High cost of treatment continues to hurt poor people suffering from non-communicable diseases such as kidney disease, diabetes, breast cancer, and heart diseases as community-based health insurance Mutuelle de santé doesn’t cover the cost. They request the government to subsidise the cost. They say that the cost is only covered by RAMA which is a formal workers’ medical insurance scheme, leaving people in the informal sector, mainly those using Mutuelle de santé, that can’t cover it. Elias Nambaje has been suffering from Kidney disease for 15 years and is a member of Rwanda Kidney Organisation. The main challenge, he says, is that community-based health insurance doesn’t cover the high treatment cost and the situation worsened when Covid-19 affected their income. “Dialysis and drugs are very expensive and the government should subsidise the cost,” he says. The treatment cost, he says, is in two categories. For some patients, it requires dialysis treatment three times per week paying Rwf100, 000 for each instance. “So it requires Rwf300, 000 per week, totalling almost Rwf1 million per month and many people can’t afford it. This cost is not covered by Mutuelle de santé which is used by many vulnerable Rwandans,” he says. He adds that for patients with transplanted kidneys, it requires about Rwf150, 000 per month to buy drugs. “If you face challenges and skip treatment for three days, you can die,” he says. Nambaje says that he had RAMA which is a formal workers’ medical insurance structure in the past years that could cover the cost, but when his job was affected, he had to use Mutuelle de santé which can’t cover it. The impact of Covid-19 Nambaje says that while Covid-19 has affected the income of many patients with non-communicable diseases, some programmes to reduce such diseases were also affected. For instance, car-free days that used to promote sports and examine people to reduce and detect the diseases is no longer done. When people do not do physical exercise, such diseases increase. Dr Francois Gishoma, a patient with diabetes over the past 26 years, says that patients also need enough food but their income was affected by the pandemic. Etienne Uwingabire says that people with non-communicable diseases have no immunity to Covid-19 and, therefore, should be carefully catered for. “Call for support to the patients to address their different challenges, but we also urge patients to prevent covid-19 and attend regular medical check-ups so as not to succumb to it,” he says. Prof Joseph Mucumbitsi, a paediatrician and cardiologist and the head of NCD Alliance in Rwanda, says that non-communicable diseases compose 40 per cent of all consulted diseases in hospitals, and they are the leading causes of death. “This is why studies showed that many people with such diseases easily succumb to Covid-19,” he says. So far, he says, 80 per cent of those with non-communicable diseases in countries where studies were carried out are easily infected with Covid-19 and 40 per cent of them are in intensive care. Mucumbitsi says a new programme could be introduced on TV to encourage and educate people on physical exercise to reduce attacks of non-communicable diseases.
