Spanish Doctors Train Kenyan Counterparts in Kidney Transplant Surgery

Cathy Majtenyi | Nairobi
30 May 2010

In Kenya, kidney failure has skyrocketed over the past five years following a dramatic rise in diabetes, hypertension and other ailments. The demand for dialysis - an expensive procedure for most Kenyans - far outstrips the supply of dialysis machines. And the few transplants that take place are also expensive. Through a partnership formed last year, Spanish doctors are now training a team of Kenyan doctors to perform sophisticated, affordable kidney transplants.

It's one of six kidney transplants done by the Spanish-Kenyan team in mid-March at Kenya's largest public health facility, Kenyatta National Hospital. Lead surgeon Dr. Antonio Alcaraz instructs fellow surgeons and students watching the procedure through closed-circuit television.

Meanwhile, 25-year-old Caroline Kinyanjui is recovering from her surgery earlier in the week. She donated one of her kidneys to her father, Peter Kibe, who is suffering from hypertension. "I love my dad. He has poured quite a lot of his life into me by just bringing me up in a very sober way and taking care of me. I know he would do the same if I was in that position, so I was purely driven by love and understanding that I can still live a normal life after this," she said.

Kenya's first kidney transplant took place in 1978. But the procedure was not regularly available until ten years later. Kenyatta National Hospital did only two last year.

At the same time, skyrocketing rates of kidney failure, caused by diseases such as diabetes and hypertension, make it urgent to offer more - and more sophisticated - transplants.

And that is where the Spanish team comes in. Towards the end of last year, Kenyatta National Hospital and the drug company Novartis formed a partnership called "Interlife," and invited doctors from the Hospital Clinic de Barcelona to train Kenyan doctors on new transplant techniques.

Lead surgeon Dr. Antonio Alcaraz is head of the Barcelona hospital's Renal Unit. "When we first came here, we saw that there were few facilities to undertake a very important program, a sophisticated one like a living donor program. But we thought it was enough, and we were especially impressed by the commitment of people - doctors and nurses - in trying to develop that program. So we said we will accept the challenge of raising up this program here in Kenya," he said.

While an estimated one million Kenyans suffer from kidney disease, dialysis and transplants to battle the condition are limited and expensive.

In the public health care system, for example, only two hospitals are equipped with dialysis machines, which remove impurities from the blood when the kidneys can not do it.

One of those is Kenyatta National Hospital, where almost 150 patients need dialysis, but the hospital's dialysis machines can only handle 35 patients per week.

And the minimum cost of dialysis - $117 (Ksh 9,000) a week - is virtually unaffordable for low-income patients even though it is a subsidized rate..

The Interlife partnership is now able to offer a kidney transplant and follow-up treatment for around $4,550 (Ksh 350,000) - about half of what it used to be. The drug company Novartis is supplying the necessary drugs at not-for-profit prices. Health officials say a transplant is now cheaper in the long run than continued dialysis sessions.

Dr. Patrick Mbugua says Kenyans no longer need to go to India or other places to get their kidney transplants. "We are able to do these transplants locally. We have got the expertise in this country and the only thing that we needed to do is to publicize and tell them, 'Yes, you do not have to spend all the money and go outside there, leave the comfort of your country and the beloved ones to have the transplants outside there - we can do it here," he said.

Samuel Nyabwana, head of Novartis's East and Central Africa office, says Kenya is well-placed to become a regional transplant center. "I think we have to a large extent all it takes. As Kenyans we have a sufficient pool of nephrologists, a sufficient pool of urologists, and all related scientists who will be involved with this area. We know Kenyatta Hospital has been undertaking the kidney transplants over the years, for the last 25 years," he said.

For now, patients such as Caroline Kinyanjui and her father, Peter Kibe, says they are grateful for the chance to give, and receive, a new life.