and accessing drugs rise. The aim is to prove to government that it is possible to reduce costs of managing lifestyle diseases," he said.
Elizabeth Mutimba, a community health worker in Korogocho says that support groups and motivation to bring cost down are making people attend clinics.
"Patients used to start treatment but disappear soon after because of high costs. But now, we have seen many of them attend clinics and buy medicine because the cost is low. The groups work as a force to make people attend clinics and avoid defaulting in taking drugs," she explained.
Van de Vijver sees hope in bringing down the cost of treating diabetes and hypertension in the model.
"It will help to combat cardiovascular diseases that are ravaging hundreds of people in Kenya. When the results come out next year, we will be able to prove to Kenya government that the model can work," he said.
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