I had a lazy morning in my cabin today. While I was sipping my tea and pondering a certain patient's situation, I started thinking about Hemodialysis.
I've never worked directly in a Dialysis setting, but back home a decent number of my vascular surgery patients had some kidney function problems. It wasn't unusual for one once in a while to be on dialysis, and three times a week we would wheel them in their hospital bed down the hall to the outpatient dialysis wing. I started thinking about how wild it is that someone can have completely non-functioning kidneys and be kept alive by spending a few hours every couple of days plugged in to a machine. Blood goes out a tube, through a contraption (which I barely understand) where toxins, excess fluid and other waste materials are removed, and 'clean' blood is returned back to the patient.
That such technology exists--that we have figured out a way to replace the work of such a vital organ--is pretty mind-blowing.
Quite a few people in Canada live productive, relatively normal lives sustained by this technology. Sure, there are some limitations. You can't really travel without being sure there's a dialysis facility where you're going, and arranging treatment there. There are medications and other precautions you must take. But over 23,000 Canadians rely on dialysis treatment to live.1
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My mind went on this tangent because I was a little worried.
One of our patients was having rather odd symptoms, and one of the more likely explanations was that his kidneys weren't functioning properly.
I wondered what it would be like, compared to what I've seen in Canada, to live with kidney failure in a place like Senegal.
Dakar is a big city with a number of pretty top-notch hospitals. And indeed, there are a smattering of other hemodialysis treatment centers around the country. Treatment is even free(ish). I say 'ish,' because you are often required to pay for physical resources (i.e., medications, implanted access ports, etc), even if a procedure itself is 'free.' Just over 1000 people currently rely on chronic dialysis treatment in Senegal. Well over 1000 are on wait lists. About 75% of those on the wait list will die before they get treatment.2
The biggest barrier, as with so many aspects of healthcare in West Africa, is resources. There's simply not enough specialists. Not enough machines. Not enough nurses trained to use them. Surgery must be performed to create an access port before treatment can happen, and that can only happen at one hospital in Dakar.2
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Fortunately, in the case of our patient, it is not his kidneys that are the problem. The mystery of his symptoms has been solved, and, for him at least, my worries have eased.
There's no quick, band-aid solution to the healthcare gap in low-income countries, but while I'm holed up in the hospital helping with hernia repairs and tumor removals, our Medical Capacity Building (MCB) teams are around the continent doing the real work that will make this a safer place to live. You may have heard about the visit from our enormous-brand-spankin-new sister ship, the Global Mercy, here in Dakar. While her hospital isn't quite ready for patients yet, she did draw in crowds of healthcare professionals to participate in a range of training courses--courses that can and will save lives. And our participants are quickly becoming champions of these essential skills in their own workplaces, multiplying the impact.
Since I've rambled on for long enough now, I'll shut up and let them tell their own stories.
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| The crews of the GLM & AFM assembled together after 6 weeks of service side-by-side. |
The Global Mercy has since sailed back to the Canaries to do a little more prep work before her hospital doors can open, and I'll be joining her there in a few more months.
In the meantime, we'll carry on doing our best for each patient who comes to us needing surgery.
À la prochaine,
-D
