24 January 2013

Nigeria: Boy, 20, in Abuja's First Successful Kidney Transplant

Gabriel Onogwu, 20, from Benue, has become a symbol of hope for failing kidneys across the country, after successfully undergoing a transplant.

His surgery in December is the first recorded in Abuja, done by a team of surgeons at View Point Hospital, a private clinic in the suburb of Gwarimpa. Gabriel's transplant was funded by Nafs Kidney Foundation, a philanthropic group run by Suleiman Sulu-Gambari.

For days after the surgery, he walked around with a mask across his nose to ward off germs that could compromise his immune system and force his body to reject the kidney donated by his elder brother.

Weeks later, the SS3 student of GSS, Karu is out of hospital and attempting to return to what his life was before his surgery.

"I feel great, normal, just the way I used to feel before the kidney failure," he says. This time his mask is off as he speaks to Daily Trust. But the reporter who met him had a nose mask on. "I am very, very happy to have my life back."

Millions more Nigerians are not so lucky. Millions more Nigerians, many of them young as 18, are coming down with chronic kidney disease--the gradual loss of kidney functions. Leading figures from the National Association of Nephrology indicate up to 32 million kidneys in Nigeria are failing.

When a kidney is compromised, the body loses it greatest natural filter--and with that the ability to remove toxins from the body. Prompt treatment is dialysis--a procedure that imitates the function of the kidney to remove toxins and waste from the blood. It is effective, but it also expensive.

"They deserted us"

Experts worry that the age of Nigerians facing failing kidneys is falling. Gabriel's age at 20 makes him a poster child for the poster. His situation worsened in 2011 when "he started complaining of sever headache," recalls his mother Comfort Onogwu.

"He was swollen, fatter than we knew him. We could not look at him like that. We took him to hospital, did twenty-something tests before they realised it was kidney failure."

It took nearly a year, but Gabriel was finally placed on dialysis in June 2012. Each dialysis session cost N20,000 and required up to three pints of blood (blood is the medium used in dialysis). Gabriel estimates the weekly cost of his kidney management at around N150,000--money his family couldn't afford.

"It affected my family more, because getting that amount of money every week was not easy. We couldn't continue with [three dialysis sessions] weekly, so we had to reduce to twice weekly." Experts recommend three dialyses a week as optimum, but Gabriel's sessions dropped to just one a week eventually.

"Our relations couldn't help again. They deserted us. Help was coming from people we had never met, neighbours--helping with lots of test."

Gabriel started treatment at Asokoro General Hospital, then was moved to National Hospital. A transplant was the only option left when he came onto Nafs' radar at View Point "in a very, very pathetic situation and in severe pains," says Nafs founder Sulu-Gambari.

"When they told the options of treatment and the financial implications, which obviously the family is nowhere capable of financing, I asked the management how we could assist."

The option was a transplant, and the choice was between the US at N16 million and India at N8.5 million. View Point, which has been doing minimal-invasion surgeries since it started, agreed it could do the transplant for N5 million but it didn't have every equipment needed.

"The foundation took it upon itself to acquire some equipment from London to enable them perform the surgery," says Sulu-Gambari. The acquisition was outside the N5m agreed upon, but the extra spending is being considered down payment for future surgeries for indigent patients.

Nafs has opened an account at the hospital through which anyone can directly fund future transplants. A second kidney transplant for a 50-year-old patient is scheduled for some time in March.

"The whole idea is not to assist only one person. We want it to be a continuous thing whereby other indigents that cannot afford it, the foundation will be able to step in to help. For us to have good result and sustainability, we have to be able to part with money."

Nearly 16 surgeons hovered over Gabriel in theatre, headed by Dr Nadey Hakim, director of kidney and pancreatic transplant, Imperial College, University of London, with some 2,000 successful transplants under his belt.

The foundation has defended using a top brain in kidney transplant as a means of teaching local doctors to carry out future transplants on their own. It also plans to invite surgeons from as far as Maiduguri, Kano and Abuja to sit in on the next transplant.

Giving hope

The emphasis on chronic kidney disease is for a reason, says Sulu-Gambari.

CKD is not only a painful but expensive condition for patients and their families. "The cost of haemodialysis in government hospital is about N2 million in one year; in private hospitals, it is N4 million."

"If you have successful kidney transplant, the patient becomes 100 pecent, cured, he goes back to his normal life. That is the joy in it, as against diseases such as cancer whereby you spend so much money and the outcome is not pleasant.

"This one, if the transplant is done successfully then you are hundred percent sure the patient will enjoy happy life and that happiness gives me great pleasure."

It has also immense publicity "and a lot of interest in the hospital," says View Point chief medical director, Dr Hauwa'u Bello-Gambari. "More people are coming in, trying to find out what else we can do, and patients with kidney problems have been coming too."

On the same day Gabriel and his doctors spoke with Daily Trust, they also met with Press TV. Several news organisations have also been to speak with them.

But Bello-Gambari says View Point "wouldn't be limited by kidney problems alone."

There have been few recorded successful transplants in other major hospitals, but that it is also possible in smaller, lesser known hospitals is a lesson for larger teaching hospitals--a lesson the foundation wants noted. It is also one score in favour of Nigeria in the rush to stem trips abroad for medical procedures.

Comfort Onogwu insists her family could never have afford medical bills for any treatment abroad, and a transplant back in Nigeria still isn't cheap either.

"I never dreamt I could one day go for this transplant," says Gabriel. "My family cannot even raise half a million naira." But he's back home with a new kidney to show for it.

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