'Hospital sent me home to die'

By Sipokazi Maposa

Health Writer

As the world commemorates the sixth World Kidney Day today, it will be a day of suffering and uncertainty for Cape Town musician Brett Nicol, who is fighting for his life at home after being turned down for life-saving dialysis treatment in the state health sector almost two years ago.

Nicol, of Richwood, has end-stage kidney failure and is paying a "huge price tag" for his survival, getting the treatment he needs in the private sector.

Worse still, Professor Charles Swanepoel, president of the SA Renal Society and a nephrologist at Groote Schuur Hospital, which turned down Nicol for treatment, has revealed that funding constraints and staff shortages force them to turn down about 40 percent of renal patients for dialysis.

When Nicol was diagnosed with chronic renal failure in April 2008, doctors gave him just three months to live.

The 44-year-old, whose illness has forced him to give up his music career, today called for the government to invest more in dialysis, saying that many people of his age and younger died in the "prime" of their lives due to a very "strict government criteria" that shut out those most in need.

He was turned down for dialysis at Groote Schuur because he was "too sick".

"I was basically sent home to die. They said they couldn't do anything for me because I was too sick. The fact that I was not married with children also counted against me.

"I think the system is very unfair and it has robbed many young people of their lives," Nicol charged.

Recently, Mitchells Plain woman Busiswa Danxa was similarly turned down for treatment, because she was not a strong candidate for a kidney transplant.

The 24-year-old mother also had tuberculosis that counted against her.

Swanepoel said the two cases were far from isolated.

The public health sector had to turn away scores of very sick renal patients who were not considered eligible for kidney transplant.

These patients had either end-stage kidney failure or were not fit enough to undergo the major surgery required in the event of a transplant.

Groote Schuur, he said, cared for at least 120 renal patients at any given time.

Of those on the dialysis programme, 80 patients were on haemodialysis, a form of dialysis that removes waste products from the blood by passing it out of the body, through a filtering system, then returns the cleaned blood to the body. The other 40 were on peritoneal dialysis, a therapy administered via a permanent tube in the abdomen which flushes out the toxins. The advantage of this therapy was that it could also be done at home.

Swanepoel said financial constraints and staffing shortages were a major problem, because of government finances.

"The cost of dilating people is way too expensive. Unfortunately that's a reality of provisional public health, and sometimes we have to take such tough decisions."

The problem was compounded by a shortage of donor organs in the face of increasing incidence of diabetes, the primary cause of renal failure in South Africa.

Many citizens were reluctant to donate their organs because of a lack of relevant education. Religion and culture also played a big role in discouraging people.

"If we can get more people to donate, that would make a lot of difference," Swanepoel said.

Provincial health department spokeswoman Faiza Steyn said that of the 104 renal patients at Tygerberg Hospital, 10 were no longer eligible for transplants due to poor health.

"We share all kidney donations (from deceased donors) between Tygerberg, Groote Schuur and the private sector, and we work closely together to ensure optimal use of what has become a very scarce resource. Demand completely outstrips supply," she said.