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This 'business' of dialysis

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Dear Editor,

I write in response to a letter published in the Observer of 24th March under the caption 'They have us by the kidneys'. This was obviously penned by someone in an emotional state, precipitated by the illness of their father, who did not bother to check the facts. The writer chose instead to smear the reputation of nephrologists who go beyond the call of duty by giving quality care to patients with End Stage Renal Disease (ESRD).

I am not a nephrologist, but have been involved in the management of patients with ESRD since the first patient in Jamaica (and the Caribbean) was dialysed for ESRD in Mach 1970. We then had one kidney machine in the island, whereas we now have in excess of fifty for use in the public hospitals situated in Kingston, Montego Bay, Spanish Town, May Pen, and Mandeville. This increase has been in part due to the efforts of the Kidney Support Foundation of Jamaica of which all the nephrologists accused of not pushing for an increase in public facilities for the care of indigent ESRD patients are members.

Jamaica has at least 900 new cases of ESRD each year, the majority of which cannot afford private dialysis and eventually die awaiting dialysis. The waiting lists at the public hospitals are therefore understandably very long. Any patient may join the list, but no preference is given to status, colour, creed, or wealth. Obviously those who can afford it will opt for private dialysis. The indigent, however, have no choice as the Government is financially stretched spending about $1.5 million per patient per year on dialysis.

The nephrologists who have the "guts" and foresight to invest in private units to help in the management of ESRD throughout Jamaica should be commended rather than chastised.

L Lawson Douglas

Professor of Urology

llawsondouglas@yahoo.com

This 'business' of dialysis

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