Tucked away in a sprawling suburb of Ikeja, the capital city of Lagos State in Nigeria, the staff of KidneySolutions® work tirelessly to bring smiles to the faces of Nigerians with all forms of kidney disease, many of whom suffer from end-stage kidney failure and who require life-sustaining dialysis treatments. KidneySolutions® represents part of a growing trend of foreign-trained Nigerian medical specialists who have taken decisive steps to bring their knowledge and expertise back to their home country.
The scarcity of doctors with specialist training in Nigeria remains a vexing topical issue. Currently there are not enough nephrologists in Nigeria to provide specialized kidney care and dialysis to people who need them. We recently met with Dr. Emmanuel Anekwe, a US-trained interventional nephrologist and one of KidneySolutions® ’ proprietors. He was very glad to share some of his experiences with HealthBlog Nigeria in a brief interview.
HealthBlogNg: Congratulations on setting up KidneySolutions®. Setting up such an enterprise in Nigeria is no mean feat. What type of challenges did you face during the process?
Kidney Solutions: One of our goals in setting up KidneySolutions® was to ensure that our equipments and services met international standards. One of our biggest challenges was technical in nature. Dialysis treatment is only one aspect of the services that we offer but it requires the use of large quantities of water that must be far purer than drinking water. So procuring the equipment, getting them installed by proficient people, and getting qualified staff to run the equipment on a daily basis has been one of the biggest challenges.
We have invested a lot in getting the best equipment and the best people. This has paid off and we are delivering dialysis using ultrapure water to AAMI standards daily. Many dialysis units do not use ultrapure water. Other challenges are not new or unknown in setting up a business in Nigeria and mostly relate to high cost of importation, power supply, reliable water supply etc. But we are glad to report that KidneySolutions® is open for business with sufficient technical expertise providing expert compassionate care that meets international standards.
HealthBlogNg: In your opinion, how will this project change the plight of Lagosians and Nigerians with kidney failure? How will you do things different from similar establishments?
KS:This project and many like it going on as we speak, are in many ways similar to the massive change brought about by the mobile phone revolution. With more providers and competition, the cost of the service has fallen. Or at the very least, patients now get a bit more for their money. Patients need to be very careful when selecting a kidney care and dialysis provider because most do not meet standards for safe and effective care. So even if they are paying less at one center, the truth is that they may be getting poor quality service and would have been better off going elsewhere.
KidneySolutions is already different because we use all brand new equipment and use sterile disposable consumables where needed rather than recycling or sterilizing materials ourselves. In addition, not only do we have very active and stringent internal quality assurance and monitoring procedures but we believe patients should be treated with dignity and respect. From the front desk to the consulting room to the dialysis treatment area, patients are treated with dignity and respect in an effort to finally provide expert compassionate care.
HealthBlogNg: How prevalent is kidney failure in Nigeria? How is the situation now, as compared to the past 10 years?
KS:The issue of kidney disease is a multifaceted one and in the spirit of promoting and practicing preventive medicine it is probably best to start any discussion of prevalence with the prevalence of kidney disease before it becomes kidney failure. This would hopefully ensure that more effort is put into avoiding kidney failure which is a more devastating and expensive situation for individuals and the society in general.
The number of adults in Nigeria living with some form of clinically significant kidney impairment is somewhere between 10 and 30%. That is a high number and is likely higher among older people (over the age of 60). Data on the epidemiology of kidney failure in Nigeria, while also difficult to determine with accuracy is expected at a minimum, to reflect the epidemiology of kidney failure in the African American population in the United States.
Gross estimates on the number of prevalent patients with kidney failure in Nigeria lie at approximately 1500 per million population. This number is likely an underestimation for the country as a whole and is expected to be significantly higher in urban areas with access to modern western healthcare for diagnosis and higher capacity for healthcare spending. Basic statistics looking at trends over time are not readily available but there is a growing epidemic of the disease worldwide along with increases in the obesity, diabetes and hypertension – the most common causes of kidney disease.
HealthBlogNg: How has the response been since KidneySolutions® opened to patients?
KS:The response to the opening of KidneySolutions® has been interesting and very encouraging. Our specific focus on kidney disease prevention and management beyond just dialysis care has been of particular interest to patients and visitors. Our out-patient and preventive medicine approach is also of interest. People come in, ask questions, see the environment of care and are interested in learning more about what we do.
HealthBlogNg: How do you see the future of healthcare in Nigeria?
KS:Healthcare will continue to grow in its availability, sophistication and quality over time in ways that parallel and hopefully will surpass what has been seen in other areas such as the mobile phone industry. Patients are smarter and more enlightened. They know what they want and demand for it.
Healthcare providers will have to meet these demands by ensuring increasing value for cost in the services they provide. Specialty care service arenas are growing and will continue to grow as it is too expensive to have multispecialty all-in-one centers and more efficient to have centers that focus on one area or the other such as nephrology, cardiology, oncology, urology, endocrinology, infectious disease, obstetrics and gynecology etc.