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LACK OF HEALTH LEGISLATION KILLING EMASWATI

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MBABANE – According to recent reports compiled during World Kidney Day in March, 200 people died in 12 months due to chronic kidney disease (CKD).

It was reported that these were often people who were on dialysis but struggle to afford the high cost of reaching facilities where the treatment is available. However, it has also been gathered that some patients can afford to travel to other countries such as South Africa (SA) for kidney transplants but this is expensive. Even those who can afford sometimes fail to get donors since the law in the neighbouring country does not allow the donation of organs to foreigners.

An earlier report obtained from the Institute for Health Metrics and Evaluation for 2019 revealed that CKD is among the top 10 causes of death in Eswatini. Further, on World Kidney Day, it was reported that there are 298 people undergoing haemodialysis. However, the service is only available at Hlatikhulu, Raleigh Fitkin Memorial (RFM) and Mbabane Government hospitals. This makes it difficult for people living in rural areas to be assisted, resulting in them turning to non-effective herbal treatments.

Also, it was reported on World Kidney Day that about 34 emaSwati do dialysis at home.
The American Centres for Disease Control (CDC) and Prevention describes it as a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke.

Save

Though Eswatini can afford the expertise in terms of doctors and equipment to carry out kidney transplant and save hundreds of lives, this is not available in the country. This is because there is no legislation currently allowing medical experts to carry out organ transplants. Currently, The He- alth Bill of 2022 is still being debated and submissions are said to have been made regarding organ transplant. However, according to Khosi Fakudze of the Eswatini Kidney Foundation, many lives could be saved if kidney transplants could be done.

Donate

Fakudze also revealed that there were instances where emaSwati travelled to SA for a kidney transplant but it was a lengthy process. She said one had to find a relative who was willing to donate an organ. Also, she said the laws did not allow people above 60 to be donated organs. Fakudze said the South African law for transplants was tough so that people were protected from being trafficked and their body parts used.  She said if the Health Bill was to be enacted, this would be a big benefit for people suffering from CKD. Fakudze said it was cheaper than dialysis or sending the patients to other countries for treatment.

Also, she said the important thing, for now, was to educate the public about organ transplant. She said many emaSwati had not been educated on organ transplant and that they did not know how this functioned. “This should be done before the Bill is made into an Act,” said Fakudze. She said organ transplant required what she referred to as a ‘cadaver donor’. She said a person whose body would be used as a cadaver donor needed to consent before their death that they would donate their body part to help someone.

For people who are HIV positive and taking antiretroviral (ARV) drugs, organ transplantation treatments may not be all that good news.
According to Fakudze, when an organ is transplanted into another person, the new organ could be rejected by the host body. She said this was because normally, a foreign body was usually rejected. Fakudze said this was the body’s immune system trying to remove a foreign body. She said for someone who was HIV positive, it would mean that this could be risky because one would have to have a very low immunity system to accept a donated body part. She said this was difficult for some who were already taking an immune booster. Meanwhile, very few African countries have the legislation to allow organ transplants. On the continent, only the Ivory Coast, South Africa, Seychelles, Sudan, Nigeria, Namibia, Kenya, Ethiopia, Ghana, Mauritius, and Tanzania do organ transplants.

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