Wambua's fight with brain tumour, blurry vision and Sh2.5M bill

In March 2024, Paul Wambua’s life took a tragic turn. His normal routine, which involved manning his Jua Kali stall, was quickly swept away by a severe headache.  He remembers that at first, he started losing his vision and assumed it was normal. However, the blurry vision accompanied by severe headaches persisted. Wambua, 61, went to the hospital for the first time in weeks, since he first felt blurry vision.

 This visit would, however, become just one of many to come. “I went to the hospital to be treated; after a week I had to go back to the hospital. I feared my eyes would be damaged”. At this point, Wambua had made more than six hospital visits: “I was in a lot of pain, I couldn’t even sleep”.

He says, “I stayed on the couch throughout the night; my head was in a lot of pain, and I couldn’t see anything”. The pain forced Wambua to stay at home. This predicament would mean Wambua could not continue with his daily Jua Kali hustle to support his family.

The father of four had been to four hospitals by the time it was discovered, and he was diagnosed with a brain tumour. A month later, he would seek a second opinion, which showed the tumour as it was.

 “They told me that I was going to get surgery,” Wambua remembers. He also recalls suffering excruciating pain in his joints, affecting his ability to walk on steep slopes. He says mentally he was not affected; however, he admits that before the diagnosis, he did not know what a tumour was. “I had not heard of a brain tumour before,” Wambua said.

He was referred to Aga Khan Hospital to get specialised treatment. While this was a relief, it presented an even bigger burden for the father of four. Wambua was slapped with a total estimated bill of Sh2.5 million at the Aga Khan facility, or a trip to India for the brain surgery, both of which were a painfully distant dream for him.

 “I was really worried when I heard that such conditions are treated in India,” Wambua reckoned, noting that he couldn’t bring up the conversation with his family, “I saw my end”. “I was shocked. I did a rough calculation of what it would cost to go to India for treatment, and I could not afford it,” Wambua recalls. At the hospital, he was relieved it was not an open surgery; the doctor assured him he would remove the tumour through the nose, Endoscopic Endonasal Surgery (EES).

 India is a leading global hub for advanced brain tumour treatment. On average, brain tumour surgeries in India range between Sh710,875 (USD 5,500) and Sh1.45 million (USD 11,270), depending heavily on the complexity of the tumour and the specific facility chosen. Healthcare data reveals that approximately 10,000 Kenyan patients travel to India annually for specialised medical care, with oncology and neurosurgery consistently ranking among the top three primary drivers for travel. Data on medical tourism by the Ministry of Health (MoH) has shown that India attracts roughly 97 per cent of all Kenyans who seek treatment abroad.

After all the hustle, Wambua would find relief, as his hospital bill was catered for by the hospital and the Social Health Authority. “The hospital was kind enough to settle the Sh2 million to cover my surgery, while SHA covered the remaining Sh500,000,” Wambua. Now in his recovery journey, Wambua says his eyes haven’t fully recovered yet, but a lot has improved since the surgery on 25 December 2025.

Today, many Kenyans are burdened by the high cost of healthcare, which is further compounded by little disposable income due to the high cost of living. Global health and economic studies have documented poverty and homelessness as a result of getting trapped by unexpected hospital bills. A joint World Health Organisation (WHO) and World Bank report highlights that in 2022, 2.1 billion people globally face financial hardship due to out-of-pocket health expenses, with 1.6 billion pushed deeper into poverty. In Africa alone, soaring healthcare costs continue to drive over 150 million people into poverty each year.

 In Kenya, many people rely on out-of-pocket payments for medical services, despite an aggressive push by Insurers and authorities.

 Wambua’s case is not unique. Many families across the country have built their lives on a steady payment from their pockets, when the reality is, a single hospital bill can consume an entire household’s savings.

A 2023 Budget Watch by the Parliamentary Budget Office showed that Kenyans spend about Sh150 billion each year directly from their pockets on healthcare. Further, according to the 2022 Kenya Demographic and Health Survey, only about one in four people had some form of health insurance. The World Health Organization’s 2024 assessment of Kenya’s health-financing system also highlighted fragmentation across coverage schemes and the need for stronger financial protection.

Like many average people, Wambua’s living conditions changed drastically. Currently living with his son, Wambua cannot afford his own place, as the condition took him off work. “My life changed a lot. I feel so bad because I don’t have a place of my own,” Wambua said. Initially, Wambua's humble abode was near a river bank, and it was swept away, forcing him to move in with his son in a single-room apartment in Njiru, Nairobi. Wambua is married with four children.

He says his health condition, which has robbed him of his livelihood, affected his family in a big way. “My wife was mostly affected, and my daughter, who was taking care of me in hospital.” Typically, brain tumours present themselves differently depending on the tumour's size, growth rate, and exactly where it is located in the brain. Clinical evidence shows that common signs include persistent, severe headaches that get worse in the morning, sudden seizures, vision or hearing loss, and unexplained balance or speech problems.

 Dr Beverly Cheserem, an Assistant Professor and Consultant Neurosurgeon based at Aga Khan University Hospital, is one of the two doctors who undertook the surgery on Mr Wambua. According to Dr Cheserem, Wambua’s tumour was in the pituitary area, between the eyes and behind the nose. For individuals who present with a brain tumour, in some instances, for both men and women, their libido can become particularly low. For women, their periods can disappear due to the excess production of a hormone called prolactin.

“Another hormone that can be produced in excess is cortisol. In this situation, people gain a lot of weight, develop skin stretch marks, and may experience high blood pressure, diabetes, cataract formation, weakness of the bones,” Dr Cheserem said. She adds that growth hormones may also be produced in excess, making children grow rapidly and unusually tall.

“If it happens after puberty, people can develop coarse facial features, a large tongue, spacing of the teeth, high blood pressure, diabetes, and rapidly changing shoe and clothing sizes. They also tend to be very sweaty”.

 “By the same token, as the tumour grows, it can shut down these hormones and create the opposite effect,” she posed. Brain tumours also lead to visual failure. Typically, it starts with a gradual narrowing of the visual field.

Over time, the edges slowly disappear, and people begin missing things to the side. “As it becomes more advanced, patients may start bumping into doors,” She said. And while pituitary adenomas are overwhelmingly benign, they are highly treatable, and their main effects relate to hormones, fertility, and vision. “All of us should have our eyes tested periodically. People should specifically ask for a visual field test,” she recommended. According to Cheserem, lack of exact brain tumour incidence in the country is a major challenge when it comes to addressing barriers to awareness.

“Many people have their visual problems attributed to something else until someone eventually thinks to order a head scan,” she posed. In Kenya, there are more than 70 neurosurgeons; “comfortably, I would say about half of those neurosurgeons can perform pituitary surgery”. Pituitary patients are managed by a team that includes a pituitary surgeon, an endocrinologist, an ophthalmologist, and occasionally a radiation oncologist.

“One challenge is that people receive a diagnosis and immediately decide to travel abroad, where they often receive what I would call episodic care,” she says. “The vast majority of patients who come to my clinic do not actually require surgery”.

“Before someone gets on a plane, I always advise them to first seek an expert opinion locally,” Dr Cheserem said the country already has laboratory services, endocrinology, ophthalmology, surgery, and radiology capacities.