Dialysis in Africa: a personal perspective on a demonstration project in Cameroon

Despite belief to the contrary, technologically sophisticated medical care can be established in developing countries. The process requires intense effort. Preliminary work must include resolving ethical dilemmas, acquiring adequate funding, establishing supply lines, and cultivating proper political support within the host country. Our organization, WORTH (World Organization of Renal Therapies) has successfully launched and is maintaining a dialysis unit in the sub-Saharan African country of Cameroon. So far our complications rate has been trivial, and our metrics indicate that we are successfully delivering safe, effective treatment that can preserve the lives of people with end-stage renal disease in a part of the world where medical care is laboring under difficult conditions. Work is about to begin in establishing a second dialysis unit in that country. We try here to delineate our experience, and we offer a direct challenge to other nephrologists to be activists in delivering modern, advanced technology medicine to more challenging places than those where it is currently flourishing.