As head of NMCH’s Renal Unit, Dr Cecil Levy is responsible for one of the largest paediatric dialysis units in the country. In this interview, he talks about the great strides NMCH has made in only a year to ensure that South Africa’s children have access to world-class renal treatment and care.
“I’m very blessed to be at NMCH as the dialysis unit is a state-of-the-art facility and I work with excellent staff,” says Dr Levy.
Dr Levy works closely with nephrologist, Dr Tholang Khumalo with the assistance of Sister Beauty Sangweni and her team of specialised nursing staff.
“We work in tandem with our nurses so we are able to provide a really good service to our young patients.”
The Renal Unit at NMCH adopts a holistic approach and uses both peritoneal and haemodialysis to treat patients with renal failure, be it from congenital or acquired causes of kidney disease.
“With haemodialysis you take blood out of a patient, pump that blood through a filter which cleanses the blood and then pump the blood back into the patient,” says Dr Levy.
Patients who receive this treatment require a nurse with them all the time and will usually need to visit NMCH three times a week for three or four hours. Luckily NMCH has teachers and volunteers who visit the children and help with their schoolwork.
When it comes to peritoneal dialysis, Dr Levy explains, “We put the fluid into the abdomen through a plastic catheter [pipe] that is inserted through the front of the abdominal wall and then the inner abdominal lining acts as a filter between the fluid and the blood.”
Peritoneal dialysis is done at home on a machine that is easy to use, and patients that are using this mode of treatment will only need to come to the hospital once a month.
“The problem is that patients often can’t do peritoneal dialysis for many years if they get recurrent infections. We start all of our children on peritoneal dialysis but as time goes on, if they’re waiting too long for a kidney, eventually the peritoneal lining of the abdomen fails and they need to move on to haemodialysis,” says Dr Levy.
Care that goes beyond clinical treatment is also a critical component of the delivery of a quality service to patients in the unit.
“Some of our patients have major social problems. They often come from indigent families and either their parents have jobs and so they can’t attend the clinic with the child, or they don’t have jobs and it’s too expensive to come to the clinic,” says Dr Levy.
Dr Levy stressed that everyone works together at NMCH and this gives the patients an advantage.
“We get input from everyone. We work closely with the hospital social workers as well as dieticians to mitigate some of these challenges,” he says.
NMCH is proud to boast the latest, cutting edge equipment when it comes to treating children with kidney disease.
Dr Levy’s eyes light up when he speaks about the Renal Unit’s technology.
“We’ve got top of the range machines which allow us to dialyse a large number of children. We have an amazing computer system that tracks what we’re doing in real-time, online, the whole time. This allows us to keep a careful eye on how the child is doing over a period of time as it stores all that data,” says Dr Levy.
He added, NMCH is one of the few hospitals that have access to this computer system.
As the ideal treatment for renal failure, Dr Levy emphasised the need for kidney donations and urged people to educate themselves about the process.
“There’s a huge shortage of organs nationwide, and there’s a lot of ignorance and fear about donating an organ; a live organ and certainly a deceased donor organ where the family just don’t want to give permission for the use of the organ after death.
“When we talk about live donor transplantation, we’re talking about an adult who’s above the age of 18 years, who’s able to give consent. You can put an adult kidney into a child from the age of one year who has a body weight of around 10 kg. When an infant needs a transplant, the parents are usually the best match,” says Dr Levy.
Kidney dialysis is sub-specialised care and exceptionally expensive.
NMCH therefore relies on donations from the public to ensure that more children receive treatment.
“People must remember, they really are donating it to a child who doesn’t really have the money or the capacity or the understanding to be able to do something for themselves.”
This month, you can support our Renal Unit at NMCH to ensure more children suffering with chronic kidney disease can get the care that they need. Click here to find out how you can help https://bit.ly/2H7RWeG.