Thanks for your candid expression of your feelings and frustration with the medical infrastructure in Uganda.
You have essentially described a state that is known as end stage renal disease. This occurs most commonly after a long time with high blood pressure. The kidneys basically just die off, after repeated assault of their arteries by the high blood pressure. At this stage medications can’t help and the only permanent solution would be a renal transplant. During this period however dialysis will prolong a person’s life.
As we discuss the issue of Uganda having a dialysis system we have to realize that there different types of renal dialysis and it’s a high end form of medical care. Running a renal dialysis unit requires a lot of expertise, patient dedication; close monitoring and the equipment used calls for high maintenance. It’s not just a matter of the government or private hospital buying the equipment it’s also very expensive to run these units. At the present time I wouldn’t feel comfortable advising someone to use a renal dialysis unit in Uganda except for a matter of dealing with an acute renal condition awaiting a transfer outside the country.
As to who is to blame in this and many tragic deaths is a matter of intense debate. The doctors surely know what to do but they are handicapped in away, the government has a big role in acquiring these equipment but one can argue that they are also not available in the various private hospitals we have some of which definitely have the funds to acquire them but lack the necessary expertise to run renal units. This is very unfortunate and it doesn’t seem like there is a plan in the immediate future set out by the ministry of health to address this problem. More funds to date are geared towards primary health care in hopes that in this way they can save more people and be cost effective. You can now figure one of the reasons why the life expectancy in Uganda is put close to 43 years.
I would advocate for the government and the medical community to establish a renal unit. The kidneys are very important organs and they need some help in many cases. A renal unit is not only of use in end stage diseases but in many other conditions both in the old and the young.
The medical field is such that when you don’t advance the tier below suffers. A dialysis unit is essential at least in a referral hospital and there is no excuse for not aspiring to get one. The funds to acquire one, train the specialist and run it can easily be got if there was a fundamental change in the healthcare system at large. We spend way much money unnecessarily and there is no way we can argue against this. We currently can’t have a well functioning unit because of lack of expertise and the lack of vision in the ministry of health but these socialist tendencies can’t be used to destroy our very precious lives. The irony is that those who are currently owning the country and running the deals can afford to go anywhere outside the country for such procedures as they need on government or embezzled funds. Where there is a will they surely will be a way.
One can use the same argument on acquiring an MRI,CT scan, heart and lung machine and several other equipment. All medical equipment are very expensive. With a streamlined system whereby at the least every citizen has a mandatory check up every year and those who can’t afford be on the governments tab we can surely wean away at early stage those people who would have used these expensive procedures in the future. If we diagnose hypertension for example at an early stage we can treat the citizens at a cheaper price with medication and reduce the number of those who would have needed the use of a renal unit it the future. By doing this you are not only reducing future cost but you are at the same time improving their quality of life, increasing productivity and life expectancy. However the structure we have now is not meant to treat everyone, to me the primary health structure is a total failure but that’s a topic for another day.
So I will argue that we need this unit for good medicine, we need it for our medical community, we need it for our citizens the government owes it to the people to provide the best healthcare to date and each and every life is precious. Some things have to be done, it’s just like going to the moon.