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At the beginning, Carolyn Atim thought that the headaches she lived were only the residual echoes of pregnancy. The consultations then indicated that it had high blood pressure. Light of image, barely twenty, Atim had given birth to a boy in 2013.
Nine months later, the headaches had not disappeared and she felt relentless fatigue. She brushed them.
“I was so tiny,” she said. “And you know the perception that a small person does not suffer from high blood pressure!”
His doctor suggested that he take full tests. She therefore did them: renal function, liver function and complete blood accounts. The verdict came as a blow. “You have a terminal kidney phase,” said the specialist.
Atim did not know where to place this sentence. Terminal step. It seemed so final. “You look at yourself and you are told that you have a chronic disease,” she said. “You see yourself die. I had hallucinations to be buried. I saw myself in a coffin. “
Holistic costs of kidney disease
In Uganda, kidney disease is not only a medical condition – it is a verdict with economic, emotional and systemic implications. The country accumulates slowly towards better care, thanks in part to pioneers like Dr. Robert Kalyesubula, one of the first nephrologists in Uganda.
When he started his profession 15 years ago, he was only the third in the country. Today, there are 13 kidney specialists and two others are expected. It is progress, but measured in relation to an increasing burden.
“About seven Ugandan out of 100 live with kidney disease,” said Kalyesubula.
This translates into 7% or approximately 3.2 million people – a statistic that may not seem extraordinary at first glance. After all, the world burden is heavy.
A 2023 report in nature revised the nephrology considered that 850 million people – one in 10 worldwide – Live with a certain form of chronic kidney disease. In the United States, the rate increases to 15% of adults; In Europe, it varies from 10 to 16% depending on the country.
But the prevalence tells only part of the story.
Inequality of health care
In high -income countries, there are safety nets: screening programs, subsidized treatment and specialized care. In a large part of sub -Saharan Africa, the same disease takes place without cushion or warning.
The World Health Organization already classifies a chronic kidney disease Among the 10 main causes of death in the world. The trajectory is alarming. By 2040, the researchers expect it to become it Fifth main cause of years of lost lifeexceeding many cancers.
Drivers are familiar: longer lifetime, increase rates in hypertension and diabetes and widespread and widespread Negligence of early detection. In countries like Uganda, where complete tests are still a luxury, the disease is often known only when the body is in full effort.
“Fifty-two percent of our patients come when they are already at the five stadium,” said Kalyesubula.
By then, the treatment is no longer medical alone – it is economical. Step five is the red zone: dialysis or death. Dialysis, in Uganda, will require four million shillings per month – around US $ 1,100, in cash on delivery – just to prevent the silent goalkeeper of the body from closing.
A transplant? This fantasy starts at 100 million shillings (about 27,000 US). This, in a nation where only 1% of the 23 million Ugandan who work earn more than a million shillings per month. Almost half survive with less than 150,000 shillings.
A condemnation to economic death
In countries like Uganda, kidney failure is not only a medical crisis, it is a condemnation to economic death. But the story of Atim did not end at the diagnosis.
She found herself in Griffe at survival – medical appointment twice a week, pill diets that swelled her cabin and a spiritual fog that refused to lift. Her saving grace came in a rare combination: a devoted husband, an unusually favorable employer and a doctor who did not simply treat it but stood next to her.
“Dr. Kalyesubula said to me,” You are still a young girl. Take me a donor, and we will find the money. God will help us, ”she said.
Atim found a donor. His sister advanced. His employer, moved by his history, urged her to go to the media – not to plead, but to plead in the event of a head office. Her husband’s workplace did the same. Friends, colleagues, family – They all mobilized.
“I was lucky,” said Atim. “Other people go to the media to beg. For me, my business said, “Come on, so that we can help you. »»
A new lease
The transplant took place in India in 2015. The morning of the operation, someone unexpected appeared at their bedside.
“I opened my eyes, and he was there – Dr. Kalyesubula. I didn’t even know he had stolen. It humiliated me, ”she said. “He had seen the journey through.”
For Kalyesubula, his work is a vocation. “One day, I was with my family at school-the day of the visit,” he said. “I had promised my daughter that I don’t work. But I received this call -“You are the one who must save me. I had to leave.
Uganda now has more than 300 dialysis machines – against only three when Dr. Kalyesubula began – and more than 25 centers have spread across the country.
Renal care develops, even slowly. However, transplants in Uganda remain rare and still count strongly on partnerships with hospitals in India. The selection process is tight: donors must be linked, young people and an almost perfect match. Atim knows how thin his chances were.
“If Dr. Kalyesubula had not insisted on a preventive transplant, I would have dialysis,” she said. “And with our income, it could have been the end.”
Instead, she recovered her life. She has gained weight. “From 40 kilos to 72,” she said, laughing. And she works full time.
Their link has increased beyond prescriptions and criticism. They speak every quarters, consult online and even joke as old friends. “We call ourselves” dear “-like a family,” she said. “We are even kidding now. He says he will no longer compete with me on weight loss – I always win. ”
Expansion of treatment for all
Kidney disease is still looming in Uganda, but progress is undeniable. More than 300 dialysis machines now serve patients in several districts. Transplants are possible – although limited to relatives of relatives – and awareness is increasing.
Dr. Kalyesubula does not mince words with regard to the role of the kidney in the body. “If it doesn’t work well, you’ll die,” he said. “Its importance is to do blood. Its importance is to eliminate toxins. Its importance is to control your blood pressure, regulate electrolytes, maintain your internal environment – so that everything else can work at all. ”
Consider him as the meticulous guardian of the body-partly concierge, the electrician in part, life support, he said. It rubs clean blood, balances the chemistry of survival and even directs circulation, ensuring that the blood rich in oxygen reaches the brain, the heart, the muscles. Without that, the delicate body machinery stops.
But here is the torsion: as only 7% of the country live with a kidney disease, he said, what do others do that they are not? Is it lucky? Genetic? Or something more banal?
The best treatment, it seems, is prevention. “Drink enough water, avoid excessive salt and alcohol, eat fresh fruit and food, move your body – do not carefully take over -the -counter medication,” he said. “And once you have clicked 30 – at least make a body balance once a year.”
Awareness
Prevention is a simple and inexpensive advice, but ignore it at a high price, especially in Uganda, where a diagnosis of kidney disease can disentangle the life of a person who works ordinary faster than the disease itself.
This is why Atim has become a leading leader in the silent world and a poorly served kidney patients in Uganda, sharing his story when asked, opening his pain so that others can find their way to theirs.
It has become an implacable defender of affordable drugs, the creation and distribution of awareness of kidney disease, the search for financing and forging partnerships in the hospital, all in the name of accessibility. It is a fight born of necessity. She knows too well the race of kidney drugs, the way in which they disappear from pharmacy shelves, the exasperating logistics of imports when the local supply is dry.
She still sees Dr. Kalyesubula Quarterly. She is still worried about infections and relapses. But she is alive and raises her son. She lives.
“The transplant gave me a second chance,” she said. “I think that’s what many people do not realize – it’s not about being whole. It’s about having time. A support system, and never to lose hope. Say to death, “not today”. And for me, that’s all. “
Questions to consider:
1. Why do fewer people in the United States die from kidney disease per capita than in Uganda?
2. What are the means to prevent kidney disease?
3. Do you think young people have to worry about diabetes?
