‘All they want is to live a few more years’

An appeal to help those stricken with kidney diseases in the North Central Province

It is as usual another busy morning at the Nephrology clinic. There is, as always, a motley crowd of patients, their ages ranging from less than one year to over eighty. The patients who have undergone renal transplants can be identified by the masks they wear.

There are yet others who are not so lucky, and have to await their turn – waiting for donors with the correct tissue type. The majority of these patients look ill. Some of them have the typical pallid look of a patient in renal failure, yet others are breathless, with fluid collecting in their lungs, or they may present with swelling of the face, abdomen or feet. The majority of these patients are kept alive by dialysis. The dialysis machines do the work of normal kidneys, purifying the blood. These patients can be identified by the tube inserted into the main vein of the neck.

The Kandy Unit: Started in 2001 it has treated over 5000 patients and completed 200 transplants

Then there are the contingents of patients from the villages in the dry zone, many of them ‘border’ villages with lyrical names – Madawatchiya, Medirigiriya, Girendala Kotte, Dehiwattekandiya, Siyambalagama, -names which conjure up idyllic rural scenes of paddy fields and blossoming lotuses, whereas in reality, an unseen danger lurks. The unseen monster of kidney disease strikes these poor peasants, in the prime of life.

These people arrive in the clinic before dawn and patiently await their turn. They have been selected, on the basis of an initial examination of urine, by the indefatigable consultant of the Unit, who makes bi-weekly trips down to the villages. They have arrived now to have their condition confirmed by a scan and or renal biopsy. These ‘patients’ are healthy young adults, in the main ranging from 15 to 40 years- so far, symptom less. About 5-10% of the population of the North Central Province (NCP) has some evidence of chronic renal disease, which is responsible for the greatest number of deaths at the Anuradhapura hospital.

An artist’s impression of the Anuradhapura Unit

To get back to the never-ending stream of patients at the clinic, it is impossible to imagine the anguish of the mother, who has brought along three healthy sons, hoping against hope that their kidneys are normal. Her husband and one son have already died of chronic renal failure. So many young farmers arrive struck down by renal failure (in the prime of life). Even after a renal transplant, they will not be able to resume their normal life, cultivating their fields. So many cheerful young people, of both sexes, present with recently diagnosed end stage renal disease, resigned to their fate, patiently awaiting a donor.

In Kandy, the Nephrology and Renal Transplant Unit was completed in 2001, and has treated over 5000 patients and completed two hundred transplants to date. Dialysis, surgery and post transplant medication is completely free of charge – the total cost per patient can be well over Rs.1,000,000.

Over 55% of the patients attending the transplant unit in Kandy are from the NCP. Many of them are too poor to find the bus fare to travel to Kandy resulting in a number of them resigning themselves to a premature death. To help these unfortunate patients the National Kidney Foundation has embarked on a project to establish a Renal Care and Renal Research Centre in Anuradhapura at a cost of Rupees 170 million. As was the case with the Transplant Unit in Kandy, the cost was borne by voluntary contributions together with state funding. Sadly, the Unit at Anuradhapura has run into difficulties, as the funding has dried up.

While most of the construction work in the six-storied building has been completed, funds are urgently needed for the installation of lifts, air-conditioning, piped medical gas systems and medical equipment including 24 haemodialysis machines.

A dialysis machine costs approximately Rs.2 million. There is a desperate need for contributions which should be sent to: ‘The National Kidney Foundation of Sri Lanka, Governor’s Secretariat, Kandy, Sri Lanka.’: Tel/Fax: 081 2222924. Payment by cheque to Bank of Ceylon, Kandy – Ac.No. 0000034040.

Maybe, the next time you settle a bill at a five star hotel or gourmet restaurant, costing anything up to Rs.5,000 a head, or fork out a tidy sum for a concert to hear the latest ‘imported’ performer, spare a thought for your less fortunate brethren of the NCP whose only wish and fervent prayer is, to be able to live a few more years and bring up their children.