How brain tumour surgery in Eldoret gave Ugandan hotelier second chance at life

Until 2023, Robert Kasaija, a resident of the neighbouring country Uganda, had been experiencing headaches for nearly two decades. However, the middle-aged Kasaija, a hotelier in Busia, Uganda, chose to ignore the pain as it was intermittent and did not severely affect his daily duties. He thought it was simply due to exhaustion from his work routine.

In 2022, however, the pain intensified in his forehead and made him feel unusually different from the way he was accustomed to. It was then that he decided to seek medical attention at a health facility in Busia, where he was prescribed some painkillers.

The problem persisted, and after visiting several health facilities in Kampala, he was treated for malaria, brucellosis, and even typhoid, but still did not feel better.

“A doctor would treat me for malaria or even brucellosis, another doctor diagnosed me with both malaria and typhoid. I was given tablets for an entire month but still couldn’t get relief. The pain in my forehead became more intense,” says Kasaija.

At one point, a family member associated the pain with witchcraft, as despite several visits to the hospital, he did not improve. He even sought help from witch doctors in Uganda, Kenya, Tanzania, Congo, and other countries at a high cost, but still did not recover.

“My friends took me to different countries to seek treatment because it was believed that I was bewitched. I would part with two to three million Ugandan shillings for every visit to the witch doctor. Sometimes I had to pay for car hire to the place, buy goats, chickens, and other required items. Still, I didn’t get better.”

By August 2022, he began experiencing vision impairment in one of his eyes, which affected his daily activities.

“I could not run my businesses as usual. I stopped driving because I could not see well, and I was always in pain. I couldn’t even operate my phone, so I would ask my wife or friend to help whenever I wanted to make a call or check something,” he narrates.

He then decided to seek treatment at one of the largest hospitals in Kampala, where a CT scan was performed. The results showed that he had a lesion in his brain.

“I was advised to undergo surgery to remove the tumour. Since I had suffered pain for so long, I did not hesitate and asked the doctor to book me for surgery immediately,” Kasaija adds.

However, the doctor attending to him told him to wait as a group of medics would discuss how to remove the tumour. Kasaija returned home while waiting for the doctor’s response, who later advised that the surgery was complicated and could not be performed at the facility.

Devastated, Kasaija sought help at another hospital, where a doctor agreed to operate on him. The doctor then asked him to return home while preparing for the procedure. A day later, Kasaija called the doctor, who said he would need to pay more money than originally agreed.

“I agreed, and the doctor promised to get back to me. However, days passed without any communication from him. When I called, he did not pick up my call or call back,” said Kasaija, who did not wish to specify the amount but stated it was over 1 million Kenyan shillings.

He returned to the first doctor who had promised to operate on him with the help of a team of doctors from South Africa who were visiting the facility. They agreed again on an amount he was supposed to pay before Kasaija left for home.

Kasaija disclosed that the doctor did not communicate with him again, and despite the pain, he decided to return to the previous facility where he had been told the procedure was complicated and could only be handled by specialists from outside Africa.

The doctor further explained that he would have to remain in hospital for a month to fully recover after the surgery, if it were done.

He returned home and, with the help of his daughter, began looking for hospitals in India where he could find help. The process was tedious and complicated, and he contemplated giving up altogether.

In early January 2023, his mother visited him and suggested a visit to a hospital in Busia, where a doctor advised him that he would need surgery to avoid further damage to his brain.

Kasaija says that at the time, he felt like his eyes were popping out of their sockets. The hospital in Busia advised him to visit its main facility in Nairobi, where a neurosurgeon would be consulted to operate on him.

Fortunately, he had a friend, Peter Maina, who was based in Busia and had known of his suffering. Peter had a sister, Purity Kabii, who works as a nurse in Eldoret. He asked Kasaija to send a copy of his medical records to his sister, hoping she could help them decide where to seek treatment for the condition.

Purity advised them to visit Eldoret after a doctor suggested they consult Dr Florentius Koech, a neurosurgeon at Tophill Hospital in the town.

“I met Dr Koech, who, after assessing me, said that the surgery would take approximately two to three hours. He reassured me and said that I would be fine immediately after the surgery. I couldn’t believe it!” Kasaija explains.

According to Dr Koech, the lead neurosurgeon at Tophill Hospital, Kasaija had a tumour in his brain around the pituitary area.

“He had a pituitary tumour that was compressing the optic nerves, thus affecting his sight. We had to remove the tumour through the nasal cavity, a procedure known as endoscopic transnasal transsphenoidal surgery,” explained Dr Koech, who spoke to The Standard.

During this surgery, an endoscope, a long tube with a camera at the end that sends images to a screen viewed by the surgeon, is inserted through the nose. There are usually no external incisions and no visible scars.

On 24th January, Kasaija was scheduled for surgery at Tophill Hospital, which turned out to be successful. Immediately after the surgery, Kasaija was able to see clearly. He stayed in the high-dependency unit (HDU) for less than six hours and later moved to the ward.

His wife, Sylvia Kababiito, could not contain her happiness when she saw him up and well.

“I want to thank Dr Koech for helping my husband. I had struggled with him looking for medication for a long time. We are grateful,” she says.

During his admission, the Ugandan Minister of State for Gender Labour and Social Development, Mutuuzo Peace Regis, visited him to make sure he was doing well.

“When he called to tell me that he was doing fine, I couldn’t believe it because he had been struggling to get treatment. I am impressed by what the hospital has done for him. It’s encouraging to know that Kenya has advanced and that quality modern healthcare is available,” said the minister.

Kasaija was discharged four days after the operation and was allowed to travel back home to Uganda in good health.

“I had regained full sight and was glad that I would resume my daily activities. I can independently work, unlike before when I had to call for support while doing essential tasks,” he said, celebrating his restored health.

Two years later, after several reviews, Kasaija is a happy man, with doctors giving him assurance of a clean bill of health. He says he is trying to rebuild his business, which was on the verge of closing down when he was ill. He also revealed that his employees at his hotel had stolen from him when he was undergoing surgery, as they knew he might not survive.

Dr Koech told The Standard that many patients struggle to seek treatment abroad, unaware that there are qualified specialists and modern facilities in the country.

“Most chronic and complicated medical conditions can now be managed in the country. The government has made it possible to have the required facilities and trained specialists. Many people go abroad because of the marketing strategies employed by external facilities,” said Dr Koech.

In another remarkable medical story of hope and healing, Anstacia Nyatogo, a teacher from Kisii County, made a miraculous recovery after undergoing a successful tumour removal surgery at the same hospital.

Anstacia’s health ordeal began more than six months ago when she started experiencing severe headaches, dizziness, vomiting, and the gradual loss of vision in her right eye, a condition that severely impacted her ability to work.

This led her to seek medical treatment at various clinics in Kisii County, though the underlying cause of her symptoms remained undiagnosed, leaving her family worried and frustrated.

Anstacia then visited an eye clinic, where doctors discovered the root of the problem: a tumour located near her eye, pressing on vital nerves and blocking her vision. The diagnosis was confirmed after an MRI scan, revealing the seriousness of the condition.

The doctors recommended radiation therapy to shrink the tumour, and she underwent 25 sessions. However, the tumour began to grow again after a slight improvement. As her symptoms worsened, including unbearable headaches, nausea, dizziness, and complete loss of vision in her right eye, the family turned to an oncologist. The oncologist advised them that there was little that could be done if radiotherapy failed and suggested an embolisation procedure to block the blood supply to the tumour.

However, the family was told that even this was only a temporary measure, and Anstacia would have to live with the tumour for the rest of her life.

At this point, a family friend suggested an opinion from a neurosurgeon, Dr Florentius Koech, who explained that the tumour could be removed, a possibility that had been dismissed by other doctors due to the tumour’s delicate position near critical nerves.

“We decided to trust his expertise and travelled from Nairobi to Eldoret to seek a second opinion. The moment we arrived, Dr Koech and his team made us feel welcome and assured us that they would do everything possible to help my wife,” said Sila Obuba, Anstacia’s husband.

Anstacia’s treatment at Tophill Hospital began with an embolisation procedure to block the blood vessels feeding the tumour, followed by surgery.

The surgery, which lasted over five hours, was complicated due to the tumour’s location near delicate eye nerves and blood vessels. Despite the risks, Dr Koech and his team successfully removed the tumour, which had caused so much pain and suffering. The surgery was a success, and Anstacia’s recovery began almost immediately.

"After the surgery, my wife’s symptoms disappeared. She could eat, talk, and most importantly, see again with her right eye. The dizziness and vomiting stopped, and she was no longer in pain," Sila Obuba added.