Business for Peace Award

Dialysis centers overcrowded, underfunded

Published on 17 June 2013 in Health & Environment
Rammah Al-Jubari (author), Rammah Al-Jubari (photographer)

Rammah Al-Jubari


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Rammah Al-Jubari


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The dialysis center at the state-run Al-Thawra hospital is overcrowded, underfunded and overused. Their 28 dialysis machines operate around the clock as patients continue to swarm the center.

There are 21 such facilities in 15 governorates throughout the country. Most make do with four or fewer machines.

Five-thousand-and-eight-hundred patients frequent Al-Thawra’s Center for Renal Diseases and Urology. There are 28 machines at the center, and there are always 28 patients being treated at a time, a patient for each dialysis machine.

Staff at the hospital say they must operate the machines around the clock, compromising each machine’s performance.

“Each machine is supposed to perform three dialysis sessions a day. Our machines, however, perform seven daily dialysis sessions; the center treats 196 patients a day,” said Dr. Najeeb Abu Asbo, the head of the center. “Dialysis machines should be stopped for an hour after each dialysis.”

In his mid-thirties, Muneer Al-Masani should be enjoying the health and vitality afforded by youth. Instead, he is wheelchair-bound, being pushed toward the entrance of Al-Thawra’s dialysis center by his father.

Al-Masani suffers from chronic kidney failure. After undergoing surgery, a medical error left him paralyzed. Al-Musani consequently lost his job, exasperating the financial difficulties resulting from his illness.  

Because resources in Yemen’s other governorates are even more limited, many patients come to Sana’a for treatment. Six of Yemen’s 21 governorates have no such centers. Those requiring dialysis in Amran, Dhale, Marib, Al-Jawf, Raima, Abyan and Lahj must leave their governorates and travel for treatment.

Dialysis patients are typically required to receive four-hour sessions, three times a week. Patients at Yemeni centers must instead cope with two-hour sessions, twice a week, said Bassam Al-Syaghi, the administrative supervisor of the Al-Thawra’s dialysis center.

Patients worry that the center is unhygienic, preferring to lay down newspaper before laying on one of the center’s 28 beds. Some even bring their own sheets or blankets to use as barriers between them and the worn-out mattresses.

Factors leading to illness

Contributing to the large number of patients suffering from kidney failure and other diseases requiring dialysis is a lack of access to clean water and sanitation.

The doctor treating Al-Masani, Abdullah Al-Matari, stated that the likely reason behind Al-Masani’s illness is a microbial infection resulting from drinking contaminated water. Al-Matari said that it was the leading cause of illnesses requiring dialysis.

“Other factors include extensive use of anti-biotics without the consultation of a doctor, high-blood pressure and diabetes,” Al-Matari said.

A helping hand

There is help for those struggling. Aside from the free services at Al-Thawra, there are charitable organizations helping patients with residence, food and other necessities.

Al-Rahma Association in Sana’a provides necessary medications, as well as housing and food for those coming from rural areas, Al-Rahma Association general secretary Ameen Muhram said.

Established in 2004, Al-Rahma receives no financial assistance from the government, and instead relies on donations.

Al-Masani and his father rent a room in an area near the hospital. Their rent is YR 8000, or $40 a month.

Dialysis treatment at Al-Thawra is free, but medications can be a heavy burden for patients and their families.

“We don’t have enough money to buy the medication from pharmacies. We used to be given the medication for free, but today we must bear the cost,” Al-Masani’s father said.

He receives help from family and those donations

“I have six daughters, they are all married in Taiz. Muneer is my only son. I have sold everything I own in order to live Sana’a so he can have the best treatment. We depend on help from others, including my daughters. I am only able to visit them once a year because I am so busy with Muneer.”

Transplants

The center also performs kidney transplants.

Amal Al-Hyab had the procedure done in 2012 after her mother donated one of her kidneys to her. She said she leads a mostly normal life after the transplant.

Al-Masani has not been as fortunate. He does not share a blood type with his father and has found no one willing to donate a kidney to him.

“I cannot afford to buy him a kidney,” said his father said.

Kidney transplants in Yemen began in 2005 and the operations themselves are free at Al-Thawra. One-hundred-and-thirty-eight transplants have been performed by Yemeni staff.

Demographics

In 2007, students at Sana’a University Medical School conducted a study on patients requiring dialysis. The sample size consisted of 415 males and 298 females. The study concluded that the majority of patients requiring treatment are between 19 and 40 years of age.

The study also concluded that late diagnosis and treatment were the chief factor behind such chronic illnesses.  

They recommended periodical tests for kidney performance for those suffering from diabetes, high blood-pressure, urinary tract infections or kidney stones.

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