The Sunday Mail
The first kidney transplant at Chitungwiza Central Hospital will be done by the end of this year at the Sally Mugabe Kidney Transplantation Unit; the hospital’s chief executive officer, Dr Obadiah Moyo said in an interview with The Sunday Mail Extra on Tuesday last week.
After accompanying this publication on a tour of the state-of-the-art renal and kidney transplant unit, Dr Moyo said all systems were on the ready for the first transplant and the staff were undergoing preparative training sessions for the first operation.
“We don’t want to mess up our first operation so we want to be sure, so we are continually training our staff so that when we say we are having the first operation, we wouldn’t want to be found wanting.
“As we speak, everything is 100 percent set, the equipment is ready, the staff are ready. We can safely say by the end of the year we would have done our first transplant,” said Dr Moyo.
However, the programme will also identify and treat kidney problems early before they progress into chronic conditions that require dialysis.
Speaking a week earlier during a kidney transplantation workshop hosted by the hospital, the permanent secretary in the Ministry of Health and Child Care, Brigadier-General (Retired) Dr Gerald Gwinji assured the hospital of financial support in the transplantation programme.
“As we move to establish this noble programme, be rest assured that the Ministry of Health and Child Care will move to ensure adequate availability of all essential resources to sustain the kidney transplantation programme, especially in the acquisition of post-operative immune-suppression medicines and any other requirements.”
During the workshop, Dr Gwinji affirmed his wish to see the kidney transplantation unit opening at the “shortest possible time”.
This development is a relief to many Zimbabweans who are having to endure the high costs of dialysis.
The sessions costs between $150 and $200 in public institutions and up to $250 at private hospitals, with renal patients having to bear the brunt for the sake of survival. Renal patients are required to have two dialysis sessions per week for life or until they have a transplant done.
Due to the high costs of dialysis, many succumb to renal failure.
However, this will soon be a thing of the past. The resumption of kidney transplants in the country after a 24-years hiatus is anticipated to save huge sums of foreign currency as renal patients will no longer be required to travel to South Africa, India and other Western countries for transplants.
Parirenyatwa Group of Hospitals stopped kidney transplants in 1992 when more resources where being channeled towards fighting the HIV pandemic.
Dr Luke Muchemwa, a nephrologist, applauded the re-opening of the kidney transplant unit in the country.
“It’s commendable that we are working on re-opening a kidney transplant unit in Zimbabwe since 1992. It will help renal patients from travelling to other countries to seek the service and will also cut the cost that comes with out-sourcing medical services,” said Dr Muchemwa.
So far, Chitungwiza Central Hospital has sent eight health professionals to India for expertise exchange programme ahead of the re-opening of the kidney transplant unit.
A team of three surgeons, four nurses (selected from theatre and dialysis) and one nephrologist were seconded to Apollo Hospital, India in February this year for a month’s training in kidney transplants.
The Apollo Hospital transplantation team is expected to be part of the team that will make the first operation when the unit opens its doors to the public to offer expert knowledge and play supervisory role until they are satisfied with the performance of the local team.
In India, a kidney transplant costs at least $25 000 while in South Africa it goes for $40 000.
“If the procedure is done locally, the cost is anticipated to be at most $16 000, even though the actual costing hasn’t been done yet. Performing kidney transplants locally will certainly save renal patients airfare and accommodation costs,” said Dr Muchemwa.
“Taking into consideration the cost of dialysis where a renal patient forks out at least $400 every week, resumption of kidney transplants will come in handy,” Dr Muchemwa said.
Zimbabwe currently has more than 600 patients on dialysis. However, health experts say this number is only a tip of the iceberg as these numbers are collected from centres offering dialysis services.
Dr Muchemwa said Zimbabwe will be relying on live-related donor kidney transplants where relatives of the patients will be the main source of the kidneys.
But noble as it is, organ donation between relatives or from well-wishers might become the unit’s main challenge as many people have a dim view on such donations. Zimbabwe National Traditional Healers Association (Zinatha) director of medicine research, Sekuru Elisha Mutanga equated organ donation to practicing rituals using human organs.
“Our culture and tradition as Africans doesn’t allow organ donation because people are born in different families and have different totems. If ever one donates an organ to the next person, it defeats the whole purpose as to why that person was created in the first place,” said Sekuru Mutanga.
“The body keeps a person, a soul, and receiving an organ from another person spoils it. Everyone was given their original organs by God and if a case arises that one’s organ is damaged, there are traditional medicines that can fix all that.
“Organ-donation isn’t different from practicing rituals where people use body parts to advance their personal interests such as wealth acquisition.”
Despite an increasing waiting list for solid organs, the number of people willing to donate organs is practically non-existent in Zimbabwe.
Each day, about 57 people worldwide receive organ transplants, while 13 die waiting for a possible gift of life.
“We can’t, however, stop those who want to go ahead with organ donation and transplantation because it’s their personal choices,” Sekuru Mutanga said.
Renal failure is when one’s kidneys stop functioning and has to go through an artificial process called haemodialysis or continuous ambulatory peritoneal dialysis (CAPD) to remove toxic body waste from the blood, including urine and water.
CAPD involves inserting a soft thin tube, a peritoneal catheter, through the wall of the abdominal cavity for waste removal.
If the waste is not removed, the patient swells up and dies a painful death.
It is estimated that about 1 000 people develop renal problems in Zimbabwe annually. According to the Kidney Fund, kidney injury is caused by medicines and drugs. When one is confirmed to have kidney damage through investigations by a physician, dialysis treatment is prescribed.
A cardiovascular surgeon establishes a haemodialysis catheter insertion or arterial venous fistula and the patient undergoes counselling and starts dialysis.
Kidney disease can be caused by hypertension, long standing diabetes mellitus, glomerular-nephiritis (acute inflammation of the kidney), ascending urinary tract infections and HIV.
Health experts say dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when one’s own kidneys can no longer take care of one’s body needs.
“When one’s kidneys fail, dialysis keep the body in balance by removing waste, salt and extra water to prevent them from building up in the body; keeping a safe level of certain chemicals in one’s blood such as potassium, sodium and bicarbonate and also help to control blood pressure,” said Dr Muchemwa.
Government has in the past years procured and installed dialysis equipment worth around $2, 5 million in central and provincial hospitals to make dialysis more accessible and affordable for many.
A complete renal care programme should include a transplant programme, which should be achieved with the opening of the Sally Mugabe Kidney Transplantation Unit.
Health experts recommend a low fat diet, exercising regularly, frequent medical check-ups, avoiding tobacco and limiting alcohol as measures to protect one’s kidneys.
