Kidney failure patients in Yemen in great need of support [Archives:2006/974/Health]
August 21 2006
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“I left my family, my school and my home to be able to attend these sessions,” 13-year-old Abada Abdullah said, speaking about the kidney dialysis she must have while confined to her bed, unable to move her small body freely due to the many tubes connecting her to the kidney dialysis machine.
“I left my parents and my eight sisters in Amran governorate to live with my uncle in Sana'a to receive treatment for kidney failure, which I suffered nine months ago,” she added.
Razaz Mohammed Abdou, 16, of Mahwit governorate also left his family and school to live in Sana'a with his father. “I've had kidney dialysis for three years. I must attend the center twice a week for this purpose,” he explained.
Abdullah and Abdou aren't the only children in a room containing 17 dialysis machines at Al-Thawra Hospital's kidney center in Sana'a. According to a dialysis department nurse, the center also receives infants with kidney failure who must access the room for dialysis.
Nephrology consultant Dr. Najeeb Abuesba confirmed that the number of kidney failure patients in Yemen is increasing, pointing to the fact that no statistics or scientific medical studies exist to estimate the number of such patients in Yemen. “Unfortunately, there are no studies estimating or research on the reason for the increasing number of Yemenis suffering kidney failure.”
According to Abuesba, many indexes require study and research in this field. “For example, it previously was very rare to see patients from Ibb governorate at the center, but nowadays, most patients suffering kidney stones or kidney failure are from Ibb governorate, which leads us to think of the causes. Maybe they're chewing qat that's been sprayed with bactericide, maybe the region's water is polluted or contains a high salt rate or maybe there are other reasons that must be discovered,” he surmised.
The only center
“I've seen patients lose consciousness awaiting their turn for kidney dialysis,” said Amat Alrazak Al-Thulaya, who was hooked up to a dialysis machine, “I feel sorry for them. They come from distant regions seeking this treatment which is unavailable in their areas.”
Hussein Mohammed Abdullah agrees with Al-Thulaya, adding, “I spend five hours in one trip from Marib to Sana'a, costing me YR 6,000 just to get to this session. I must attend these sessions twice a week, so imagine my loss.”
Abdullah noted that many citizens in his region are suffering due to pollution from petroleum mining. “I personally know 12 people from my region with kidney failure and two of them have passed away,” he said, calling for establishing such a center in Marib.
Dr. Ahmed Al-Ansi, director of Al-Thawra Hospital in Sana'a, pointed out that the center daily receives hundreds of patients exceeding its capacity. “Our kidney dialysis machines are working 24 hours a day, which will affect their competence,” he warned.
Abuesba noted that the center covers 13 Yemeni governorates and kidney dialysis costs the hospital $4,000 daily. “Patients must have three kidney dialysis sessions per week, that is, at least 15 hours a week. However, patients at the center receive only two dialysis sessions, which means only six to eight hours, thus delaying their recovery,” he explained.
He called on all involved organizations to establish and provide centers in various Yemeni regions to handle the increasing number of kidney disease patients. “I suggest arranging national campaigns to support kidney failure patients, like these annual campaigns launched to support cancer patients. If kidney failure patients receive proper treatment early, they will recover sooner and return productive individuals to society,” Abuesba asserted.
Kidney failure causes and treatment
The kidneys are a pair of organs whose functions include removing waste from the blood and regulating body fluids. When kidneys become unable to perform their function well, this can lead to what's called kidney failure or sometimes renal failure, which slows or stops blood filtration, thus causing toxic waste to build up in the blood.
“There are two types of renal failure. Acute renal failure may be caused by bacterial infection, injury, shock, congestive heart failure, drug poisoning due to misusing drugs or severe bleeding following surgery. Many diseases like malaria and bilharzias also can lead to this type of kidney failure. The second type, called chronic renal failure, is a progressive deteriorating of kidney function over a long time period and can be caused by diseases such as diabetes,” Abuesba explained.
“I'm now conducting a study on 110 patients who entered the center during the pervious eight months suffering acute renal failure. Results have revealed that most of the children were suffering malaria and diarrhea and 25 percent of the women experienced acute bleeding after childbirth, while many other patients had kidney stones and high blood pressure.”
According to Abuesba, treatment may include drugs to address the underlying cause or stimulate proper kidney function; kidney dialysis, wherein the blood is filtered mechanically; or in some cases, kidney transplant. “There's no other treatment for these patients,” he confirmed.
Kidney transplants finally available in Yemen
The center is the only one in Yemen performing kidney transplants and such surgery wasn't even available until 1998. “Kidney transplants began in Yemen in 1998, in cooperation with the kidney center in Al-Mansoura, Egypt. Such surgeries were performed seasonally, about two cases per year, with Egyptian medical teams visiting Yemen and performing the surgery on patients who already had many tests in Egypt and had returned to Yemen for the operation,” Abuesba explained.
However, since the center's 2004 opening, Yemeni medical teams now perform such tests and surgeries. “We freely do kidney transplant surgeries, on average one operation weekly. The center also provides patients with drugs they must use after the operation,” Abuesba said, confirming that while the patient doesn't pay for the operation, the donor sometimes must pay $200 to $300 for the tests.
Taha Ahmed Ali Al-Maqlahi, 26, from Ibb governorate's Wadi Bana recently had a kidney transplant after suffering bilharzias and kidney stones, which affected one of his kidneys. “The doctors at the center recommended a kidney transplant, so I prepared myself to travel abroad for the tests and the operation. However, I finally decided to do the surgery at the center, with my sister as the donor,” he recounted.
However, not all patients are as lucky as Al-Maqlahi. Sixty-year-old Abdullah from Marib mentioned that he can't have a kidney transplant because he has heart disease, so he's had kidney dialysis for two years.
Abuesba explained that treating severe kidney disease may include kidney dialysis, a procedure wherein blood circulates through a machine that removes waste and excess fluid from the bloodstream. Some patients use dialysis for a short time while their kidneys recover from injury or disease while others must have dialysis their entire lives or until they have a kidney transplant.
“Kidney transplants are the most common transplant operations and they have an excellent success rate. Unfortunately, there aren't enough kidneys available for those who need them,” Abuesba added.
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