A dialysis machine will not solve the problem

Jul 12, 2009 Letters

Dear Editor,
There has been constant reference to the plight of a young woman who is in need of dialysis.
It is of course unfortunate that in a country which celebrated 43 years of independence recently that the health services cannot provide dialysis and the unfortunate woman has to resort to begging.
There is a common misperception that a dialysis machine would solve her problem. Nothing can be further from the truth.
When the owners of the 3G dialysis outfit were contemplating the setting up of a dialysis centre I was approached to be the physician.
This was done because the owner was familiar of my training in Internal Medicine including Nephrology after qualifying.

I supported the idea but said that since the father of Nephrology in the Caribbean was no other than our own Guyanese Prof. George Nicholson, DM (Oxon), FRCP, FACP that he was more qualified to initiate the project. I therefore importuned Prof Nicholson to participate and after overcoming many obstacles the entity became functional. He comes here every month from his base in Barbados.
It is not a machine that deprives the GPHC of dialysis, but a complement of doctors and supporting staff that is the impediment. Guyana has no Nephrologist and no supporting staff so even if we had a dozen machines the poor lady would still be in a predicament.
The question of transplant surgery is a more difficult one. The plumbing of removing one kidney from a donor and implanting it on a suitable recipient is relatively easy and can be performed by an accredited urologist but one needs tissue typing to ensure compatibility and a physician steeped in immunology to deal with rejection post-operatively.

Guyanese do not seem to understand that the country as a whole and the governmental health facilities in particular are totally devoid of recognised specialists in the requisite field and this is the impediment to both dialysis and transplant surgery, not to mention the inadequacies in any of the sub-specialties.
In summary it is not machines that we lack that is responsible for the problem, but it is personnel.
Another problem is a cultural one in a country where there is an inherent unwillingness to donate suitable organs without which there can be no transplant surgery
Walter Ramsahoye

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