Lack of funds stalls renal unit

Due to the high cost of dialysis, life for an ordinary Zimbabwean suffering from renal failure can be a nightmare.

With a dialysis session costing between US$150 and US$200 in public institutions and up to US$250 at private hospitals, renal patients are forking out fortunes.

They are required to have two sessions per week.

Due to the high costs, many patients are succumbing to renal failure since they cannot afford the treatment.

Zimbabwe currently has more than 600 patients on dialysis.

Kidney transplants are not done in the country with patients travelling mostly to South Africa and India for the service.

In 2014 alone, the Indian Embassy in Harare issued 267 medical visas.

Only two years ago, renal patients were overjoyed when it was announced that the Sally Mugabe Renal Institute at Chitungwiza Central Hospital (CCH) was set to install a kidney transplant unit.

The unit was set to be functional by the end of 2016.

The late distribution of funds has, however, dampened the spirits of the patients since the kidney transplant unit is yet to open its doors. Chitungwiza Central Hospital chief executive Dr Obadiah Moyo is not certain on the dates on which the transplant unit will be opened.

“So far we have managed to buy the required equipment for kidney transplants to commence. More still needs to be done, especially in the theatre rooms,” Dr Moyo said.

The reopening of the kidney transplant unit requires at least half a million dollars in equipment procurement besides other preparatory costs.

So far, Chitungwiza Central Hospital has sent eight health professionals to India for expertise exchange programmes ahead of the kidney transplant unit’s reopening.

A team of three surgeons, four nurses (selected from theatre and dialysis) and one nephrologist were seconded to Apollo Hospital, India, for a month training in kidney transplants.

Parirenyatwa Group of Hospitals, the only institution that conducted kidney transplants back then, stopped doing so in 1992 as it shifted its attention to the fight against the HIV/Aids pandemic.

The resumption of kidney transplants will result in the country saving a lot of foreign currency since renal patients will no longer be required to travel to South Africa, India and Western countries for transplants.

In India, a kidney transplant costs at least US$25 000 while in South Africa it goes for US$40 000.

Dr Luke Muchemwa, a nephrologist, said once operational, the transplant unit will be a cost-cutting measure.

According to Dr Muchemwa, performing a kidney transplant locally would require at least US$16 000.

“It is commendable that we are working on reopening a kidney transplant unit in Zimbabwe. Renal patients will not need to travel to other countries to seek this service. This is also a cost-cutting measure,” said Dr Muchemwa said.

“When the Apollo Hospital team came for assessments, they recommended a number of changes to be made on what we had done and our team is working on it.”

Added Dr Muchemwa: “Taking into consideration the cost of dialysis where a renal patient fork out at least US$400 every week, resumption of kidney transplants will come in handy.

Many people are, however, not eager to donate kidneys.

Dr Muchemwa said local renal patients depend mostly on organ donations from relatives.

Zimbabwe National Traditional Healers Association (Zinatha) director of medicine research Sekuru Elisha Mutanga equated organ donation to practising 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.

Each day, about 57 people worldwide receive organ transplants, while 13 die waiting for a possible gift of life.

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 including urine and free water from the blood.

CAPD involves inserting a soft thin tube called 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.

Kidney disease can be caused by hypertension, long standing diabetes mellitus, glomerular-nephiritis (acute inflammation of the kidney), ascending urinary tract infections and HIV.

There are more than 600 people who are living with kidney disease in the country, but statistics are projected to be more than what is recorded in health institutions. Apart from the high costs related to renal failure, renal patients encounter challenges as lack of resources and lack of appreciation and knowledge on kidney donation.

Government has in the past spent more than US$2,5 million in the procurement and installation of dialysis equipment in district and provincial hos-                                                                                 pitals.

A complete renal care programme should include a transplant programme.

However, part of the programme seeks to identify and treat kidney problems early before they progress into chronic conditions that require dialysis.

Health experts recommend low fat diet, exercising regularly, frequent medical check-ups, avoiding tobacco and limiting alcohol as measures to protect one’s kidneys.

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