Nursing is often mistakenly perceived as a uniform profession - one that consists of general patient care and assistance. But there's a lot more nuance to this career than most people know about. Case in point: Flora Wachira, 34, is an oncology nurse.
Oncology, the study of cancer, is particularly relevant in Kenya. According to the Journal of Cancer Policy, cancer is the third leading cause of mortality in the country, accounting for 7 per cent of annual deaths. A 2015 Nation Newsplex review of health data showed that the rate of death from cancer in Kenya is outpacing population growth and may double by 2026.
These numbers serve as a sobering backdrop to the work Flora does. Trained at the Aga Khan University, School of Nursing and Midwifery, Kampala Uganda Campus, Flora has been working as a nurse for nine years.
Seven of these were spent as a general nurse in Uganda. In 2015, she was trained and certified in oncology nursing at Aga Khan University Hospital in Nairobi, where she continues to work.
Flora's responsibilities include administering chemotherapy drugs to patients, supporting them through radiotherapy, and accompanying patients and their families through the process of cancer diagnosis, treatment and survival. She also educates students and junior nurses on cancer care.
Take us back to the moment you decided to study nursing
In 1998, my elder brother was admitted in a local hospital, back in Molo, Nakuru County.
The response of the nurses and the doctors wasn't what I expected; it was wanting. When my brother asked for pain management, or to be reviewed, the nurses kept telling him, "Just wait for the doctor, he's coming." The attitude just put me off completely. I felt so bad.
At the time I thought, "Were I nurse; I'd listen to the patient. However long it would take for the doctor to arrive, I would be right there with the patient."
Why did you decide to specialise in oncology?
Cancer is a chronic condition that needs attention in the country and worldwide. It's very costly and aggressive. For those people who are deep down in the villages, they only hear of cancer as a curse, or as something that you will never heal from. So I thought, "I need to start to be there for these patients. I prefer reaching out to the communities, educating them on prevention measures and - for those who may have cancer - bring them here."
Which is the most fulfilling moment you've had in your career thus far?
I'm so happy that the government is able to help patients with the National Hospital Insurance Fund (NHIF). Initially, it was so difficult when a patient was diagnosed and he or she couldn't afford treatment. Most of them would even go to the extent of doing a fundraiser, or sell everything they had. At the end of the day, they could maybe only get the first cycle of treatment or surgery only. I'm really happy that most of our patients nowadays are getting 100 per cent treatment through the NHIF. And I pray that this will continue.
I am sure there have been disappointing moments as well...
In 2016, a 23-year-old was diagnosed with bone cancer in Murang'a County. She was married with a child. She went to hospital with pain on her lower limb. She was told "this is cancer, we need to amputate your leg.
You don't need treatment when you amputate, you don't need any chemotherapy." She believed what she was told and continued with her life.
Last month, she came here, ill. The doctor sent her for investigations only to find the cancer had metastasized to the lungs and the heart. Breaking this news to this client was the worst experience I have ever had. It was an emotional time for us at the Oncology Department.
How do you deal with job-related trauma?
We get monthly counselling by a hospital counsellor. We try to talk out the challenges we've previously had. You pour it out; sometimes you even cry to just release and offload everything.
What advice would you give to Kenyan youth who would like to work as oncology nurses?
If you want to be a specialised oncology nurse, do not do it for the money or because it's a unique cause. Have that heart because without it you, you can't survive in this career.
You'll be crying every day, you'll be stressed every day. You need to have passion and a caring heart. Do not do this because you were forced by your parents or because your friends think it's the best career for you.
What qualifications does one need to qualify as an oncology nurse?
You must first do a diploma in General Nursing, which takes three and a half years. You can then specialise by adding a two-year extension in oncology, which the Aga Khan University offers. Before this program was offered, you could do your diploma in General Nursing, and then get trained on the job as an oncology nurse. After a year of training, you got a certification.
Where, besides a hospital setting, can one work as an oncology nurse?
You can also work in home care. Patients who have Stage 4 cancer and cannot go to the hospital can receive palliative, or end-of-life care at home from an oncology nurse.
Where do you see yourself in 10 years?
Currently, I'm planning to do my masters; I want to specialise in paediatric oncology. A paediatric oncologist once showed me some pictures of children he treated 17 years ago - it was encouraging.
In future, I'll meet with my former patients and they'll say, "I remember my nurse, she helped so many years back." In 10 years, I'd like to involve myself in research.
The cause of cancer is not yet known; we only have the predisposing factors. We need to know the exact cause of cancer.