Wednesday 27 March 2013

I sold my house to pay for surgery —Renal transplant survivor


The number of Nigerians with kidney failure is said to have doubled in recent times, even as a renal transplant survivor speaks on the challenges posed by the disease, Bukola Adebayo reports Stella Emmanuel’s kidneys did not fail overnight. In 1999, things were looking up for her while working for a reputable bank
, and she was even thinking of tapping into the rich opportunities that abound in the oil sector. She narrates, “Everything was going well for me; I went for an interview at an oil company but after the medical test, the company’s doctor said they wouldn’t be able to employ me because they found protein in my urine and I should go and see my personal physician. “I did not know what that was indicative of, but I just said to myself that I had probably been eating too many eggs, so I decided to cut down on them. I tried to change my diet such that I stopped eating much of proteinous foods.” That was the first symptom, but she did not take it seriously. Emmanuel, who spoke to our correspondent at a screening and awareness programme organised by St. Nicholas Hospital in Lagos on Thursday, said she did not know the implication of having protein in her urine until 2005. She continues, “That year, I was treating malaria frequently, which was diagnosed as typhoid. My doctor later told me that my kidneys had failed and I was placed on dialysis thrice a week for four months before I later travelled for a transplant in India.” This was no fun fare for a young lady who was used to being vibrant. She had to sell a property to finance the treatment. Getting a donor was another hurdle she had to scale and time was ticking. Stella says, “It was my 67-year-old mother who donated hers for me. She gave me another chance at life. We were concerned about how she would cope with such a situation but she insisted that it was better I outlived her.” Emmanuel, who is also the founder, True Health Foundation, said after all the trying experience, she decided to set up the foundation to help indigent patients, especially pregnant women with kidney diseases, access medical care and treatment. “My mission is to see that acute renal kidney diseases are detected early, so that it can be managed with just about five dialyses, and it does not have to degenerate to the chronic stage like mine where they would have to do dialysis for life or have a transplant.” Emmanuel is also concerned about the fate of other renal patients in the country, due to the lack of renal transplantation facilities in spite of the number of Nigerians who need this intervention on a daily basis. According to her, lack of dialysis facilities in many locations in the country, especially in the North and the Eastern parts, in addition to the cost of dialysis and the actual treatment, are killing patients. She recalls, “When I was undergoing dialysis, patients came from Warri and all over to Lagos, to have dialysis. Bear in mind that these people are not even in the best state of health. Dialysis is also not cheap. Each session is N35,000, and you should have three in a week. “How many people have N400,000 to spend on medical treatment each month? Many do not even earn up to that. I had to sell my house to be able to afford my transplant and dialysis.” She called on government to provide dialysis facilities in major areas in the country, such that people would not have to travel to Lagos or other state capitals when they need dialysis. Also, as a renal transplantation survivor, Emmanuel appealed to government to facilitate drugs for survivors so that they won’t have to travel out of the country each time they need medical attention. She says, “I can tell you that having a renal transplant is no joke; you must keep taking drugs and do checkups to make sure that the body accepts the new kidney. It is a strange object and that is a whole lot of trauma. Worse still, if you cannot afford necessary drugs, the kidneys would fail again. “Just the same way government provides free drugs for people living with HIV/AIDS, I think it would be great if it makes a similar provision for renal transplantation survivors too. You have spent so much already on transplant and to ensure that those who have had transplantation actually survive, there must be an official intervention.” However, She is more passionate on the need for medical doctors and other stakeholders in the sector to educate Nigerians on the need to have some basic medical tests on early detection and treatment of these chronic and deadly diseases. She states, “You know it was a would-be employer’s doctor who told me that I had protein in my urine. Nobody was there to tell me that the protein in my blood was not because I ate too much beans but that I had kidney problems. If it were an ideal situation, my case would have been detected early.” Experts have raised the alarm that the number of Nigerians who would develop kidney disease is increasing. A consultant nephrologist (kidney specialist), Dr. Ebun Bamigboye, who is also Emmanuel’s physician, said the incidence of chronic kidney failure in the country is not only increasing but is also at an alarming rate. He revealed that one in every seven  Nigerian is at one stage of kidney failure or the other. Bamigboye said, “We estimate that we get about 15,000 new patients with chronic kidney disease every year. About 50,000 patients in Nigeria require dialysis, but just 1,000 are on it as we speak. The prevalence rate of kidney failure in Nigeria is 15 per cent and this is high in every sense.” Bamigboye, who is also the head of the Kidney Care unit, St. Nicholas Hospital, said the reason for this increase was that Nigeria had one of the highest populations of people living with hypertension and diabetes, HIV and other infections, which were major causes of kidney failure. “Nigerians are predisposed to kidney diseases because one out of four of us have hypertension. In Lagos alone, diabetes incidence is 10 per cent. Infection is common; HIV prevalence is about four to five per cent; 15 per cent of Nigerians have Hepatitis B, six per cent have Hepatitis C. All of these cause CKD; so, we should not think it is witchcraft manipulation when people have kidney failure,” he noted. Another challenge he identified is the ignorance and lack of health information among Nigerians, which often leads to late presentation of diseases in health facilities. Bamigboye said, “How many Nigerians know the signs and symptoms of hypertension, diabetes or kidney disease? By the time you start seeing blood in the urine, swollen stomach and face, the kidneys have failed. He said, “It is so severe that if you have kidney failure and you do not do dialysis or get a transplant within two weeks, you will die. You can imagine the number of people that are dying every day because of kidney disease.” Facilities for renal treatment are still in acute shortage in Nigeria. As for dialysis, Bamigboye said, “Dialysis is not readily available. We have only about 50 centres all around Nigeria doing it. Renal transplant is very expensive, as the average cost is about N5m.” He urged Nigerians to toe the path of prevention rather than treatment due to the huge amount involved and government’s unwillingness to provide facilities. He urged them to resist lifestyles that could predispose them to kidney diseases. He said, “We should focus on prevention and early detection. If we screen people with diabetes, hypertension and HIV, we can detect those who will have kidney problems and end-stage renal diseases quickly and treat them.” He warned against the use of herbal concoctions, uncontrolled alcohol consumption, smoking, abuse of analgesics like pain relievers and antibiotics, and bleaching creams, all of which, he said, could overwork the kidneys and lead to their failure. Bamigboye said, “Abuse of simple analgesic like pain killers over time kills the kidneys. Also, taking herbal products that have no prescriptive dosages is a deadly habit. Bleaching creams contain certain ingredients that affect the kidneys, as such, they should not be used. It hurts to have kidney failure.” Punch Nigeria

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