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They have us by the... kidneys

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Dear Editor,

I recently had occasion to take my father, who is diabetic and hypertensive, to the University Hospital of the West Indies (UHWI) for treatment of complications related to his end stage renal disease. My father’s condition had progressed to the point where he needed haemodialysis at least twice weekly.

After meeting with the nephrology team, I was amazed to discover that the waiting list for haemodialysis at the UHWI and Kingston Public Hospital is now over a year. By that time, without dialysis, my father will be dead.

We were advised that emergency hemodialysis could be done on an “as needed” basis, but that for ongoing, regular dialysis we needed to seek care at a private facility. I immediately began to wonder why the UHWI, supposedly the pinnacle of medical care in the Caribbean, has such grossly limited facilities, especially when taking into account our population of almost three million. It was not until I began to investigate the ownership of these private dialysis units that the matter became clearer.

Your readers may be astonished to discover that a large number of these private units are owned and operated by the same kidney specialists who work at the public hospitals. This puts the modus operandi of these specialists in question. They first encounter patients at the public hospitals where they counsel them about the importance of haemodialysis several times per week indefinitely (or at least until an elusive kidney transplant is performed). They advise of the futility of having haemodialysis done publicly as the waiting list is too long to make that a viable option. The next step is to direct the patients to private dialysis centres where they are charged up to $60,000 per month.

The unethical nature of this practice is mind-numbing. Furthermore, it raises an important practical question. What incentive is there for these kidney specialists to expand and improve access to dialysis at the public hospitals when they know that there are millions of dollars to be earned with public dialysis capacity inadequate so that patients will have no choice but to choose private care?

Does the Government and the administration of these facilities not see the conflict of interest in this? I am exhorting patients and families affected by this injustice to speak up. Furthermore, I am imploring the Ministry of Health, the administrations of the UHWI and the KPH, and investigative journalists in the media to take a closer look at this troubling matter. While we want our medical consultants to live comfortably, the health and well-being of our vulnerable patients with chronic kidney disease cannot be sacrificed.

Simone Curic

simonecuric@gmail.com

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