Kidney Disease Treatment

Apr 11, 2010 Editorial

The heart-wrenching story of nineteen year-old Satish Gobin – carried in our newspaper early last month – who was recently diagnosed with chronic renal failure, epitomises the tragedy of living in a poor country in an age of technological wonder.
Satish’s parents (his father is a canecutter) struggled to raise him and give him an education that he may enjoy a better life than they had. He had just secured employment with the Guyana Geology and Mines Commission when his potentially fatal disease was discovered.
The kidney, most might know, filters out from our blood, several toxic by-products of the body’s metabolism. We excrete these products in our urine. In renal failure this filtering capability is gradually lost so that the toxic substances accumulate in the body with their ultimate fatal consequences.
In the not so distant past, it would have been accepted that Satish’s fate was to die the slow and long painful death that is the prognosis of the disease. But today he and his parents know that that there is a treatment available right here in Guyana, which had long been the preserve of the richer countries. That treatment is dialysis with the eventual prospect of a kidney transplant.
The dialysis machine essentially replicates the function of the kidney so that it is a very sophisticated filtering device for the affected person’s blood. In the US, there are almost 400,000 patients undergoing dialysis treatment generally at privately run centres or in their homes.
Most patients are scheduled for three visits per week to a centre each of which entails being tethered to a dialysis machine for four to five hours per visit. The machines in the homes allow more frequent and longer periods of filtration and lead to a much better result in the patients’ well being.
The costs to patients in the US hover around US$160 per visit but can be reduced to about a third of this if only the amortisation of the machines and the labour costs are to be covered.
For about five years now, there is a private operation in Georgetown that has been providing dialysis treatment at some US$175 per visit. To cover the recommended three weekly visits, then costs US$525 or $105,000. One can only imagine the desperation of a canecutter as he watches his only child literally die before his eyes just because he does not have the funds to cover the dialysis costs.
This raises the old moral question of how just is it for the rich to be able to hold off death just because they have the money. The government up to now has been assisting with some of the costs of the private dialysis treatment for some patients. But we have to accept that this is only a palliative.
The ultimate treatment of replacing the diseased kidney presents the question even more starkly: kidney transplants cost approximately US$150,000 each in the US and US$35,000 in India. Where is a canecutter to secure even the latter amount of $7 million? The CIOG has been working strenuously over the past few years to establish a dialysis centre that will charge US$100 per visit but it is conceded that even this amount will be beyond the means of the average Guyanese, not to mention a canecutter.
The answer, we believe, is for the government to establish a dialysis centre as part and parcel of its health delivery program. We understand that we are a poor country but we will have to prioritise our spending. We have no desire to go into details at this juncture but evidence abounds about expenditures on infrastructure that ranks far below this most need.
As for the transplanting of kidneys (for which Satish’s parents are prepared to be donors) we have had at least four successful operations done here by foreign doctors. The goal was to have local surgeons become qualified in the procedure. How far along have we advanced on this road?
In the meantime, we the citizens of Guyana must accept that we are our brothers’ keepers and assist the government in its subsidisation of the dialysis treatments. There is an account for Satish at Republic Bank – #769340.

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Kidney Disease Treatment

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