- NORMAN GRINDLEY/DEPUTY CHIEF PHOTOGRAPHER
Medical facilities use this machine for haemodialysis, a type of artificial kidney treatment available in Jamaica for persons who have advanced or end-stage kidney disease. Advanced or end-stage kidney disease or renal failure results when the body's kidneys have stopped functioning and so cannot clear waste and other toxins from the body. Without dialysis or a kidney transplant, persons with this illness will die.
Trudy Simpson, Staff Reporter
HEALTH OFFICIALS estimate that more than 600 persons die each year in Jamaica because they cannot access treatment for end-stage kidney disease.
Dr. Lawson Douglas, professor of urology at the University Hospital of the West Indies (UHWI) and director at the Kidney Support Foundation of Jamaica, said that nearly 900 new cases of end-stage or advanced kidney disease emerge each year but, because of inadequate funding, the number of facilities and staffing to treat them, many persons, often from rural areas, die.
"We need at least one machine unit in small rural towns," Prof. Douglas said. "Right now, the very ill patients in rural Jamaica have to travel up to 80 or 90 miles to go to a dialysis facility."
The treatment for end-stage kidney disease is either regular dialysis or a kidney transplant. The process of dialysis, takes place in an artificial kidney, removing toxic substances and waste material from the blood. Currently, Jamaica has three government-assisted or 'public' dialysis units located at the Kingston Public Hospital (KPH), the University Hospital of the West Indies (UHWI) in Kingston and the Cornwall Regional Hospital in St. James.
TREATMENT EXPENSIVE
The standard treatment for persons suffering end-stage kidney disease is three, four-hour sessions of dialysis per week but Prof. Douglas explained that because of shortage of haemodialysis machines, many persons are receiving only two sessions per week in order to accommodate more clients on the limited number of dialysis machines.
Dialysis treatment is also expensive. Daphney Bartley, who manages KPH's renal unit, said that many persons needing the services are unemployed and cannot afford to pay even the reduced rates charged by government-run institutions. Each session costs between $4,000 and $4,500, mostly for supplies related to the process, but most patients are allowed to pay what they can afford. The cost is much higher at privately-run renal units.
Lester Woolery, chairman of The Kidney Support Foundation, estimates that about 400 patients are dialysed each week at the three publicly-run units in hospitals but there are long waiting lists of persons needing the two types of dialysis - haemodialysis and peritoneal dialysis. In a background paper describing the local situation, Mr. Woolery estimated that the hospitals have an average of 45 persons who require dialysis on their waiting lists.
"The demand outstrips the supply. It's an expensive process. The recurrent expenditure is tremendous. It's very difficult for some hospitals to sustain this. What you really need is some partnership with the private sector," said consultant nephrologist, Professor Everard Barton.
Prof. Douglas said that the private sector can help with more public education and through fostering organ donation. Corporate Jamaica can also assist in funding a more structured training and incentive programme for nurses and doctors in the specialist area of nephrology. In addition, he urged the private sector to help fund kidney transplants and post-transplant medication, which prevents the body from rejecting the new kidney. Corporate Jamaica can also help purchase and maintain dialysis machines and defray other expenses associated with maintaining the programme, they said.
Know about your kidneys
The body has two kidneys. Kidney disease can attack anyone at any age. A number of kidney diseases can be successfully treated if detected early but they may be fatal if neglected.
WARNING SIGNS
Puffiness around the eyes, particularly in children. Gradual swelling of parts of the body, often the ankles.Back pain - just below the rib cage. Increased frequency of urination or changes in pattern of urination. Problems associated with urination - pain or unusual sensation; bloody or tea-coloured urine.High blood pressure which must be diagnosed by a physician. Diabetes.TREATMENT
Some kidney conditions can be cured. In other cases, treatment can relieve pain, slow the disease and prolong life. Among the treatments are:
Diet such as regulating salt intake. It may also include more water and protein intake; Diuretics (drugs used to increase the urine flow) help avoid fluid build up in the body; Antibiotics - which prevent or limit damage to kidneys caused by bacteria; Steroids - which can effectively relieve symptoms in many cases; and,Surgery - which can correct birth defects and remove obstructions.HOW YOU CAN HELP FIGHT KIDNEY DISEASE
Learn about kidney disease Know the warning signs Consult your physician immediately if symptoms occur Become an organ donor Give your support to groups in your community which are working for more research and better patient care.Sources: Kidney Support Foundation, Jamaica, National Kidney Foundation, USA , Renal Unit, KPH and http://www.nephrologychannel.com/rrt/peritoneal.shtml
For more information, contact Lester Woolery at 968-3456-65, Jean Rhone at 927-5810 or the renal units at the Kingston Public Hospital, University of the West Indies or Cornwall Regional Hospital.
