Category Archives: medical insurance

Insuring the masses

In a quiet month for banks Equity Bank is making some quiet strategic moves for the long term, that may shake up the insurance sector in Kenya.

They have started selling insurance cover to their customers through their wholly owned subsidiary Equity Insurance Agency. Like with the health care package they started selling last year, it is quietly marketed to customers within the banking halls only – no public adverts so far and little mention elsewhere. Customers can sign up for motor vehicle insurance, domestic over, personal accident & travel, medical, and fire & burglary for businesses.

Equity continues a trend of rolling out products that are useful but have low penetration in Kenya like medical insurance and mortgages (they own a ¼ of Housing Finance)

Also they were earlier reported to have acquired an investment banking license from Juanco Investments – a little known company who’s also one of their shareholder.

Take Crash Positions

The Nairobi Stock Exchange (NSE) halted trading today for 15 minutes after the index fell by over 5%. (damn: just as I’m ready to sell some shares)

Elsewhere:

Safaricom: AKS says that pre-IPO shareholders lockout window has ended – so now can Vodafone start buying up some Safaricom shares and stem our losses?

Equihealth while other banks are sleeping, Equity Bank leads the way again this time venturing into health insurance. They have four plans starting as low as 6,700 (~$100 a year that include pre-existing conditions, HIV/AIDS, maternity, dental, eye-disease. (wow, medical insurance is a minefield, but Equity can sets its own terms in the industry and change the rules in the medical insurance industry)

The plans are;

  • Mango @ cost Kshs. 6,700 per person per family for inpatient (Kshs. 13,300 per person for in & out patient), covers up to Kshs. 75,000
  • Passion @ Kshs. 8,500 per family (Kshs. 15,100 per person for in & out patient), covers up to Kshs. 150,000
  • Melon @ Kshs. 16,000 per family Kshs. 27,600 per person for in & out patient), covers up to Kshs. 500,000
  • Apple @ Kshs. per family (Kshs. 35,700 per person for in & out patient), covers up to Kshs. 1 million

Scangroup: (Bharat Bank) As part of the sellout employee shareholders are seeking shareholder approval to sell up to 25% of their shares during the lockup period which is supposed to end in August 2009

Drip Cycle

0000 can’t believe two hours have passed and the drip is finished. Finished reading Next (a gift from AfroM) and I now start reading this week’s Time. They can’t start a new drip because wrist is swollen where the vein has had enough. Note: Nurses seem more callous at night. Are they tired or more hardened to the calls of patients at midnight?
0012 Nurse disconnects drip – releasing me to go to the toilet. “Always carry your phone with you” – is something you are advised when you check in as phones tend to disappear, usually if you fall asleep during visiting hours. The toilet lights are off at night and there’s no switch but using my Nokia screen – there’s no need for a light.
0017 Back to bed. Not really sleepy and I don’t use the mosquito net
0028 Mosquito buzzes my face. There’s a myth that Nairobi mosquitoes don’t transmit malaria, but I don’t wish to complicate my recovery/treatment by proving this out and I clumsily put the net down to cover the upper half of the bed and fall asleep
0145 Doctor comes in with a nurse. They make a new cut in my left hand and insert a tube to attach a new drip. Drip in right hand is removed and sealed with a bandage.
0200 Another nurse comes and connects the drip bottle to the new tube. Back to sleep.
0530 Use toilet but this time I use the urinal – it’s a paper gourd that they bring round and is good for two flows. When on drip and drinking fluids throughout, one needs to go to bathroom a lot
0625 Nurse comes in to administer blood pressure, pulse, and temperature tests
0632 Get SMS from Couch Tato telling me when I might find a rare DVD I am looking for. (Does he ever sleep?)
0640 new jug of drinking water delivered by a waiter.
0800 Watching CNN news: I must find out what the differences are between Sunni’s and Shiite’s.
0821 Breakfast brought in. Even though I am supposed to be on a low-fat diet, they keep bringing some fatty foods. Take porridge, Weetabix, banana, and tea leaving aside the boiled egg and sausage.
0852 finish breakfast – takes longer to eat with the wrong hand
0937 finish reading Time magazine
0955 Take a shower, and get new gown & shorts as my bed is changed. I am not able to walk about because my doctor shows up. She examines me, is happy with progress but asks that a blood sample be taken tomorrow morning after which she’ll consider discharging me
1000 Back to bed. If I had my Celtel line I’d be able to make more daytime calls, but stuck with Safaricom and waiting for whoever calls. I get a call from the office
1005 Drip reconnected. Must finish my Lucozade bottle by tomorrow when I leave. Hate this stuff
1145 Finish reading a chapter of a manuscript and use paper toilet before visiting hours start
1150 Dietician brings suggested menu/foods for my recovery after I leave hospital and we discuss what is acceptable and what’s banned
1205 Have to use the toilet. This time I ask to be disconnected and walk to the bathroom. Getting sloppy, this is the first time I have left my phone behind. I rush back to find its still there
1210 – 1215 first visitors of the day – and one brings another bottle of Lucozade
1220 Itch on my right hand and realise it’s a mosquito bite from last night – I hope it drank saline instead of my blood.
1222 Lunch arrives
1225 More visitors. My sister is first and I send her downstairs to buy the newspapers (perks of being in the hospital) and a Safaricom airtime card. They’re here as I eat lunch. Have a wide discussion about the poor state of roads, book publishing.

1405 Back to the toilet. As I am washing hands, I drop my phone in the sink. I scoop it up and take paper towels back with me where I strip, dry, and clean the phone which seems to be intact.
1440 Still reading a newspaper but no drip running. I go to the nurses’ station to ask to be reconnected to drip.
1500 Still no one. I ring my buzzer and when nurse responds, ask again to be reconnected to drip. There seems to be a slacking of work as nursing shift ends and another begins as those going off have to prepare extensive reports.
1520 – 1530 New nurse comes and attached new drip bottle
1540 Start reading Foul about corruption in the soccer administration world. It’s a great and someone should give a copy to our sports minister who’ trying to sort out Kenyan soccer. Other countries like Antigua and Jamaica have gone though what Kenya is going through (interim committees, normalization committees, suspension, and threats) FIFA does not appear to like government interference and prefers to deal with local sports administrators however corrupt they are.
1550 Waiter comes round but I decline afternoon tea. Other patients are asleep and I ask him to turn off TV, which is now showing an (annoying) kids variety show.
1650 Still reading Foul when first evening visitors arrive. Some visitors are interesting, others are tiring. For many, I have too repeat the story of who I ended up here. I engage some visitors in constructive talk; get advice on recovery while others have nothing to say. Still pick up some tips – I may get my full allocation of Stanbic IPO shares, and while this hospital has no internet for patients (am told), Kenyatta National Hospital (of all places) is a wireless hot spot
1830 I get a late visitor. Near the end of visiting time, guards don’t let in more visitors (except VIP’s) but my buddy assures me she can get past any time as she has a stethoscope in her car she wears.
1850 My boss visits. He’s on leave, but working on other projects. He advises me to enjoy the enforced rest and avoid dealing with office matters
1900-1920 Watch the 7 PM news as I eat dinner. Chicken again though not as fatty this time.
1945 Go to bathroom again
2000 Drip is reconnected. Lie back and drift in and out of sleep. TV still on with Spanish soaps with bad accents, and later the 9PM news. I try and remember the name of the movie where Wesley Snipes or Steven Seagal’s characters’ rip drip tubes from their arms, fight people sent to kill them and flee from hospital in a wheelchair.

0015 Wake again TV still on. Busta & Diddy’s “Pass the Courvesoir” video is on but not as interesting to watch three years later.

What’s New

Last week we attended a seminar on the HIV situation in Kenya today. It was sponsored by an (ACU) – AIDS Control Unit (that’s probably part of the giant National AIDS Control Council ) – which is a paid kitty to educate as many workers about HIV. Here’s what I found new, but maybe many of you already know.

Economy
– AIDS is related to trade, and follows routes of productive trade; trading places like Salgaa and Mlolongo in Kenya, which are popular stops for truck drivers, are known as pandemic centres in the medical community.
– A human has about 36 years of productive life, but 22 of those can be lost to HIV
– Globalisation, social mobility, conflict and war have also contributed greatly to the spread of AIDS around Africa.
– HIV costs the economy greatly through loss of manpower, increased medical costs, replacement staff, funeral expenses, increased dependency etc.

Video
They started the session by showing a very moving 20-minute video on STD’s and HIV that I first saw in 2002. The video’s narrator was unknown to most people a few years ago when the video was shot, but is today Kenya’s Minister for Communications – MP Raphael Tuju.

Stats
You learn lots of new statistics and facts:
– 80 – 90% of those who die are in the 15 – 49 age category (most productive years)
– STD’s facilitate the spread of HIV and are responsible for 80% of infertility in Kenya (and Chlamydia, is rarely detected as it causes no discomfort)
– 70 – 80% of transmission in Kenya is through sex, 5 – 10% is mother to child, smaller percentages are from drug use, or blood transmission
– 90% of adults who get tuberculosis are likely to have HIV (remember, we are immunized at birth against TB)

It gets scary
– Wives in (rural) Kenya are highly susceptible to the virus and STD’s because they often have sex, when not in an aroused state, leading to bruising, and bleeding which facilitate infections.
– The second phase of the HIV, known as the asymptomatic (silent) phase, can last from 0 to perhaps 15 years; a person carrying the virus, may not display any symptoms or illness.
– HIV is mostly discovered in the third phase, when someone suffers many illnesses; but it’s often too late for any meaningful treatment
– The daily papers are full of obituaries of young people who passed away after short illnesses that are normally curable
– HIV can be passed to a baby through breast milk (also during pregnancy and the birth process)

Drugs are scary
– Anti-retro-viral drugs (for treatment of HIV) have very bad side effects which have even led to the death of some patients
– One you start a particular drug cocktail, it is not advisable to switch to a cheaper, generic one
– Overuse of antibiotics during pregnancy can cause fungal infections.

Bad traditions
– “We were circumcised on the same day, with the same knife” is a call to brotherhood that men often use. But such practices need to be updated, so that, perhaps, one knife per boy is used on that special day.
– While the Luo are chastised for their wife inheritance customs, in other communities (all over the country) young widows (whose husbands may have died from AIDS, and don’t know their own HIV status) have silent affairs, cohabit, or even re-marry.
– The Church is still very negative towards potentially useful practices such as contraceptives and is also not very supportive of HIV+ people.
– Many family members still show very little sympathy or support to their HIV+ relatives
– Many employers still show very little sympathy or support to HIV+ workers.
– Many government programs relating to AIDS are carried out without involving the views or efforts of HIV+ people
– Many hospital workers, who are not AIDS specialists, show very little sympathy to HIV+ patients.

There’s hope
– The cost of drugs has come down from about 50,000 shillings a month in the mid-90’s to about 10,000 a month today (even 100 shillings for some generic doses at Kenyatta Hospital and other public hospitals)
– Hospitals now test pregnant mothers for the virus – and with drugs and caesarean operations, they have a 40% success rate in delivering HIV negative babies from mothers who are positive.
– Behaviour change (i.e. eating a balanced diet, avoiding re-infection, and living healthy) can prolong the life of a HIV+ person
– Many employers now provide contraceptives (free condoms) in the workplace, enable discussion (such as this seminar)
– There are many free VCT (voluntary counselling & testing) centres around the country that offer anonymous services. There are over 6 different HIV tests available now from the simple & cheap (which take some minutes) to the complex.
– A person with HIV can officially retire on medical grounds and get their full benefits. Also, under the law, they may continue to work, without hindrance.
-(Cynical but true) HIV has spawned a massive industry of NGO’s and community-based organizations that provide donor-supported employment and livelihoods for thousands of Kenyans. (We all got paid 500 shillings to attend the seminar and each speaker received a couple of thousand for their talk)

Uh oh

It seems like the NSHIS Bill may not be dead after all, maybe in ICU with a chance of making recovery, and a life with some permanent disability requiring hefty medical bills.

I rarely like to see foreigners lecture Kenyan’s (I prefer Museveni’s way i.e. Africans deal with African problems which has succeeded e.g. Sudan, Somalia), but please read an article by Bo Goransson, the Swedish Ambassador to Kenya. He shows that systematic corruption in Kenya is mainly out of a warped expectation wananchi have about their MP’s ability to bring development to them. These same MP’s are likely to pass Ngilu’s monstrous Health Bill, which they will of course not pay a shilling for themselves, or be responsible for implementing – but will tell their constituents that they brought them free healthcare. I hope that the NSHIS Bill becomes the second instance in modern times where the public can judge an MP’s vote on an issue – the first was the aborted 2003 constitution. In the past leaders have been judged by their person, tribe, preferred candidates, godfather, party, spouse, or family etc.