DANIEL Bakara (37) is bitter over the death of his mother a few years ago due to something that he feels was avoidable.
His bitterness and rejection is how the family battled to raise money for h is ailing mother who suffered from kidney failure.
“As a family, we had no idea of how best we could save our mother when doctors said it was kidney failure. It was a sad reality as we moved from one private hospital to another,” he recalled.
“Even public hospitals could not help either. We watched helplessly as her health deteriorated before she breathed her last.”
Bakara hails from Mhangura, a mining town in Mashonaland West province.
Zimbabwean health advocates are pushing for radical change in the health care system, with kidney transplantation part of the key focus areas.
Kidneys play a crucial role in maintaining overall health by performing several vital functions, including filtering waste products and excess substances such as water, salt and toxins from the blood to form urine.
Former Health minister Obadiah Moyo, a medical practitioner who is also chairperson and special adviser of Zimbabwe Kidney Foundation, said it’s time for engagement for a revamped social development.
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“In Zimbabwe, the population of patients with chronic kidney disease is rising, putting a strain on the nation’s few dialysis treatment centres, whether government or private,” Moyo said.
“The government covers the whole expense of delivering dialysis in its facilities, increasing the financial burden.
“Patients from both public and private dialysis units opting for kidney transplantation are referred abroad at high foreign currency costs,” added Moyo, who carried out a study focused on reviewing the economic advantage of kidney transplantation in relation to renal dialysis as a means of establishing a kidney transplantation programme in Zimbabwe.
In the study, where cost-effectiveness between kidney transplantation and dialysis was compared, it was shown that transplantation is a cheaper solution with a higher quality of life than dialysis.
“It was also shown in most of the studies that among the dialysis modalities, haemodialysis (HD) was more expensive than peritoneal dialysis (PD).
“In one of the studies, the cost values were US$37 395 for HD, US$27 007 for PD, and US$11 426 for kidney transplantation,” Moyo explained.
“The quality-adjusted life years per patient were 0.46 for HD, 0.49 for PD, and 0.61 for KT. As far as cost-effectiveness and raising the health status, wellness level, good living and survival, kidney transplantation is rated highly and a better modality than dialysis.
“It is a more appropriate renal treatment for introduction in Zimbabwe to save on the scarce foreign currency.”
Chronic kidney failure cases are rising in Zimbabwe due to hypertension, diabetes and population aging (about 1 000 cases per million annually).
“This results in a high requirement for dialysis therapy in public and commercial dialysis facilities across the nation. The government covers the whole expenditure of HD in government sector dialysis facilities for all individuals on renal replacement treatment, resulting in tremendous financial demand,” Moyo explained.
“The majority of patients in both public and commercial dialysis centres seek kidney transplantation overseas (for) a lower risk of infection, in contrast to the significant risk of infection connected to the vascular and peritoneal access needed for dialysis treatment.
“The chances of KT recipients having so many problems that are usually associated with dialysis are minimised. For instance, dialysis patients are confined to strict dietary control and fluid intake and have the inconvenience of attending remote dialysis centres.”
He added: “An effective kidney transplantation might be a blessing of freedom from dialysis equipment and reliance upon everyone else.
“Furthermore, kidney transplantation recipients have substantially fewer cardiovascular complications than patients on dialysis.”
The former minister has won several international awards in recognition of his contribution to the international society in nephrology, helping shape public policy in the care of patients with end stage renal disease and also set up a state-of-the-art kidney transplantation unit at Chitungwiza Central Hospital in 2015.
Moyo holds a Post Graduate Diploma in Kidney Transplantation science and a Masters degree in Organ (Kidney) Transplantation from the University of Liverpool UK, qualified with another Post Graduate Diploma leading to a Masters degree in Renal Medicine from the University of South Wales, UK.
He completed a Masters degree in Chemical Pathology from the University of Zimbabwe.
He is a Fellow of the Royal College of Pathologists (UK) and a holder of a Doctor of Medicine Degree from the College of Medicine and Health Sciences, St Lucia, West Indies.
“The public–private partnership model is in keeping with national and global developments, and it will help the country strengthen its medical facilities and service delivery,” he further explained.
“The collaborative regulatory framework is now at the heart of the leadership’s desire to achieve because it will be consistent with the state’s concept of implementing good medical services.
“The collaboration will establish a strong, profitable scenario where both players are guaranteed to equally benefit, thus greatly improving patient care, and upgrading the centre’s capability into a global player in kidney transplantation.”
Moyo, however, explained that the government’s key objective is that socially disadvantaged patients will receive treatment without any prejudice and that legal compliance of the partnership process is adhered to.
“A memorandum of understanding can be drawn with a framework and joint technical co-operation, respective mandates, and work-related programs in developing a kidney transplantation programme at an identified centre in Zimbabwe,” he said.
“The government’s primary responsibilities would be to provide all the relevant infrastructure and bring up to the standard the intensive care unit, theatres and post-transplant wards, dialysis units, laboratory, pharmacy and radiology services.”
Muchanyara Cynthia Mukamuri, the executive director of Self-Help Development Foundation (SHDF) and Women’s Coalition of Zimbabwe chairperson, hailed Moyo’s suggestions saying it is a major and much-needed development for Zimbabwe.
“This will help in early detection and awareness of kidney diseases, access to dialysis and transplant information,” she said.
“For better renal healthcare, this move is a strong step toward saving lives and strengthening public health.”
Cimas group chief executive officer Vuli Ndlovu agreed that kidney disease is a significant health concern not only in Zimbabwe, but globally due to limited access to early diagnosis and treatment, which could help manage the disease in its initial stage.
“Additionally, Zimbabwe records approximately 1 000 cases of kidney failure each year,” he said.
“However, only about 700 patients are considered to have access to dialysis treatment, leaving many without the care they desperately need.”
Ndlovu said the availability of dialysis services was mainly concentrated in urban areas like Harare, making it difficult for patients in rural regions to receive timely treatment.
“Regular screening is essential if someone is at risk of kidney disease due to diabetes, high blood pressure, or a family history of kidney problems,” he said.
“I strongly encourage routine visits to healthcare providers who can detect kidney issues early, especially for those with risk factors.
“Early detection and timely treatment can significantly slow the progression of kidney disease and improve long-term health outcomes.”
There is a Cimas Haemodialysis Centre in Harare.
Kidney is the most frequently transplanted organ, where 111 000 kidney transplants were performed in 2023.
Globally, Turkey is ranked as the best for kidney transplants, due to advanced healthcare infrastructure and expertise in renal medicine.
