Patients battling severe kidney failure now have to wait longer to access dialysis at the renal unit in Mulago Hospital, due to an increase in the number of patients, mainly from neighbouring countries and high running costs.
Dialysis is a treatment for severe kidney failure and is vital for patients whose kidneys can no longer work effectively. For such patients, waste products and fluid build-up in the blood and dialysis is what they need to take over a portion of the function of the failing kidneys to remove the fluid and waste.
A walk into the Renal Unit of Mulago on Monday found that all the 17 beds in the adult outpatient ward had patients wired on dialysis machines, undergoing the blood purification procedure to get rid of toxins in the body, while others were waiting in the queue to spend four hours on the machine before the last lot for the day.
Dr Simon Peter Eyoku, who heads the unit told URN that all 26 dialysis beds that the hospital has including the Intensive Care Unit, in the pediatric ward and the sister Mulago Maternal and Neonatal hospital are full, yet for those who need the service, it’s often the only option after losing 90 per cent or more of kidney function
Each month, he says his unit conducts over a thousand such procedures. The unit currently has a total of 79 patients seeking this treatment twice every week, a procedure they have slashed from the medically recommended three times due to running costs and a high number of patients.
Recently, he says they are seeing an increasing number of patients coming in from Kenya, Sudan and the Democratic Republic of Congo jostling for the service together with many Ugandans who often start at private facilities but end up in Mulago as costs start to pile. Eyoku reveals that some of his foreign patients have resolved to rent houses in Kampala so they can afford to commute to Mulago twice weekly.
One of such patients is 30-year-old Scovia Danjua who came from Sudan and has been on dialysis as she saves to fly to India for a transplant. Each week, she parts with 300,000 Shillings to afford dialysis at Mulago which is a bit subsidized since the same service can go for as high as 500,000 Shillings per session in a few private health facilities that offer this service.
However, aside from Mulago, this service is offered at Kiruddu National Referral Hospital where 30 dialysis machines are installed. Even here, Moses Odongo, a renal nurse who has worked there says they are equally overwhelmed by numbers and yet it’s run by a team of just ten staff.
For him, even if they weren’t attending to foreigners, they would still have a huge workload considering that there are no such services in the countryside.
Dr Baterena Byarugaba, the Executive Director of Mulago Hospital observes a need for decentralization such that dialysis can be accessed at the regional referral level. He worries that with the rise in numbers of people presenting with hypertension and diabetes, a lot more people will develop kidney complications.
For now, he says, Mbarara hospital has received two dialysis machines to be able to cut off the numbers but still, he reports people still opt to come to the centre, crowding the facility.
Eyoku worries that the crowds and the fact that many are pushing for a free service might compromise what they offer explaining that currently they are using state of the art machines with biocompatible membranes which rid the patient of the smallest toxins yet many machines in the country can’t do this. Each membrane costs 353,000 Shillings.
Meanwhile, whereas there are patients who have been on dialysis for as much as 10-years, this treatment is supposed to be used by sufferers of chronic kidney failure for a short time as they are ready for transplant, as Odongo explains.
However, Uganda continues to refer only a small number of people for transplants in India and Turkey. Only two patients were referred last year and none was referred in 2020.