Heartbreak for stranded families as State freezes overseas treatment

A five-year-old with heart disease was all set for a life-saving flight to India.

The air tickets were ready. But out of the blue, the Ministry of Health suspended overseas medical travel support.

Now, the boy’s inconsolable family cannot understand the “insensitivity” of the government. A donor had committed to pay Sh1.9 million, whereas the Social Health Authority (SHA) was to foot the overseas treatment charges capped at Sh500,000.

Now the donor has since withdrawn funding to redirect it to other patients, leaving the Pipeline Estate, Nairobi, family in despair.

“My son was scheduled for surgery, but we cannot travel,” the boy’s mother, Lillian Ng’ang’a, told The Standard on the phone, unable to share more details amid sobbing.

The suspension, SHA officials said, is meant to allow the vetting of health facilities outside the country.

But patients, families and advocates have described the last week's move as “painful and life-threatening”.

“This is painful, uncalled-for, and much hurting to the patient community,” said Evans Majau, founder of Kenya Mended Hearts, a patient support organisation for children with heart defects.

“I pleaded with the donor to hold on, unsuccessfully. This is so insensitive. The patient and family remain helpless. I can do nothing much to save the child.”

Many families had completed the required processes, including document authentication and pre-authorisation from SHA.

Some patients had already flown out. “My surgery is yet to happen. I am just going through organ donor tests since we came,” said one patient from a hospital bed in India.

The patient, who did not want to be named, left Kenya last month with the assurance of undergoing a smooth procedure.

They travelled after presenting all documents to SHA, and left with an assurance that the General Overseas Programme would be issued after two days.

The total cost for the surgery is Sh4 million.

“We are not fundraising the Sh500,000 ,but if they do not pay, we clearly have to come out of pocket, which was not in our initial budget when we put together funds as a family, friends and well-wishers,” the patient said.

“With their silence and lack of email response, no communication to me or the hospital, we do not know if they’ll pay or not.”

John Gikonyo, president of the Renal Patients Association, said the move would affect most patients in need of specialised care.

“A case of a patient who was to travel to India for kidney transplant is hurting. The patient was set for the procedure, including the donor, only to have the process halted,” he said.

He described the move as careless and inconsiderate.

“It is very insensitive to issue such a directive without notice, leaving patients already in transit stranded. Some of the procedures, especially heart surgeries for children, are supported by donors. Once donors pull out, patients lose everything. There should have been an orderly way of doing things,” he added.

Majau also criticised the Ministry of Health for failing to prepare adequately before transitioning services from NHIF to SHA. He noted that the government had six months to contract hospitals in India, where most Kenyans seek treatment, but did not.

A Health Ministry official said the Benefits Package and Tariffs Advisory Panel was finalising the official list for overseas referral.

Overseas treatment, according to the official, would only be granted to patients in need of specialised care.

According to the Social Health Insurance Act of 2023, the Social Health Insurance Regulations, 2024, and the gazetted Benefits Tariffs, treatment outside Kenya is offered at a rate of Sh500,000 per person per annum for services not available locally.

The official noted that SHA was aligning with the provisions of the law and has commenced the contract process.

“The new system will connect all stakeholders including members, referring specialists, local hospitals, the Kenya Medical Practitioners and Dentist Council, the Ministry of Health, overseas facilitates, and SHA ensuring seamless coordination.”