Kidney failure is reportedly a growing problem in Belize and the rest of the Caribbean, and the number of people who can be treated with haemodialysis—a procedure 3 to 4 hours long which must usually be done 1 to 3 times a week, to substitute for the blood cleansing the kidneys would have done—is usually much higher than the number of people who really need the care.
At an informational session on Tuesday morning, January 25, Director of Health Services Dr. Michael Pitts said that in the case of Trinidad and Tobago, for example, the government can treat 400 cases with a TT$105 million budget (about BZ$33 million)—but an estimated 1,500 people demand the care. The end result for those who can’t access or afford it is, regrettably, death.
The disease burden in Belize is high—and it is believed to be escalating. Pitts said that the proportion of people living in Belize with hypertension is 15%, while the proportion for diabetes is 23%—nearly one in every four persons. These two medical conditions are most commonly linked with renal failure when not properly managed.
Ministry of Health officials say that the current health budget is just under $90 million. Of that, $1.8 million would be spent on the first public sector haemodialysis program, which, they say, will look at each patient more holistically.
There is currently no official information to indicate how many people in Belize need dialysis, since the country has no renal registry; however, Pitts indicated that the public dialysis units would be able to treat 6 more than the 26 currently on the government-subsidized program.
Of those 26 patients, our newspaper is informed that 11 have been transferred to the Karl Heusner Memorial Hospital’s dialysis unit—one of two public units being set up in Belize.
The second unit is being set up at La Loma Luz Adventist Hospital in San Ignacio/Santa Elena, Cayo, and that unit is expected to take its first patient in just a few weeks.
The remaining patients currently undergo haemodialysis at the Belize Healthcare Partners Limited (BHPL), the first private facility to offer the service in Belize.
Pitts underscored the need for both programs, in the private and public sector, to continue operating. The KHMH and Loma Luz would take those select cases of people, chosen by a patient selection committee, who simply cannot afford to pay the $550 required per session at the private facility. (In Chetumal, said Pitts, it costs $330 a session.)
A person who needs the usual 3 treatments a week would, therefore, be spending between $50,000 and $90,000 a year on this treatment to stay alive—a conservatively calculated price tag that only the wealthy could sustain without some form of subsidy program or insurance coverage.
To assist some of those who fall outside that bracket, the World Organization for Renal Therapies (WORTH) is partnering with the Government of Belize for at least the first three years of the dialysis program, which will cost the parties roughly $3 million a year to operate—about the same amount of money expended from the national health budget for the whole of the Toledo District.
This $3 million in spending equates to treatment in Chetumal for 58 patients—at the BHPL cost, it works out to about 35 patients. However, the Ministry of Health says that patients are getting more rounded care under this Ministry of Health/WORTH dialysis program.
Whereas patients needed to travel abroad to get their fistula connections—needed to connect the patient to the machines—there is now a doctor in-house who does that procedure.
The program will also give patients access to lab tests, medications not previously available in Belize (which are supposed to improve their condition), hormonal treatments, nutritional advice, and the services of a social worker.
The current proposal is to ask patients to make a contribution towards the program of $15 to $80 per session, based on what they can afford. This could generate, minimally, about $70,000 for the program.
Dr. Wayne Trebbin, WORTH founder, will be the nephrologist serving the patients, mostly from overseas through modern communications links with 15 trained nurses who will be manning the units in Belize City and Cayo.
Why do we need our kidneys?
The kidneys perform a wide range of vital functions in the healthy body, such as:
- Removing wastes and water from the blood
- Balancing chemicals in your body
- Releasing hormones
- Helping control blood pressure
- Helping to produce red blood cells
- Producing vitamin D, which keeps the bones strong and healthy