Uganda does not need a Dialysis Machine now


I am again going to go with the argument I have been using on HIV and AIDS in Uganda . It is not important for Uganda to run AIDS centers as it is not important to run dialysis machines. I look at medical systems like in Ontario , the Ministry of health here does not even own dialysis machines it rents them from companies like Baxter or GE medical. And  they run them from corner to corner of the great country of Canada for we have the ability to fly them  to wherever they are required. It is a very expensive structure that to run the needs of the ministry of health in only Ontario a single jurisdiction, one needs more money to run the entire governments of East and central Africa if not more. Why should Uganda government own them?

But here is the most important question. Even if we were to run them, what will be the cost? And is that the best manner in which we should spend this money? In other words, health care money is spent with a calculation of saving more lives and not spending for the sake of spending, how many people would the ministry of health for example heal from dying of curable diseases than running a dialysis unit? And I am not being cruel here but I live in Ontario where medical care is run on a social democrat principle, every one in Ontario   is entitled to health care, from a broken toe nail to a heart transplant. But that service is only delivered based on what benefits will be to the recipient. Should Uganda care more about dialysis machines than say fight a curable disease like Malaria? Should we care more about heart surgeries than for example again fight road accidents, when more Ugandans die of car accidents than Malaria across the board?

There is a danger of copying the medical structures out here and we cry for them to be installed in Uganda when we actually have not even developed to use such. Let me ask you Doctor, how are you going to run a dialysis machine on Uganda electricity that is not stable? So what is more important for Uganda to do today? Setting up a dialysis unit or stabilizing the power supply? Again I am using the meagre resources we have and pointing it to where it can be of greater value given the circumstances. There are places in this country where you will die for you cannot get a dialysis machine. Oh and let me put it this way, when you have cancer and you are admitted in a hospital barely 45 minutes outside Toronto, let us say Oshawa, you will die faster than if you are in a Mount Sinai which is in the city center. For Oshawa simply does not have the facilities Mount Sinai has.

I just hate to see that we open up that country to more advanced systems before we can even sterilize a damn needle before we pock it into a human being. Setting up priorities I guess is my argument. And I know I am going to be burnt on this posting for somebody saw something called a dialysis machine out of Uganda why not take it to Kapchorwa hospital?

Edward Mulindwa
Toronto

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Comments

10 Comments so far. Leave a comment below.
  1. 3TOC,

    I think Uganda needs that dialysis machine as much as it need the malaria tablets, the electricity, the good roads, the hep B vaccines. It is difficult to put a price on life- any life.

  2. you do make a point particularly whether the cost of having a dialysis machine will surpus the benefit of it. I would however have appreciated this more if you had for example provided evidence that its indeed cheaper for the govt to rent a machine or develop a programme with nairobi hospital to fly out patients as its cheaper by XXX dollars and instead save that money for AIDS, malaria, roads etc…and so it would probably be more useful if you analysed what smaller towns do in such cases, and use those as examples of how uganda can adapt.

  3. Mohammad Ayyub,

    Dear Edward,
    I can understand your feeling about setting a dialusis,I am a pharmacist by qualification and working for Pharmaceutical company which provide medicine for ckd patient and kidney transplant patent, i came to know that there is not good care in Uganda for ckd as somany patient who are aware that the disease is curabale are going to other countries and also coming to India,why the Govt of Uganda is not thinking to help their own people who are dyeing of kidney failure, a lot can be done for saving life .
    Mohammad Ayyub

  4. Rose,

    Dear Edward,

    I must say I am disappointed in your writing. Clearly we can see that you dont have enough information on what you are writing about. If the country had more people like you, it would still be 1960 in Uganda and 2010 in the rest of the world. Not having enough infrastructure does not make the whole situation hopeless. I presume that even in Ontario, they started slow and made it to the top. Why not think so of your own country. The day any one of your relatives suffers from kidney disease requiring RRT, that is when you will realise that we have dialysis in Uganda.

  5. laker Brendah,

    Like any other country in the world Uganda needs a dialysis machine although it may not be in position to meet the costs. But never the less if they country can have it why not!!! We shall be great full because many life´s will be saved. Thanks.

  6. Dr R Kalyesubula,

    Iam a Nephrologist trained at Yale University, USA and currently working at Mulago hospital on the dialysis unit.
    I was very suddened to read the headline that Uganda doe not require a dialysis machine. This is rather sad and unfounded as we already have a dialysis unit with six dialysis machines taking care of over 25 patients who would have already died had it not been for this intervention. This is in addition to the hundreds of women and children we have saved with acute dialysis.
    It is these sentiments that have kept us from development and advancement if Toronto has Dialysis why should Uganda not have it? I s there a cost to human life.
    Until we stand to make a difference with the little we have and use it wisely, our country will never be a better place to live in.
    Edward, why are you in Toronto and not in Kampala?

  7. ABDULI,

    Edward is a foolish man indeed. Why justifying Ontario needs dialysis and not Uganda you point could been somehow understood better if you left Ontario as an example. I live in Ontario myself and do work in Health care field and I doubt if you do. If Kenya has it why not Uganda this is a good example instead of comparing Ontario and Uganda or I you trying to let us know you live in Ontario big deal Huh!! there is about 10 dialysis clinics in Kenya if not more and therefore it’s possible in Uganda. Next time when you make a comparison please compare oranges by oranges and not apples.

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  9. Zayne,

    Your very ignorant, how can you compare Uganda to Ontario. Like Rose said, wait till you have a patient with Kidney failure….

  10. Dan Derricks OLING,

    Ugandans are suffering from Kidney Failure each and every day. Ask Nephrologists’ like Dr. Kalyesubula who made a response here in; how many new cases they receive in Mulago National Referral Hospital every week, I am talking about the current situation and how many patients are struggling for the now more than six machines that Mulago has and where all these patients come from. Edward do you even have an idea of how many Ugandans die on the way before reaching Kampala where all the few dialysis centers are in Uganda. I lost my wife five years ago to this silent killer from Mulago where she was on dialysis for four months before her death while preparing to head to India for Transplant. Last week but one I lost a very close friend who passed on while being rushed for dialysis in Kampala. I now run a Kidney Foundation in Northern Uganda (hope you know where it is and many more…) in memory of her to help others. There are many challenges affecting our social services-health sector in particular and this area of health has not until a few years ago been a much known let alone invested in area. Priority, priority, priority…..always and truthfully the sad truth of our problems’ source. Its even sad that people like you are making wrong choices and seeking for followers. KD, CKD and even ESRF are true in Uganda and very much on the rise-No amount of money is worth a life-a child’s or an adult’s, a poor or rich person.
    Edward, use your time well-the life you have to do better, if this has been your approach, its regrettable to many of us.
    Dan-eAF (Emily Akello Renal Foundation Promoter).

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