Destiny or Poverty: Kidney failure in Madagascar

Kidney failure. This disease presents itself as the ultimate ordeal of several Malagasy people in recent years. Unlike COVID-19, the government is not able to manage all the patients affected by kidney failure. However, this problem is very costly. So for those who lose their lives, is it die time or lack of money? Destiny or Poverty?

Some people do not know about kidney failure or do not think about the severity of this disease. Two basic types may occur: acute kidney failure or acute kidney injury and chronic kidney failure or continuous kidney injury. An indispensable knowledge: your kidneys are very important for your body, especially for your survival. The kidneys are two bean-shaped organs, each the size of a fist located just below the rib cage, one on each side of the spine. Your kidneys remove waste and excess fluid from your body. They also remove the acid produced by your body’s cells and maintain a healthy balance between water, salts and minerals in your blood. Healthy kidneys filter about 100ml of blood every minute, eliminating waste and excess water to make urine. When your kidneys or even one does not do its work, death is near. All your waste spreads throughout your body. They are even visible on your face or your eyes when the creatinine level rises to 1,000 ml/min or 2,000 -normally this should be between 107 and 139 ml/min in men and between 87 and 107 ml/min in women.

Only two alternatives. There are two choices for patients: entering dialysis sessions (an artificial kidney that cleans blood) or performing kidney transplantation. Both choices are beyond the means of most of patients. A person must complete three dialysis sessions three times a week in order to continue the daily duties. A session costs between 200,000 ariary and 250,000 ariary -a dollar is worth more than 3000 ariary-. However, the minimum wage of Malagasy is declared 200,000 ar.

What about transplant? The minimum cost is $25,000, more or less 16 times the nominal GDP. The patient still has to travel to India for the surgery. According to statistics in 2015, 7.000 to 10.000 Malagasy are suffering from this disease. It is already 2021. A disease caused by several symptoms. If we believe that seniors are the most affected, we are all wrong. Apart from hypertension or diabetes, kidney malformation can also be the cause. Even children are victims.

Out of reach. With all the expenses: dialysis, blood analysis once a month the minimum, drugs like calcium or antibiotics, where to find all this money? If the person would like to live like the others, he must carry out the three dialysis sessions per week. With what money? Reducing sessions causes even more diseases like having water in the lungs. Work for which the salary cannot cover only one session? Make a request for aid to the State or associations and wait several years of response? There are a few who have the means and arrive at the 900th session of dialysis, but for many who have lost their lives to this disease and do not have the means to fight it, is it its destiny or is it because of poverty? The answer lies in you and what you believe.

To conclude, kidney failure kills many people like other more famous diseases. Young or old, everyone can be a victim. For others, their life depends on their means. If the patient has enough money, can live with the disease for several more years. Some take it as fate, it’s time to leave or destiny is to live several more years. In both cases, take care of your health.

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