Years of waiting, one machine, thousands of lives

Patients with heart disease live with emotional and financial challenges across the country. [File, Standard]

The first welcome at Gongo Resource Centre in Gem Sub County, Siaya County, is not from people but from a chorus of barking dogs.

As we drive into the rural homesteads, several dogs move around the compound, alert and watchful. Their presence appears unusual, but the reason becomes clear later. To protect their farms and keep the animals away, residents have turned to dogs, which have become a common sight in many homesteads.

At one of these homes lives 47-year-old Faith Seda, a widow and mother of six children whose own battle is not with wild animals outside her compound, but with a condition affecting the most important organ in her body - her heart.

It is shortly after lunch when we find Faith at her home. Standing beside a basin, she carefully washes utensils as part of her afternoon routine.

For many people, washing utensils is a simple household activity. But for Faith, even ordinary tasks have become a measure of how much her health has changed.

She moves slowly, taking moments to rest. The energy she once had is no longer the same. Walking for some distance, standing for long periods, or performing household chores often leaves her exhausted.

Faith’s quiet life in the village hides a painful journey that has lasted for years: a journey of hospital visits, financial struggles, failed attempts at surgery, and waiting for an opportunity to repair her failing heart.

But now, after years of uncertainty, she believes a new chapter may finally be beginning.

Her hope lies in a major development at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu, where the arrival of a modern heart-lung machine is expected to allow doctors to perform open-heart surgeries closer to patients who have previously travelled long distances to Nairobi, Eldoret, and others outside the country.

For Faith, the machine represents more than medical equipment. It represents a chance to return to a normal life.

“I remember well in 2022 when I was five months pregnant. I fell down, and after that I started experiencing strange things in my body. My heart was beating very hard, and at first I thought it was because of pregnancy complications,” she recalls.

But the symptoms continued.

Faith noticed an unusual movement on the side of her neck, something that worried her and pushed her to seek medical attention. “The tissue inside my neck was beating hard like a heart. That thing developed, and it is still there to date,” she says.

Her search for answers took her through different health facilities in Siaya before she was advised to seek specialised heart care in Kisumu. “I was told I needed medication, but I also needed to look for money because I required surgery. I was advised to go to a heart centre in Kisumu,” she says.

The journey was not easy, and as a mother responsible for her family, every hospital visit came with financial pressure. Transport costs, medical expenses, and taking care of her children while battling illness became a heavy burden.

Eventually, Faith reached JOOTRH, where doctors conducted specialised tests, including an ECG and echocardiogram, to understand what was happening inside her heart.

The results confirmed that she needed urgent specialised intervention. “The cardiologists assessed me and told me my heart was not okay. They told me I needed surgery,” she says.

However, at that time, JOOTRH did not have the equipment required to perform open-heart surgery.

Faith was referred to Kenyatta National Hospital in Nairobi, one of the few public facilities in the country offering the procedure. She travelled with hope that the surgery she had waited for would finally happen.

Now at Kenyatta, she was admitted and prepared for the operation. “I was ready for surgery. Three patients who were ahead of me underwent their operations, and I was next,” she recalls.

But the procedure never happened. “The machine developed technical problems, and the surgery did not take place,” Faith says.

The disappointment was overwhelming. “I had already prepared myself mentally that I was going for surgery, but it did not happen,” she says

Although doctors informed her that she would be booked again, remaining in Nairobi became difficult because of financial challenges.

“I was struggling to stay in Nairobi because I had no finances. I decided to return home,” she says.

She returned to Kisumu, where she continued receiving care from Dr Juma Odoro, a cardiothoracic surgeon at JOOTRH.

For years, Faith waited for the day when the specialised equipment needed for her surgery would be available closer to home.

That hope came when JOOTRH acquired the Essence Perfusion System, a modern heart-lung machine manufactured in Germany. The equipment will allow surgeons to perform open-heart surgeries by temporarily taking over the work of the heart and lungs during an operation.

When Faith learnt that the machine had arrived at JOOTRH, she says she felt a sense of relief. “I was very happy because I have moved through many hospitals searching for this surgery. Now it is closer to our homes,” she says.

Faith says her condition has affected her ability to perform daily activities and care for her family.

“I have a family to feed. I am a widow living with my children. Getting back home and doing household chores has been a big challenge,” she says.

Doctors diagnosed her with an enlarged heart, a condition that affects the heart’s ability to pump blood effectively. “I was told my heart is swollen and blood is not being pumped well. The doctors told me that after surgery things will improve,” she says.

Like Faith, 27-year-old Sarah Oluoch from Awasi in Kisumu County has spent months living with uncertainty, waiting for a procedure she believes will give her a chance to reclaim her life.

Sarah, an orphan, lives with her aunt. Her health journey began in June last year when she started experiencing unusual fatigue that she could not explain.

“I started feeling tired. I could even faint. Sometimes I would just collapse. I did not understand what was happening to my body,” Sarah recalls.

The symptoms forced her to seek medical attention at a nearby dispensary, where she was referred to JOOTRH for further assessment. At the referral hospital, doctors conducted several tests, including an echocardiogram, and discovered that Sarah had damaged heart valves.

“I was told that two of my valves were damaged. I was advised to keep coming for clinics, and I was put on medication. Later, I was told to see a surgeon,” she says.

The further review by specialists, Sarah was diagnosed with rheumatic heart disease, a condition that had affected the functioning of her heart valves and required surgery. “The surgeon told me that surgery was the solution so that I could live a normal life,” she says.

However, at the time, JOOTRH did not have the equipment needed to perform open-heart surgery.

For more than a year, Sarah has lived with the condition, depending on medication while waiting for the operation that could change her life.

When JOOTRH acquired the heart-lung machine, she saw a new opportunity. “Now that JOOTRH has the machine, I do not need to travel long distances. This is important for me because getting money is a problem and I'm ready for surgery, "she says.

In Kenya, heart disease continues to place a growing burden on families and the healthcare system.

The World Health Organisation (WHO) identifies cardiovascular diseases as the leading cause of death globally, accounting for millions of deaths every year. The majority of these deaths occur in low- and middle-income countries, where access to specialised care remains limited and in Kenya are among the leading causes of illness.

Dr Odoro estimates that based on Kenya’s population and disease patterns, the country should be performing approximately 10,000 cardiac surgeries annually, yet only about 1,500 procedures are currently being done each year.

Every year, thousands of Kenyan families face a quiet but devastating health crisis: congenital and acquired heart disease. Over 5,000 children require open-heart surgery annually in Kenya, not to mention hundreds of adults whose conditions demand the same intervention.

At JOOTRH alone, the cardiac clinic sees three to four patients every week who require surgery, translating to roughly 200 patients a year from Kisumu and surrounding cross-border regions like Busia and Migori. Sadly, many patients lose their lives or deteriorate past the point of safe surgical intervention while waiting for a slot at overwhelmed facilities elsewhere.

For JOOTRH Chief Executive Officer Dr Clinton Okise, acquiring the heart-lung machine from the government is part of the hospital’s journey towards becoming a fully specialised Level Six referral facility.

“This is a heart-lung machine that we imported. It cost about Sh99.9 million. But there are other components required for it to operate, including specialised sets, and the total investment comes to about Sh150 million,” Dr Okise says.

He explains that the investment was made after recognising the increasing demand for specialised cardiac services in the region.

For years, many patients from Western Kenya requiring open-heart surgery have been referred to Kenyatta National Hospital, MTRH, and other facilities.

The new machine will allow surgeons to perform open-heart procedures where the heart temporarily stops during surgery while the machine takes over its functions.

Dr Odoro explains that the heart-lung machine is critical in making such operations possible.

“Open-heart surgery means that we operate on the heart while it is open. To do this safely, the heart needs to be still. The heart-lung machine takes over the work of the heart and lungs by oxygenating blood, removing carbon dioxide, and pumping blood back into the patient,” Dr Odoro explains.

He says the machine allows surgeons to operate while ensuring that the rest of the body continues receiving oxygen.

“This machine is what enables us to perform open-heart surgery. Without it, you cannot safely carry out these procedures,” he says.

According to Dr Odoro, one of the common conditions requiring open-heart surgery in Kenya and across Africa is rheumatic heart disease.

Initially, the programme targets performing between 10 and 15 surgeries during specialised camps, with a long-term goal of managing approximately 100 to 150 cardiac surgeries annually as the service expands.

The condition damages heart valves, affecting their ability to function properly.

“Most of the patients we see requiring open-heart surgery have valve disease, especially rheumatic heart disease. The valves become damaged and may need replacement with either tissue or metallic valves,” he says.

The disease often begins with untreated throat infections caused by bacteria known as Streptococcus.

“The infection affects the throat, and later the body’s immune response can attack the heart valves, causing damage. This process usually begins when people are young, but the effects may appear years later,” Dr Odoro explains.

He says the burden is especially high among communities with limited access to early diagnosis and treatment.

Apart from rheumatic heart disease, other conditions requiring open-heart surgery include heart tumours, such as myxomas, and some problems affecting major blood vessels.

Before the arrival of the new equipment, many patients had limited options.

“Open-heart surgery is expensive because of the equipment and consumables required. The machine itself is costly, and the materials used during surgery also add to the cost,” Dr Odoro says.

However, the introduction of the Social Health Authority (SHA) coverage is expected to make the services more accessible to patients.

Dr Okise says SHA will cover the cost of the surgery for eligible patients treated at the public facility.

“When you go to private hospitals, heart surgery can cost almost Sh2.5 million. But through SHA in a public facility, the cost will be covered, and patients will not be asked to top up,” he says.