How a mother got cancer and her experience led the daughter to offer home-based care to other patients

What do you know about cancer? You know that cancer causes more deaths than TB, HIV and malaria combined. You know that the leading cancers among women in Kenya are breast cancer and cervical cancer. You know that the leading cancers among men are prostate cancer and esophageal cancer. You know of someone who has had cancer or died as a result of cancer. You knowJadudi, who successfully underwent treatment for a cancerous tumor following successful fundraising by #KOT. What you do not know is that 30% of patients with cancer require palliative care. Naomi Kinyanjui, the founder of Welcare Health Services Limited did not know that until her mother was diagnosed with brain cancer.

Naomi’s mother was enjoying her retirement years when she suddenly developed seizures. Naomi and her siblings rushed to her aid and took her to hospital. At some point, she had become incoherent thus they suspected that she had had a stroke. The doctors carried out a number of tests in order to determine the cause of the seizures. The diagnosis shattered Naomi and her siblings. Naomi’s mother was diagnosed with glioblastoma; an aggressive brain cancer. According to American Brain Tumor Association, glioblastoma is highly aggressive because the tumor grows in a part of the brain that has a large network of blood vessels. Naomi’s mother underwent surgery and chemotherapy but the treatment had detrimental effects on her health. The quality of her life changed significantly as a result of the tumor. She needed help in order to walk, eat and sleep without falling off the bed. The prospects of recovery did not look good. The family had to make a decision on the course of care she needed from there onwards.  The journey towards caring for her mother marked the birth of Welcare Health Services Limited.

“I was no longer a full time employee that time,” says Naomi. For years, she had had a successful career at a company that used act as a liaison between health care providers and the oil and gas companies. Caring for her mother was a strenuous task. Like all mothers, Naomi’s mother would often insist that she knows what she is doing. Attempts to get her to adhere to a schedule were met with resistance on some occasions.

“We decided to hire a nurse to take care of her. Watching her bond and work with the nurse offered us some comfort,” says Naomi. From that moment onwards, Naomi could not stop thinking of the thousands of patients who need palliative care at home. She plugged her resources and time towards laying the foundation of Welcare Health Services Limited.

“It is not advisable to ask the house help to care for a terminally ill patient. Most house helps don’t have the skills, patience and capacity to provide appropriate care to the patients,” says Naomi. Welcare’s mission is to provide care to patients within the confines of their homes. Welcare also provides paediatric nurses who provide guidance to new mothers.  Welcare has a network of professionally trained nurses and nurse aides to cater for their clients. All the nurses who work at Welcare are registered with the Nursing Council of Kenya.

“Before we start offering care to the patient, we have to meet the family members and the patient. We assess the needs of the patient in order to determine whether he or she needs a nurse aide or a nurse,” says Naomi. The nurses work in 12 hour shifts. The roles and the responsibilities of the nurses or the nurse aides are clearly spelt out in the agreement between the family and Welcare. In instances where the patient needs care on a 24 hour basis, Welcare can provide two nurses to cover the two shifts.

On a typical day, a care giver nurse aide from Welcare reports for duty at 8am and leave at 7.30 pm. Naomi works closely with the family members to ensure that the nurse and the patient get along. She calls the nurses and carries out follow up visits in order to ensure that the patient is receiving excellent care. The care giver nurse aide helps the patient carry out tasks such as eating, taking medicine and light exercises.

“In the event that the patient develops complications that require urgent medical attention, Welcare works closely with the nurse and the family to get the patient to hospital,” says Naomi. Naomi looks back at the years she spent in employment with gratitude. She developed working relationships with ambulatory service providers which come in handy in her current position as the CEO of Welcare Health Services Limited. Naomi is quick to state that Welcare does not offer any clinical prescriptions. The role of the nurses and nurse aides is restricted to care giving. Hiring a nurse aide care giver from Welcare for a patient costs Kshs. 1,350 per day while hiring a nurse costs Kshs. 1,500 per day.

“How does your family cope with your mother’s sickness?” I ask as we proceed with the interview.

“We take each day as it comes,” she says.

“Shouldn’t Welcare do more for the family members?” I ask.

“Welcare intends to offer psychological support in the future.” She adds as her eyes glisten passionately. Empathy is at the core of what Welcare does on a daily basis. Running Welcare comes with its fair share of challenges. Given that the services provided by Welcare are highly personalized, the nurse and the patient have to develop a good working relationship. The development of the relationship does not come naturally at times. Currently, Welcare can only cater for patients who live in Nairobi due to limited resources.

In spite of the challenges, Naomi is hopeful about the future. She would like to work closely with insurance companies. She would like to see patients and their families relieved from paying for Welcare’s services out of their pockets. She would also like to expand her reach beyond Nairobi so that city residents who have family members who need palliative care no longer have to worry about the quality of care their relatives are receiving.

You can reach Naomi via Tel: 0770 746 657

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