Mulago kidney transplant programme hangs in balance

At the moment, one needs between $20,000 (Shs71m) to $30,000 (Shs107m) to go for the cheapest kidney transplant procedure in India where most patients in Uganda are referred because the country does not have the capacity to conduct the procedures.
The cost is, however, too high for most Ugandans.

Dr Diana Atwine, the Permanent Secretary in the Ministry of Health, under whose jurisdiction Mulago hospital falls, said the hospital might be handed over to government by the contractors in September and not July as it had been communicated earlier.

“I can’t, therefore, tell if we shall have finished installing the machines at the unit by end of year,” Dr Atwine said.
Although preparations are ongoing at the Intensive Care Unit on block 6A where the transplants will be conducted, Mr Enock Kusasira, the hospital spokesperson, said the lack of adequate funds may even delay the programme further.

“We shall need the money for routine servicing of the equipment because if you give Mulago a lot of equipment but don’t increase their budget, the machines will break down and it won’t be long before the operations halt,” Mr Enock told Daily Monitor in a telephone interview yesterday.

Experts at the renal unit at the hospital where patients with kidney diseases go for treatment, also said it might be hard for the programme to start even in the next two years, given the inadequate staff and the acute lack of specialised equipment needed in carrying out numerous tests before conducting the transplants.

A senior nephrologist at Mulago hospital’s dialysis unit stressed that for any country or facility to start conducting complex procedures such as kidney transplants, it must have a team of at least 30 experts, including nephrologists, physicians, surgeons and nurses who are specifically trained to conduct transplants.

However, when contacted, Dr Byarugaba Baterana, the Mulago hospital executive director, insisted that they are doing all it takes to have the hospital start conducting the transplant procedures this year.

The charges
Although Dr Baterana had earlier stated that the surgeries would be conducted free of charge, he, this time said patients will have to part with $8,000 (about Shs28m) for a single surgery to facilitate buying of drugs, paying experts and servicing the machines.

The organ and tissue transplant Bill, which allows the process of organ transplantation and donation to be conducted in the country, is also still at the draft stage.

Without the law, Dr Jackson Amone, the secretary of the Uganda Medical Board, which qualifies patients for further treatment abroad, said even if Mulago hospital is ready to start carrying out transplants by end of year, it would be hard without the law.

Last year alone, a total of 14 patients were recommended for treatment in India by the medical board.

Mulago hospital also has a total of 110 patients on dialysis treatment, which substitutes the normal functioning of the kidney, 90 of which require kidney transplant.