Healthcare Should Fit Into People’s Lives: Njeri’s Story

Njeri’s alarm goes off at 4:45 a.m. in Kitengela. By half past five, she is squeezed into a matatu, hoping to beat the jam on Mombasa Road, and by 7:30 she is at her desk in Upper Hill with a cup of chai and a spreadsheet that must balance before the partners’ meeting.

She is 34, an accountant, and very good at her job. She is also tired, the kind of tired a weekend doesn’t fix, and for about two months she has had headaches that come and go.

Every few weeks she promises herself a check-up. Then she does the maths.

A check-up that “costs half a day”

For Njeri, a clinic visit is never just the appointment. It is asking to leave early, a matatu back towards home, a wait she cannot predict, maybe a lab queue, then the chemist. “A check-up costs me half a day,” she tells her sister on the phone. “Half a day I don’t have at month-end.”

So the check-up moved. First to after the audit. Then to after her cousin’s wedding committee had finished. Then to “when things calm down”, which for a working adult in Nairobi can mean never.

Meanwhile, she managed the headaches the way many of us do: painkillers from her handbag, more water, an early night when she could get one. Itaisha tu, she told herself. It will pass.

Five minutes at the pharmacy

The turning point was not dramatic. One Saturday, buying more painkillers at a pharmacy near the Kitengela stage, Njeri noticed a blood pressure machine on the counter. The pharmacist offered to take a reading. It took five minutes.

The number was high. He let her sit quietly for a few minutes and measured again. Still high. He was calm and clear: one reading is not a diagnosis, but this needed a doctor’s attention soon, not “one of these days”, and painkillers alone were not the answer. He explained which symptoms would mean going to hospital the same day and suggested she see a doctor within the week.

Njeri was surprised. She had assumed high blood pressure happened to older people, or to people who look stressed. What surprised her more was learning that headaches are not a reliable warning sign. Most people with high blood pressure feel nothing at all. Her reading was found because she finally checked, not because her body sounded an alarm.

That week she took a Friday afternoon off and saw a doctor. The doctor repeated the measurement, asked about her family (her mother has lived with presha, the everyday Kenyan word for high blood pressure, for years), requested some routine tests and agreed a plan with her, including a date to review her readings.

Njeri was not careless

It would be easy to call Njeri careless. She is not. She manages other people’s money, tracks every contribution to her chama and plans a two-hour commute to the minute. What she lacked was a way for healthcare to fit into her day.

Her story is common. Kenya’s 2015 national STEPwise survey found that roughly one in four Kenyan adults had raised blood pressure, and many of them had never had it measured. That is not a story about people who don’t care. It is a story about how hard it can be to fit care into ordinary lives.

Why so many of us postpone care

If you have ever put off a clinic visit, you will probably recognise at least one of these:

·       Time off work. For casual, daily-wage and self-employed workers, a clinic visit can mean lost income. For salaried workers, it can mean an awkward conversation with a supervisor.

·         Traffic and distance. A 15-minute consultation can sit inside three hours of travel, whether you are crossing Nairobi at rush hour or travelling from ushago, the rural home, to the nearest health centre.

·         Unpredictable waiting. Not knowing whether you will be seen in 30 minutes or four hours makes planning hard. Long waits usually reflect busy facilities and stretched health workers doing their best, not a lack of care.

·         Cost uncertainty. Many people don’t know what a consultation, test or medicine will cost until they are already there, so they wait until they “have hospital money”.

·         Not knowing where to go. Pharmacist, clinical officer, doctor, specialist, lab? When the first step is unclear, doing nothing feels easier.

·         “Itaisha tu.” Some problems do pass on their own. But silent conditions such as high blood pressure and diabetes don’t announce themselves. They are found by checking.

What healthcare that fits into life looks like

Care that fits real life doesn’t mean cutting corners. It means removing the friction that stops people acting early:

·         Finding the right professional easily, by what they do, where they are and when they are available.

·         Booking ahead, so you can plan around work, school runs and commutes instead of waiting all day.

·         Online consultations for suitable concerns, such as follow-ups, going through results, or asking whether a symptom needs to be seen in person. Emergencies and anything needing an examination or tests still happen face to face; see our guide What Should Never Be Handled Online?

·         Clear costs before you commit, so money worries don’t decide for you.

·         Follow-up that doesn’t fall through the cracks, so a high reading leads to a review and a plan, not a forgotten slip of paper.

Care that fits also happens in person: a pharmacy blood pressure check, a Community Health Promoter’s home visit, a workplace screening day, a clinic that opens on Saturdays.

Three things you can do this week

1. Know your numbers

Get your blood pressure checked at a clinic, a pharmacy, a workplace health day or by a Community Health Promoter. Ask about blood sugar and your weight or waist measurement too, and write the numbers down. If a reading is high, don’t panic and don’t ignore it: see a doctor or clinical officer, who will usually repeat it and advise you.

2. Choose a “health home”

A health home is a regular clinic or clinician who knows you and your history. It could be a public health centre, a mission hospital or a private clinic near home or work. When something comes up, you already know where to start, and someone can see how your numbers change over time.

3. Save the emergency numbers

Save 999 and 112 (emergency services) and 1199 (the Kenya Red Cross toll-free line, which also offers free psychosocial support) in your phone today. Add the location of your nearest hospital with a 24-hour emergency department.

When not to wait

Call 999 or 112, or go to the nearest hospital immediately, if you or someone near you has:

·         a sudden, severe headache unlike any before

·         chest pain or pressure, or difficulty breathing

·         signs of stroke: think FAST (Face drooping, Arm weakness, Speech difficulty, Time to call for help)

·         sudden confusion, blurred vision or fainting

Key takeaways

·         Postponing care is usually about time, cost and uncertainty, not carelessness.

·         Most people with high blood pressure feel nothing. The only way to know is to measure it.

·         In Kenya’s 2015 STEPwise survey, roughly one in four adults had raised blood pressure, and many had never been checked.

·         A high reading needs follow-up with a professional: not panic, and not painkillers alone.

·         This week: know your numbers, choose a health home and save 999, 112 and 1199.

The idea behind Ask RemoHealth

Njeri’s story is exactly why AskRemoHealth exists. Our mission is to make healthcare accessible for everyone, anywhere and anytime: not by replacing clinics and hospitals, but by making care easier to find and reach. On askremohealth.com, you can search for doctors, specialists, clinics, labs and pharmacies, view their profiles, book appointments, or consult online where that suits your concern. If there’s a question you’d rather not ask out loud, you can ask it anonymously in the community.

Are you a healthcare professional or run a facility? List your services on AskRemoHealth so that people like Njeri can find you on the day they finally make time.

This article is for general health education and does not replace advice from a qualified healthcare professional. If you have a medical emergency, call 999 or 112, or go to the nearest hospital immediately.