Saving lives one kidney at a time

21 Aug, 2016 - 00:08 0 Views
Saving lives one kidney at a time

The Sunday Mail

Dr Obadiah Moyo
The essence of the renal programme cannot be underestimated. The incidence of renal failure in Zimbabwe stands at close to 1 000 new chronic cases per year besides the numerous hundreds that fail to receive assistance for one reason or another.

Significant cardiac, cerebrovascular and renal mortality in Zimbabwe have been attributed to hypertension. Available data suggest that hypertension exists in about 15 percent to 20 percent of the adult population.

Hypertension is estimated to be the cause of nearly one-third of the cases of end-stage renal disease, while chronic glomerulonephritis, obstruction due to schistosomiasis herbal/toxic poisoning and diabetes mellitus are additional causes.

Early detection and treatment of hypertension and obstructive nephropathy (including schistosomiasis and prostate disease) offer the best opportunity for immediate preventive programs. Presently, eight haemodialysis machines are in use at Chitungwiza Central Hospital (CCH) maintaining patients on haemodialyis.

Transplantation is, from an early stage an essential component of an integrated renal programme in any country embarking on any type of care for patients with chronic kidney disease and plans are under way to start a low-key programme at CCH.

The first kidney transplantation having been carried out at Parirenyatwa Hospital in 1992. The hospital gratefully acknowledges the initiative by the CCH Core Kidney Transplantation Team and all those who are willing to assist in carrying out kidney transplantations for willing and suitable renal patients in Zimbabwe.

The local team has continued to prepare itself for this ubiquitous task by holding weekly continuous education meetings at the hospital with external guests invited to come and make presentations.

Training and Support

A familiarisation tour of South African public and private hospitals was carried out in early January 2016 and a lot of positive ideas were gathered during the visit.

Surgeons, nephrologists, anaesthetists, theatre and renal nurses were also seconded to Apollo Group of Hospitals in India where they had both practical and theoretical hands on experience in kidney transplantation.

A lot of various individual professionals and organisations have also pledged support for the programme because of its immense benefit to the nation.

This programme would not have been possible were it not for the help of the Government through the Ministry of Health and the Zimbabwe National Army.

To have gone this far, it would not have been possible without the unparalleled support by Mimosa Mining Company. They have literally taken the programme to be theirs and we thank them and encourage them to be with us in all the times.

Through the help of Mimosa the hospital has currently managed to construct five cubicles which will house recipients of the kidneys post operation. The building is now complete with only a few equipment still to be secured.

The unit is set to be officially opened by His Excellency at a date to be announced soon by the Office of President and Cabinet.

This programme is not just for Chitungwiza; it is nationwide and patients are being identified from all over the country. It is an on-going exercise. A register for these patients is being kept at our renal department.

Partnership

The hospital is planning for the pre-operation, intra and post-operation stages to be well planned in order to avoid failure as what happened in the post-operation stage of the 1992 transplant.

CCH shall, therefore, enter into a technology transfer agreement where foreign partners will assist in kidney transplantation.

The hospital shall:

  •  Register personnel from our foreign partners with the Medical and Dental Practitioners Council of Zimbabwe as well as the Nurses Council of Zimbabwe;
  • Identify prospective candidates for transplantation from Zimbabwe and do the initial work ups of the patients;
  • Provide all the relevant personnel to be used for the programme besides the specialists from the partner;
  • Collect revenue from the prospective kidney transplant patients; and
  • Follow up and review patients, post-operatively after discharge.

Identified Partners Responsibilities

Co-ordination for the establishment of a kidney transplant programme.

Identifying prospective candidates for transplantation from other countries outside Zimbabwe for transplantation at Chitungwiza Central Hospital.

Transfer of technology through training of all categories of Zimbabwean staff as part of a technical agreement.

Assessment of CCH facilities and equipment before commencement of the programme and provision of relevant guidance.

Secondment of a fully composed transplant team including surgeons, anaesthetists, nephrologists as well as transplant nurses.

Creating a pharmacy at the hospital for the availability of all anti-rejection drugs as well as the provision of medicines required for pre-, intra- as well as post-operative management of the kidney transplant patients at stipulated Government-approved rates.

Supervision of transplant operations pre-, intra- and post-operatively until the patients are discharged.

Liaison with local nephrologists on the patient’s well-being post operatively after discharge from hospital.

Conclusion

A successful kidney transplant can be a gift of independence from the machine and depending on others. The newly transplanted patient who has an attitude of gratefulness accepts his future days as a blessing.

Dr Obadiah Moyo (MD, MPhil Med, PhD, FRCPath, FSB, CBiol, FRSPH, PGA MCKD, FISN) is the chief executive officer of Chitungwiza Central Hospital.

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