Dialysis centres

“We have to put money together for fuel and travel in a group from Tsumeb to the nearest dialysis facility in Otjiwarongo, which is about 170 kilometres away. We do this three times a week!”

These are the words of former parliamentarian Engel Nawatiseb as he narrated to Namibian Sun the extent of the financial, physical and mental drain patients who suffer from kidney-related diseases have to go through because of a lack of dialysis facilities across the country.

Nawatiseb has been a haemodialysis patient since 2021, after having developed kidney complications caused by Covid-19.

He said the struggles of dialysis patients illuminates the need for more facilities.

This comes at a time when the health ministry is in the process of constructing and renovating several dialysis centres across the country— a move that could save government N$100 million yearly — as part of efforts to deal with rising kidney-related diseases.

The construction of these new dialysis facilities will come in handy for people like Nawatiseb, who suffers from a kidney condition that now requires him to attend three dialysis sessions every week. Each session takes four hours.

It is understood that dialysis centres charge anything between N$2 000 and N$4 000 per session.

Enhanced collaboration

Nawatiseb, who lives in Tsumeb, expounded on the challenges he and other sufferers of kidney-related diseases endure due to the absence of a dialysis facility in the town.

The former lawmaker - who also serves as the chairperson of the Hope Foundation Trust, which fights for the well-being of dialysis patients in the Maize Triangle - has, however, commended government for cross-subsidising state patients.

“We want to partner with government in the advocacy of dialysis programmes by creating awareness to live positively with kidney failure conditions. I am commending both government and Dr Glenda Kalunga for saving lives,” he said.

He further urged government not to kick private dialysis centres to the curb, and instead called for enhanced collaboration because “these private facilities really assisted Namibians at a time when dialysis facilities were few”.

Funding healthcare

There are critical shortages of dialysis services within the public health system, a situation which costs government just over N$100 million annually to foot the bill for patients who receive dialysis at private facilities, official figures from the health ministry show.

Executive director Ben Nangombe said the planned dialysis centres are part of government’s efforts to expand and modernise public health systems to respond to public needs, as well as to counter the rise in kidney-related diseases in the country.

“The dialysis services are part of our plans to bring services closer to the people and cut the expense the government spends on private centres per year,” Nangombe said.

An update from the ministry’s technology and infrastructure management directorate indicated that government spent about N$4.5 million to renovate a dialysis unit at Oshakati Hospital and N$2.9 million for the construction of a facility at Katutura Hospital – with works completed and equipment installed, Nangombe indicated.

The ministry also spent N$7.3 million on the construction of a dialysis facility at Keetmanshoop Hospital – with completion scheduled for June - while N$9.8 million went towards the construction of a facility at Rundu Hospital, which commenced in February and is scheduled for completion in October.

He added that the ministry has further scheduled construction at the Katima Mulilo Hospital, with the costing finalised and a bidding document and submission made to call for bidders who are interested in constructing the facility.

“We also plan on taking dialysis services to Walvis Bay. The preliminary designs have already been completed, with the cost estimate being finalised based on the design.”

According to the executive director, tenders for the Gobabis and Mariental district hospitals have been advertised and awarded.

Patient influx

Prominent nephrologist Dr Glendah Kalunga said there has been an influx of patients visiting dialysis centres.

Kalunga, who owns the Kidney and Dialysis Specialist Centre, said this is not only due to an increase in kidney-related diseases, but also due to awareness created by dialysis centres.

“Kidney-related diseases have been largely undiagnosed over the years due to their non-specific symptoms in the early stages, which can make their progression insidious. As a result, individuals may only become aware of their kidney problems at a late stage when it's harder to mitigate the disease,” she said.

She advised individuals to go for regular check-ups as, despite being a non-communicable disease, early screening means better treatment and, in most cases, no need to go on dialysis. “Dialysis treatment costs are hefty – we need to focus on prevention, screening and early treatment to arrest the disease and reduce the cost burden.”

Kalunga further underscored the importance of evenly setting up centres across the country to maximise their reach to patients. “There is no point in being in one area while other parts of the country are not serviced.”

She meanwhile cautioned individuals with plans to set up dialysis centres for financial gain that it would be a disservice to the patients. “[Dialysis centres] ought to be taken seriously and require professionals who know what they are doing. It would be dangerous, to say the least, [to only be in it for the money] as quality care is paramount.”