Special Report by Ebuka Onyekwelu
The United States trained Anambra-born renal care specialist, Dr. Felicia Nene Chidolue, over the weekend hinted that she is working towards ensuring that in Anambra state, kidney transplants among other specialized renal care services will be available to those seeking them soonest. Dr. Chidolue has over two decades of experience and expertise in renal care in the US, where she has reached the pinnacle of her professional career in chronic disease management.
Recently, she agreed with her husband, Dr. Okey Chidolue to replicate her US experience in Nigeria in what the Chidolues called “legacy project” and that was how the construction of the Premium Kidney Hospital located in Nnewi, began sometime last year. Premium Kidney Hospital is now completed and has commenced operation as a full kidney centre, with provision for kidney transplant expected to begin soonest. The hospital built to taste, to reflect Western hospital environment, promises to deliver nothing short of first-class services comparable to what is obtained around the world.
In this exclusive interview, Dr. Felicia Nene Chidolue bares her mind on renal care in Nigeria, what inspired the choice of location of Premium Kidney Hospital, what the government should do, and also advice to renal care patients and preventive measures against renal disease, among others
Q: What are we not getting right about renal care in Nigeria?
A: I would say it’s the lack of awareness, because renal disease is a chronic illness. We are susceptible to the causes of it which is high blood pressure and diabetes, and we wait until someone is in the full-blown stage before we act. So what we are not getting right is the preventative measure; to prevent someone from advancing to Chronic Kidney Disease –CKD, and to end-stage renal disease. Initially, you are diagnosed with CKD and when it is not well managed, the progress is very fast into end-stage renal disease which now requires you to undergo renal transplantation or hemodialysis. If we could focus a lot on the causes of kidney disease or renal impairment, it will save a lot of lives. A lot of our people here have diabetes and a lot especially our men have high blood pressure. I don’t think they are well advised that those two conditions are the main causes of kidney disease. So you find a young man in his 30s with end-stage kidney disease because he has high blood pressure that was not cared for.
Q: Why do you agree to have this facility sited here in Nnewi, Anambra State, instead of Lagos Island, Abuja or Portharcourt?
A: Laughs… First of all, I am from Nnewi and I am very passionate about my town. I have lived abroad all these years and I want to bring something home, I think I will want to start from my home town, because, this is where it all started. I also believe that we have this mentality where everybody wants to invest in Lagos or Abuja, for whatever reason. I think also the reason I went into this project is that for me, it’s a legacy project, so why not bring it back home? Then also people in those cities have choices, you know, everybody wants to put it there, neglecting the East and when you go to Lagos and Abuja, much of those facilities are owned by Igbos. That begs the question; why is everybody trying to invest there when charity should begin at home. And after living abroad for a long time, if I am here, I want to be in my town. Laughs…
Q: Can you tell us Services offered by this hospital?
A: Premium Kidney Hospital is still work in progress in the sense that I have a very big vision. The first floor of this hospital has been designed for kidney transplant which is the next phase of this project and we will finish on record time. We want to provide world-class renal care, there is absolute no reason why someone will have to travel from here to India to go and get renal services. We want to replicate what happens in developed nations here. We want to replicate that care that you will receive if you are to travel abroad, you can get it here, because, if you go to most of these developed nations, you find out that these services are also being provided by our people, so we are capable of providing such services like I provide in the US. So we can do it here and that would actually unburden people financially because to travel abroad for medical tourism is not cheap. You find out that only people that are extremely wealthy can afford it and access to quality health care should not really be tied to economic status; it should be available to anyone.
Q: Has operations fully commenced in this facility?
A: Yes, it has. We are starting slowly. We have two phases we are running concurrently; the first is hemodialysis where we are treating patients that already have end-stage renal disease and their lifeline is hemodialysis or transplantation. The other section is the management of CKD. The key actually is preventing the disease from advancing from stage 1 which is just a minor kidney impairment, all the way to stage 5 where the cat is out of the bag and that becomes a very expensive venture because hemodialysis or transplantation is not cheap. My main focus is on preventing patients from getting there. You know, end-stage renal disease; I call it a death sentence in Nigeria. It is so because of the cost involved. Average hemodialysis treatment is between N35 and N40 thousand Naira. And the treatment should be three times a week, that’s N120 thousand multiplied by 4. That’s almost N500 thousand Naira for a month. It is not sustainable. How many people can afford it and so people die because they cannot afford the care. This is also part of the mission of Premium Kidney Hospital which is to provide affordable dialysis… that takes me back to that lack of awareness because if somebody knows that taking blood pressure medicine that will cost a small amount of money in a month, will prevent one from having a life-altering illness, I think they would rather take the first option.
Q: What is the hospital’s capacity in terms of patient intake?
A: Right now, we strictly have out-patients, except if there is an emergency. Dialysis treatment is done in shift. Each session lasts for about four hours. So technically, with 15 machines, you can actually dialyze up to thirty patients in a day.
Q: I am looking at this investment and thinking about sustainability. Is there something you think government can do to help make this investment sustainable?
A: The government can do a lot. This kidney disease is not something that is endemic just in Nigeria or Africa; it’s a chronic illness that is worldwide. Developed nations have done a lot to help in terms of the payment of bills for patients. I would always use the US to buttress. Kidney disease is the only medical condition that qualifies you for medicare in the US; that is, the medical care you get when you turn age 65 in the US. But because of the enormous cost involved in end-stage renal disease, the government has undertaken it. That is the only illness that qualifies you for medicare before age 65, not even cancer. So if the government can subsidize the treatment for patients, if not directly, then by assisting the facilities with supplies, because this treatment costs N40 thousand Naira, it is not something that anybody pulled out of the blues, it is based on consumables, which are the supplies that you need to be able to do one dialysis treatment. By reducing the operating cost; the reduction can be transferred to the patient. Also by giving the facility tax breaks. If you can have such support, then you can scale down your cost of providing such services which can now be transferred to the consumer. So there is a lot the government can do to help.
Q: What is your advice to people who are managing this renal disease and also to those who are free from the disease?
A: Let me start with those that are free from the disease right now. The number one cause of kidney failure is diabetes. The second cause is high blood pressure, then autoimmune disorder, and some other causes like exposure to toxic medication, but the main ones are high blood pressure and diabetes. For those that have these conditions, my advice is that they are kidney patients in waiting. Why? Because, if those illnesses are not adequately managed, they will end up with kidney disease. It’s critical that they follow up with their doctors on a regular basis. We recommend that if you have diabetes you do a lab test that is called hemoglobin A1c (A one C), which gives you a percentage of how well your diabetes is well controlled. We always follow the National Kidney Foundation of the US or the Endocrinology Board’s recommendation of an A1c of 7% or less. So you should manage diabetes and know your A1c, to make sure you don’t end up as a kidney patient.
He is a Technical Assistant to Governor Willie Obiano’s Special Adviser on Legislative Matters, whoonce was a Special Adviser to a former Deputy Speaker of Anambra State House of Assembly. Ebuka is a second class upper division graduate of Political Science from University of Calabar, Calabar Nigeria and holds a Masters Degree in Political Science with specialization in Government and Development Studies, from Nnamdi Azikiwe University, Awka Nigeria
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