Fighting the silent killer
In a country where medical assistance, quality and service at a reasonable price is hard to come by, chronic diseases like kidney failure and its unending trips to the hospital for dialysis is a tough ask for anyone. Lack of proper diagnosis and facilities to undertake the necessary procedure in a country which entertains “cure” rather than “prevention”; the less fortunate are left a burden on their entire family and those who afford it, have the option of going abroad, writes Senit Feseha.
He was found unconscious on one fateful day in May 2016, face down on a sidewalk. His neighbours rushed him to the nearest hospital. After an hour in a coma, he woke up to the sensation of a needle pricking his skin. Due to his history with low blood pressure, the doctors did not try to make further diagnosis. He was sent home with an instruction for bed rest.
For the next two weeks, he felt lightheaded, nauseous, and weak. He could not go to work or continue with his usual routine. By that time, he had suspected something, but he was too terrified to admit it to himself and make the situation “real”. He kept on turning a blind eye to the symptoms, hoping they would disappear. The next morning, he woke up with swollen eyes, almost shut. His sister took him to Myungsung Christian Medical Centre (Korea General hospital) where the doctors found out his kidneys were scared and failing. He was diagnosed with a chronic kidney disease. He was shocked, but not completely surprised. He would need to start dialysis soon and get a transplant. Mekibeb Eshetu, 54, knew his life would never be the same again.
“God, I have always asked you for a decent life, but not a decent death,” Mekibeb remembers praying apologetically. “Please let me go in a dignified manner.”
After five months of tiresome bi-weekly dialysis, multiple blood exams and consultations passed, his half-brother was his nearest match. “A part of me was filled with hope and positivity, but I could not accept the idea of putting him at risk, no matter how big or small.” After a lot of thinking and persuasion from family, they decided to go with the transplant. “I was not ready to die” he said. They went to Thailand to get a costly kidney transplant surgery.
The health of the new kidney lasted for only two years. On late 2017, he went through a chronic renal/kidney transplant rejection. His body rejected the new kidney and started attacking it, assuming the new kidney to be a foreign entity.
“No one prepared me for this. We all thought that once a person gets a transplant, it would all end happily.” However, he was put on dialysis and was told he would need another kidney transplant. He was heartbroken.
Kidney failure is one of the deadliest diseases. It can consume the mental, emotional, physical and financial state of sufferers, and those closest to them.
Kidney disease has no severe signs and indications. Some of the symptoms can be fatigue, feeling cold when others are warm, shortness of breath after very little effort, feeling dizzy or weak, trouble thinking clearly, feeling very itchy, swelling in hands or feet, swollen or puffy face, metallic taste in food, upset stomach, nausea, vomiting, and change of colour, state, frequency and pressure of urination.
Without medical examination and professional opinion, the disease can stay under the radar for a very long time and go undetected until very advanced.
Celebrated yearly in the month of March, World Kidney Day is designed to raise awareness on prevention, timely diagnosis, proper follow up and latest medical interventions in more than 100 countries. Ethiopia is one of the participating countries that has acknowledged this praiseworthy day.
Last week, on March 8 (this year’s world kidney day), St. Paul’s Hospital Millennium Medical College held a press briefing. On the occasion, St. Paul distributed important messages to the public.
The meeting was led by: Engeda Abebe (MD), head of Surgical Department, Birhanu Worku (MD), head of Kidney Transplant and Munim Ibrahim (MD), head of Dialysis Centre. The main objective of the briefing was to raise health awareness about the disease, inform about preventative measures, and support individuals who have been working tirelessly to treat the illness.
Speaking at the meeting, Dr Munim stated that the services the hospital has been giving since it started kidney transplants, two years ago include giving indiscriminative attention for all patients with both acute and chronic kidney disease, handling renal replacement therapies and dialysis. He further stated: “We have not stopped working from day one, including weekends because it is our main objective to serve the public”.
Dr Birhanu mentioned that the hospital has served seventy patients that needed transplants over the past two years. “Our hospital has given a good number of transplants each year as an African nation and the rates are almost equivalent to other countries in the West that are said to provide good numbers on a yearly average.”
The public should always count on prevention rather than care, the doctors said. “Everyone is encouraged to make yearly check-ups,” Dr Engeda stated at the meeting. Globally, individuals with hypertension, diabetes and people aged above sixty are those primarily at risk. But in Ethiopia, while the above factors still remain the primary causes; there are many other contributing factors. He went on to say: “It’s so sad that when most of our patients come to see us, we could not figure out what exactly caused their kidney failure. It is because they have waited until it is too late to visit the hospital. A person should get regular physical check-ups, even if the check-ups could not prevent some cases, it will at least give people time to mentally and financially prepare themselves for what is coming.”
Dr Birhanu described preventable causes of kidney disease. In addition to diabetes and hypertension; kidney diseases can be caused by blockages in the urinary tract, kidney stones, pregnancy, unregulated traditional (herbal) medications, and needless usage of over the counter medication,” he said, adding that although some kidney diseases can be caused by unpreventable reasons, they can be cured or delayed in progression by proper medical follow up.
Clearing up in the misconception of dialysis in the community, Dr Munim stated: “The dialysis service is adding a lot of burden on the sick; and there needs to be increased awareness in transplantation. Transplantation is the definitive cure, not dialysis.
Regarding this year’s concurrence between World Women’s Day and World Kidney Day, Dr Engeda and Sister Haymanot thanked women for being the number one kidney donors both internationally and locally. “Women donate more than 40 percent of kidneys locally.”
The hospital is planning to start another option of dialysis for its patients—peritoneal dialysis. It is said that the new technique has several advantages compared to haemodialysis. Peritoneal dialysis is cheaper, and its users can use it at the privacy of their home, it is easy to carry around and it reduces the risk of infection (except self-inflicted infections caused by personal hygiene issues). With the help of an undisclosed local pharmaceutical company, the materials needed for peritoneal dialysis are on the process of production.
Dr Munim also mentioned that the hospital has finished a whole curriculum in renal study. “The aim is to train doctors and nurses of other 10 hospitals in the works of kidney transplant and to decentralize the service so that patients get better access. The hospitals are located in and out of Addis Ababa.”
In addition to stating the need for more community involvement, the briefing was concluded with a golden rule, “Drink more water!”
Contributed by Senit Feseha