Athaliah Reynolds, Staff Reporter

Close to 600 Jamaicans could die this year from endstage kidney disease because they are unable to access life-saving treatment.

According to health officials, these patients' lives are at risk because of a chronic shortage in the number of facilities, machinery and staffing to treat them.

Dr Charmaine Watson-Brown, head of the renal unit at the Kingston Public Hospital (KPH), said nearly 900 new cases of end-stage or advanced kidney disease emerge each year, but only one-third of these patients end up receiving renal replacement therapy, which consists of either dialysis or transplantation.

"The harsh reality is that being diagnosed with end-stage renal disease in Jamaica is almost a death sentence, if you can't afford to get private health care or go overseas," she said.

Currently, Jamaica has three state-owned dialysis units located at the KPH, the University Hospital of the West Indies, St Andrew, and the Cornwall Regional Hospital in St James. Only some 250 to 300 patients are dialysed at these departments.

Long waiting list

The waiting list for patients requesting chronic chemo-dialysis at the KPH now stands at 159.

"As a physician, you're faced daily with countless numbers of patients who need dialysis, and you really can't play God and choose (who gets access to the machines)," said Watson-Brown.

She continued: "It places you in a serious moral and ethical position, but what I do at KPH is have a waiting list. I've gotten a lot of flogging about it, but I have maintained that there must be a waiting list. It's simple, it's transparent and it's the only fair way to go."

Dr Watson-Brown said the renal unit at KPH, which represents the final referral centre for patients with end-stage renal disease, now has 75 patients on chronic chemo-dialysis, utilising some 15 machines.

"There are five groups of patients, each group with 15 patients and each patient is dialysed twice weekly, each dialysis session lasting four hours," she said. This is, however, below international guidelines, which recommend at least three dialysis sessions or 12 hours weekly for patients.

Watson-Brown said the facility, at present, cannot operate three shifts weekly because of a shortage of machines and staff, which includes certified nephrology nurses and trained technicians.

"We need replacement of our 15 dialysis machines currently in use, as they malfunction daily, severely compromising the delivery of chemo-dialysis to our patients," she said.

Watson-Brown said the machines being utilised by the renal unit at the KPH are outdated, as guidelines stipulate that they should be replaced after about seven years of use. All 15 machines at the unit are more than 13 years old.

Christine Russell-Harris, head nurse at the KPH renal unit, said there are at present only about five certified nephrology nurses in Jamaica.

athaliah.reynolds@gleanerjm.com

Deterring factors

At the KPH a single chemo-dialysis session costs $1,800. Patients require two sessions every week. The total cost of chemo-dialysis for a single patient is $14,400 per month.

There is currently a ratio of one nurse to every eight patients at KPH. The internationally accepted standard is one nurse to every four patients.