| 09 Mars 2017
9 March 2017 – “I feel anxious every time I come here as I don’t know if I will able to get my treatment,” says 37-year-old Salim Ali, a renal failure patient who for the last 17 years has come to Al Hudaydah Renal Dialysis Centre in Yemen for bi-weekly haemodialysis sessions.
Haemodialysis is a treatment for patients with severe kidney failure using a dialysis machine to clean the blood. In general, haemodialysis takes between 3 and 5 hours and is done 3 times a week.
In recent months, with internally displaced people flooding into Al-Hudaydah governorate, the number of patients receiving haemodialysis treatment in the centre has risen to over 600, despite the fact that the centre’s capacity is 400. Day and night dozens of patients are crowded in the corridors of the centre, waiting for their turn.
“We are working around the clock in 5 shifts to provide some 145 haemodialysis sessions per day but unexpected delays are inevitable as our machines are obsolete and frequently break down,” explains the Director of the Centre, Dr Maher Majam.
“Already 9 machines have broken down and it is getting more difficult to repair them as there are no spare parts for these old models. The schedule often has to be re-arranged, leading to delays of up to 3 days.”
These unpredictable delays are particularly difficult for those who travel from outside the city and who find it difficult to pay the transport and food costs required for frequent and prolonged stays in the city.
Doctors at the centre say they are admitting 60 new renal failure cases each month as 3 other smaller centres in the governorate are already operating at full capacity. Since the beginning of the conflict in March 2015, an estimated 140Â 000 internally displaced people have arrived in Al-Hudaydah, Yemen’s third largest governorate.
The centre receives haemodialysis consumables and medicines from the capital, Sana’a, but with an increased number of patients the supplies received to cover 2017 are already running low. In addition, the central electrical plant providing electricity for health facilities in the city is facing generating difficulties. “We have been told that electricity may be cut any day and we don’t have enough fuel to run generators,” says Dr Majam.
Dialysis centres at risk of closure
The centre in Al-Hudaydah governorate is one of 28 dialysis centres in Yemen struggling to continue functioning. Last November, the Dialysis Centre in Ibb governorate stopped functioning due to lack of supplies and operational costs, leaving more than 500 patients without care.
“As is the case with other health facilities, dialysis centres in Yemen are suffering the consequences of the ongoing conflict,” said Dr Nevio Zagaria, WHO Acting Representative in Yemen. “Increased funding is needed to support health system as a whole, including dialysis centres,” says Dr Zagaria.
Across Yemen, the budget allocated to health authorities has been drastically reduced, leaving health facilities without funds for operational costs and health care workers without regular salaries since September 2016.
WHO has provided some of the dialysis centres with equipment, IV fluids and fuel to operate generators. However, more support is needed to avoid possible closure of these centres and to protect patients. WHO’s Health Resources Availability Mapping System (HeRAMS) found that services for noncommunicable diseases, including kidney failure, are only fully available in 21% of the country’s health facilities.