By Violet Auma.
At the Kakamega County referral hospital, in the male ward, Joshua Odhiambo lies in bed, recovering from a bronchoscopy procedure that could finally bring him long-awaited answers.
A bronchoscopy is a medical procedure used to diagnose and treat various lung conditions.
The 40-year-old from Homa Bay has been battling persistent chest pains since June last year, a condition that has disrupted his daily life and livelihood.
Despite visiting several hospitals in search of treatment, none were able to determine the source of the blood he coughed up frequently.
Initially, he was referred to a hospital in Kisumu, where a chest X-ray revealed he had pulmonary tuberculosis.
He was placed on a six-month treatment, but his symptoms persisted.
The severe chest pains continued, and when he began coughing up large amounts of blood, he sought a second opinion from a pulmonologist in Kisumu.
The specialist then directed him to Kakamega County referral hospital for a bronchoscopy test.
Yesterday, Odhiambo was among the patients who underwent the first-ever bronchoscopy procedures conducted at the referral hospital.
With a sense of relief, he shares his experience, describing the process as “comfortable” and reassuring.
He is hopeful that the samples taken from his lungs sent to Aga Khan Hospital in Nairobi for further analysis, will finally explain the cause of his symptoms.
“For the past year, I have been treating something I did not even understand. Maybe now, I will finally get answers,” he says.
The introduction of bronchoscopy services at the county level gives him hope that others will no longer have to endure the long and frustrating journey of misdiagnosis and expensive travel for treatment.
In the female ward, another patient, Frida Nakhumicha, shares a similar story.
After surviving a road accident two years ago, 55-year-old woman suffered persistent chest pains that made daily activities unbearable.
“I was advised to avoid cooking or staying in rooms filled with smoke, but that was impossible since I rely on firewood back home. The pain became unbearable,” she recalls.
When she learned about the bronchoscopy camp at Kakamega referral hospital through her doctor, she saw a glimmer of hope.
After undergoing the procedure, she expresses relief.
“Now, I can sit, talk, and even walk with ease, something that was difficult before. Many women in my village experience similar issues, and I hope they will get the help they need after seeing my condition improve,” she added.
Odhiambo and Nakhumicha were among 12 patients who underwent bronchoscopy procedure during a medical workshop organized by Kenyatta National Hospital, the Respiratory Society of Kenya, and Kakamega County referral hospital.
Bronchoscopy helps detect tumors or bronchial cancer, airway blockages, narrowed airways, and inflammation caused by infections such as tuberculosis (TB), pneumonia, and fungal or parasitic lung diseases.
It is also used to investigate interstitial pulmonary disease, persistent cough, coughing up blood, spots seen on chest X-rays, and vocal cord paralysis.
The procedure also allows for the removal of secretions, blood, mucus plugs to clear airways, as well as the control of bleeding in the bronchi.
Dr. Andrew Owour, a pulmonologist at Kenyatta National Hospital and a board member of the Respiratory Society of Kenya, has been spearheading the bronchoscopy workshops.
Over two days, his team successfully conducted 12 bronchoscopy procedures, marking a historic moment as the first surgeries of their kind in Kakamega and the broader Western region.
“These procedure plays a vital role in respiratory care, providing both diagnostic insights and therapeutic solutions for patients with lung diseases,” Dr. Owour said.
Bronchoscopy services at county hospitals have long been unavailable despite machines being supplied by the national government in 2022.
The challenge was a lack of trained personnel, leaving the equipment idle.
“The goal was to decentralize services while reducing congestion at the national referral facility. However, most of the medics in the counties didn’t know how to use the bronchoscopy equipment,” Dr Owour stated.
“That’s why we are going around organizing these workshops and training healthcare workers. Kakamega is the second workshop after Mombasa, which was held in November last year,” he added.
Other counties that received the equipment include Meru, Machakos, Bomet, and Eldoret, all part of a national initiative to expand specialized medical services beyond Nairobi.
In response, Kenyatta National Hospital, in collaboration with the Respiratory Society of Kenya, embarked on a mission to equip doctors and nurses with the necessary skills to conduct bronchoscopy procedures.
The training efforts are now bearing fruit, with 20 doctors and several nurses now fully prepared to handle bronchoscopy services in their respective counties.
Among them is Dr. Steve Biko, a beneficiary of the training, who will oversee the procedures at Kakamega referral hospital.
Respiratory diseases are a major public health concern in Kenya and across Africa.
The World Health Organization (WHO) lists lower respiratory infections, tuberculosis, and chronic lung diseases among the top causes of illness and death in the region.
In Kenya, respiratory diseases account for over 25% of hospital admissions annually, with pneumonia being the leading cause of death among children under five years old.
Several factors drive the high number of cases major causes being air pollution from vehicles, industries, and household smoke.
Tobacco use and exposure to toxic substances like mercury in mining, also increase the risk.
Tuberculosis and HIV further weaken the immune system, making people more vulnerable to lung infections.
A 2021 study by the Kenya Medical Research Institute (KEMRI) found that cases of chronic obstructive pulmonary disease (COPD) are rising, particularly in urban areas where pollution levels are high.
Additionally, workers in Kenya’s thriving gold mining industry face a high risk of developing pneumoconiosis due to prolonged exposure to mineral dust.
For many years, bronchoscopy procedures were only available in Kenya’s capital, Nairobi, at Kenyatta National Hospital.
The cost of undergoing a bronchoscopy in private hospitals ranged from KSh 78,000 to KSh 400,000, making the procedure inaccessible to many patients.
Fortunately, with the intervention of the Social Health Authority (SHA), treatment is now covered for those in need.
Many patients from rural counties have been unable to access timely treatment due to the distance to hospitals and high cost of treatment.
As a result, some resorted to traditional medicine, which often led to delayed diagnosis and worsened conditions.
“I am so happy that these services are now available in Kakamega. It is much easier for me to come here from Homa Bay than to travel to Nairobi,” Odhiambo says, smiling with relief.
Respiratory nurse Joan Kagema from Kenyatta National Hospital confirms that three nurses in Kakamega have now been trained to ensure proper patient preparation and safety during bronchoscopy procedures.
The availability of bronchoscopy services is a game-changer, particularly for patients battling lung cancer, COPD, and occupational pneumoconiosis.
These conditions are prevalent among gold miners in the region due to prolonged exposure to mineral dust and mercury.
“Kakamega has many patients with lung and respiratory diseases. Thousands work in gold mining and face high risks from mercury exposure. The government must provide safety gear to reduce these cases,” said Dr. Biko.
He added, “For years, we lacked the capacity for bronchoscopies and other critical respiratory procedures. Now, Kakamega residents and neighboring counties can access these lifesaving services locally.”
As the program continues to expand, medical experts are hopeful that many more Kenyans suffering from respiratory illnesses will gain access to timely and specialized care, ultimately improving their quality of life.