Serving patients in Swaziland

Life-saving dialysis care is being brought to a growing number of patients in the small southern African nation of Swaziland, thanks to a clinic run by Fresenius Medical Care.

(Published: August 2018)

Located inside Mbabane Government Hospital, in Swaziland’s capital city of Mbabane, the clinic operates as a public-private partnership (PPP) and, since expanding, has almost 180 hemodialysis patients. It is administered by Fresenius Medical Care South Africa, which is based near Johannesburg, about 250 kilometers (150 miles away).

The Mbabane clinic’s history dates back to March 2007, when a renal unit opened at the hospital: at the time, hemodialysis was performed in intensive care, but due to a steady increase in the number of patients a separate dialysis unit was opened in 2009. Fresenius Medical Care took it over in June 2014.

Running a sole dialysis clinic in a remote, developing country is not simple. Swaziland – whose King Mswati III has renamed the country “the Kingdom of eSwatini” – has its own regulatory framework, and because dialysis products must be imported there can be complications surrounding border formalities. The health challenges are enormous in the nation of just 1.3 million people. At only 52 years, Swaziland’s average life expectancy is among the lowest in the world. Swazis also have one of the world’s highest rates of HIV infection, which often leads to renal disease. Funding available for health care is limited.

"The Fresenius Medical Care dialysis center has brought a lot of positive change in renal care."

 

Yet despite these difficulties, the clinic’s Medical Director, Dr. Thandiwe Dlamini, is optimistic. She credited the Swazi government for providing universal dialysis access to citizens, and praised members of her team as well as outside organizations for raising awareness about kidney disease in Swaziland. This has led in many cases to earlier detection that has made it possible to slow the progression of kidney disease inpatients, she said.

“The dedication and willingness to learn of medical officers rotating through nephrology has led to an increase in the number of doctors comfortable with the management of acute and chronic dialysis patients at the hospital,” said Dr. Dlamini, who is a specialist physician and nephrologist. “The dedication of the dialysis nursing team has been very inspiring, and instrumental, in the improvement of services offered to the patients.”

The Mbabane clinic has brought a high standard of dialysis care that has reduced mortality and increased patients’ quality of life, said Registered Nurse Ntombecane Hlatshawayo. For many families it has also meant improved living standards, since most of the patients are breadwinners. High-quality dialysis makes them more capable of holding down steady employment.

“It is of the utmost importance to acknowledge and appreciate the establishment of the Fresenius Medical Care dialysis center in Swaziland, as it has brought a lot of positive change in renal care,” she added.