Silent grief: Financial, emotional and psychological toll of cancer care in Kenya
Dr Godfrey Mutakha, a gynaecologist and his wife Mauldine Mutakha, who died last year.
What you need to know:
- Cancer is the third leading cause of death in Kenya after infectious and cardiovascular diseases, with approximately 42,116 new cases and 27,092 deaths annually.
Last Thursday afternoon, like millions of other Kenyans, Dr Godfrey Mutakha sat glued to his television set, waiting for Treasury Cabinet Secretary John Mbadi to deliver the 2025/2026 budget. As a gynaecologist who has witnessed the devastating impact of cancer first-hand, he was particularly interested in health allocations.
What he heard left him shocked and dismayed. The CS had allocated just Sh8 billion for the country's emergency, chronic and critical care fund—money expected to cater for numerous chronic illnesses, including the disease Dr Mutakha knows all too well: cancer.
The modest allocation felt like a personal blow to the doctor, who last year lost his beloved wife Mauldine, to stage four breast cancer. She was just 34 years old, a mother of two, and his best friend.
Since 2022, Dr Mutakha had spent at least Sh500,000 every fortnight on his wife's treatment and medication. The staggering costs didn't end when she passed away on July 1, 2024.
"For treatment and caregiving from 2022 up to July 2024 when she passed away, we spent Sh13 million, including money spent on funeral arrangements for her befitting send-off," he reveals, tears streaming down his cheeks.
The financial burden has been crushing. Banks and the Kenya Revenue Authority (KRA) constantly knock on his door over huge outstanding loans and pending bills. Safaricom endlessly reminds him of Fuliza loans with ever-mounting interest.
The couple's dreams—building two houses, buying land together, and other family investments—all went down the drain as every shilling was diverted to her treatment and medication. Providing for the two children he was left with has become a daunting task.
"My light was extinguished on July 1, 2024. Returning to an empty bed every night in a room that still has all her belongings neatly arranged, her scent everywhere, is a painfully stark reminder of how cancer robbed my children and me," he says. "The millions I borrowed to spend on her treatment and care, which I am now compelled to pay back, makes the pain even more numbing."
The brutal reality of cancer
Dr Mutakha's story reflects a harsh reality for thousands of Kenyan families. According to the Ministry of Health, cancer is the third leading cause of death in the country after infectious and cardiovascular diseases, with approximately 42,116 new cases and 27,092 deaths annually.
The most common cancers are breast, cervical, prostate, oesophageal, and colorectal cancers. By 2040, the number of new cancer cases in Kenya is expected to rise to 95,217 annually. Currently, approximately 82,000 people in the country are living with cancer.
The healthcare infrastructure tells a sobering story. Kenya has fewer than 10 functional radiotherapy machines for a population of over 55 million people, with most located in Nairobi, making treatment more expensive, especially for rural families.
The country also has fewer than 50 trained oncologists, heavily concentrated in urban areas. Palliative care specialists and oncology nurses are also in short supply.
Each year, over 800,000 individuals face life-limiting illnesses, but only about 14,552 receive the necessary services—services that the majority struggle to afford.
When insurance isn't enough
"Despite having comprehensive insurance coverage, we incurred substantial medical debts due to expenses associated with chemotherapy and radiation therapies, nutritional support, transportation, and consultations in various facilities domestically and internationally," Dr Mutakha explains.
"I spent at least Sh500,000 every fortnight for three years. In addition, indirect costs from lost wages, unpaid leave, and absenteeism from work contributed to the already overwhelming financial strain. I utilised all available funding sources, including loans, Fuliza, and M-Shwari. I'm currently still servicing repayment obligations."
The caregiving role brought uncertainty due to high diagnostic costs, prolonged illness duration, recurrent acute episodes, doubtful prognosis, extended treatments, frequent hospitalisation, escalating adverse effects, and multifaceted therapeutic approaches. The psychological and physical challenges of caring for the patient all had to be catered for—and none of it comes cheap.
The hidden cost: mental health
The stress of helplessly watching his wife suffer, combined with crushing financial pressures, has taken its toll. Dr Mutakha has been diagnosed with stress disorder and now spends thousands he doesn't have on mental health treatment.
"The distress of seeing what she owned still at home—her clothes, perfume, the bed we shared, the sitting room where she liked to sit, her photos and portraits, her beautiful interior design work in the house—all bring mixed feelings of love, good memories, and at times low and high moods," he says.
Stressors arising from emotional distress, anxiety, feelings of helplessness, and difficulties managing caregiver responsibilities contributed immensely to his rising stress levels.
"I am glad I sought counselling services because it is necessary for my mental health and wellbeing. This has helped me maintain stability amidst the turmoil as I navigate my 'new normal'."
Caring for children aged six and 11 in this new normal first meant explaining exactly what happened to their mother and the fact that she would never return.
"It is difficult, I tell you," he admits. "There are things my late wife used to do for the kids that I must now catch up on. She used to shop for them in a certain way which I must adhere to. I have to keep up with every detail of their schooling and make sure I don't forget any meetings. From time to time, a year later, I still have to answer tough questions about their mother's absence."
The experience has left him constantly feeling lonely and needing people around him, desiring more affection from family and friends. Sometimes he finds it hard to laugh or enjoy things he used to enjoy. He's also battling an inability to connect with some of his wife's former friends due to anxiety following her death.
"Guarding my mental health remains a priority. Visiting and talking to a counsellor on a weekly basis has helped so much," he says. "Some coping mechanisms I have developed include allowing myself to grieve fully, surrounding myself with loved ones and friends, avoiding big investments or decision-making, and keeping memories including photos to cherish the moments we shared."
Samuel Thuku, manager of Ufahamu Counselling and Consultancy in Nairobi, explains that grief is the emotional and psychological reaction we experience when we lose someone or something significant.
"It is experienced differently from one person to another and often involves shock, confusion, sadness, anger, and inability to perform day-to-day activities. Some people navigate grief quietly whilst others do so outwardly with visible reactions," he explains.
Grief follows a pattern, Thuku notes. "The most recognised one was developed by Elisabeth Kübler-Ross, who described five stages of grief: denial, anger, bargaining, depression, and acceptance. David Kessler, a colleague of Kübler-Ross, later added a sixth stage called finding meaning."
However, Thuku emphasises that there are no rigid stages of grief because each person experiences it differently. Most people undergoing grief will have symptoms and reactions that mirror the above-named stages, and identifying these stages helps one recognise the emotions they're going through.
"Be patient with yourself because grief does not have a timeline," Thuku advises. "Focus on self-care by prioritising eating well, sleeping adequately, taking breaks from work obligations, and exploring self-care activities like mindfulness and meditation. In due time, celebrate your loved one's life to preserve their memory through memorials, memory books, and other activities to honour them."
Helping children cope
On handling children during grief, he explains that the most important aspect is understanding that children comprehend and deal with grief differently depending on their age and previous life experiences.
"For small children under the age of five, they may not fully comprehend that death is permanent and may ask if the person is coming back," he observes.
Children between six and 11 years of age understand that death is permanent and may ask many questions about it. They may exhibit physical aches, poor concentration, anger, extreme sadness, and pains, just like adolescents.
"This raises the question: when and how should I tell children about the death of their mother? There is no right or wrong way of doing it," Thuku points out. "However, it is advisable neither to hide the truth nor delay it. Find a quiet place, be honest and direct, allow for questions even if they may sound irrelevant, speak slowly and pause often to allow them to process, and be empathetic."
A call for better healthcare funding
The cost of cancer treatment and dealing with the aftermath of losing a loved one, including mental health support charges, is why Dr Mutakha urges Treasury CS John Mbadi to find more resources despite the tight fiscal space and allocate more funding to health.
This, he says, will help prevent the occurrence of crushing healthcare-related liabilities by expanding provider assistance programmes, ensuring accessibility, discount schemes, and resolving unfavourable billing matters, especially for vulnerable demographics.
"The government should also adopt policies minimising the consequences borne by individuals and families with resultant medical indebtedness. They should formulate strategies for impactful initiatives, eradicating existing patient-specific fiscal burdens, and providing alternative funding mechanisms for oncology-related expenditures," he urges.
As Dr Mutakha continues to navigate his new reality— his story serves as a stark reminder of the human cost behind Kenya's healthcare statistics. Behind every cancer case is a family whose world has been turned upside down, often facing a choice between financial ruin and watching a loved one suffer.
"The walls of my home bear witness through letters and cards overflowing with love and sympathy generously offered throughout this past year—thanks to social investments we built together over time," he reflects.
