The Renal Unit

The burden of kidney disease in Kenya is highly underappreciated.This is evidenced by the general acute poverty of data to give the nation a clear picture of the extent of kidney failure amongst our people.Yet day in and out Renal units are sprouting anywhere there is a town.

The government under the Medical Equipment Services launched a campaign that saw every County in Kenya get a renal unit with about five Hemodialysis machines.

This move was golden.However the joke was that there were no trained Nephrologists and Nephrology Nurses to run these units.These professionals were concentrated at Kenyatta National and Teaching Referral hospital (KNH).

I work in a County whose first renal unit had to run by offering locums to nurses from KNH so as to run the renal unit until the county could train her own nurses.

I know this story is replicated all across the 47 counties.That is the problem we sometimes,(read always) have as a nation.We do not plan.We are fond of jumping onto the current trending topic,whip a few emotions then abandon the idea altogether.We start cars and don’t fuel them.We start songs without tunes.We dive without oxygen tanks.We hate preparation.And when we sink,we cry foul.

See,it is Paramount that renal units are ran by qualified individuals.That means Nephrology nurses do more than circulate blood through a pump.We must achieve adequate dialysis and for that reason we go back to school to specialize.It is funny then that when we come back to the Renal unit,armed with enviable skills and knowledge,the unit lacks supplies.

I wish that the renal unit was handled with as much tenderness as a newborn baby.Patients depend on the effective and efficient running of the unit.If they do not dialyse adequately,we condemn them to a life of misery and death then say if only…

We cannot continue having sessions interrupted because there are no consumables.There is nobody to repair the ever-breaking down water unit,no gloves and some other weird circumstances Renal nurses have to contend with.

As far as Hemodialysis goes,it’s very easy to transmit a myriad of blood-borne diseases if the required standards of care are not met.That is why time and again County Renal units close down in the name of waiting for supplies.This should never be allowed to happen.

We need to plan (I know it’s expecting too much from the ministry of health) otherwise the same people we claim to want to help will lose their lives prematurely.Thanks to our casual approach to the seriousness of an effective Renal unit.

Other privately owned renal units have come in to cover the man-made gap conveniently created by our public hospitals.However most of these are set up,not to help,but to make money.The fact that the National Hospital Insurance Fund(NHIF) gives good kickbacks is the motivation.

Some of these units are ran by professionals and that is a very impressive aspect of care.

However some are not.They keep employing people who are not Nephrology nurses but because on-the-job training has made them know how to operate a machine,they become the Dialysis nurses.

Talking of which,there is a difference between a Nephrology and a Dialysis Nurse.The latter can connect and disconnect a patient from a machine.The former can tell why and how not to or to dialyse a patient and assess for its adequacy.

This,friends of God,is the difference between life and quality of life.

NHIF only pays for the session of Dialysis and not the many drugs the patients are on.Not the many tests the patients must have done.Makes me ask,is Hemodialysis really free as long as one has is an NHIF contributor?

Private Renal units use this loophole to charge for the drugs and tests as they wish.

The charges are usually arm,a leg and a slice of your liver.Add that to an already financially drained patient.



Blood money.

The best we can do is hope that one day the government-owned facilities will run flawlessly.

Let there be a set-apart team overseeing every aspect of supplies to the renal unit.It is a matter of life and death.Just have what is needed at the time it is needed to avoid stopping.Then.Starting.And.Stopping.Of Hemodialysis sessions for our patients.

Supplies and maintenance are to a Renal unit what a pen and chalk are to a teacher.

Raise your glasses a better Renal unit!


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