From dialysis to kidney transplantation, hopes and challenges

James Robert Chuwa, 39, from Tanzania, shares his story as a kidney patient and recent kidney transplant recipient. He describes the challenges he faced both professionally and personally, as well as the financial burden of being a dialysis patient with no health insurance to cover the costs.

My name is James Robert Chuwa, age 39, Tanzanian, and married with three children. I received a kidney transplant on 06 October 2022 at Muhimbili National Hospital in Dar es Salaam Tanzania. Ms. Joyce Chuwa, my cousin’s sister, was my kidney donor. 

My CKD journey began in June 2014, when I noticed that even simple activities like climbing two flights of stairs were tiring me out. Later, the doctor diagnosed me with high blood pressure. I was prescribed blood pressure medications and eyeglasses, but the fatigue persisted.

In March 2017, My condition worsened when I developed chest pain and breathing difficulties. I had my blood tested at the hospital and discovered I had kidney issues due to high creatinine (866 mmol/l) and urea (29.4 mmol/l) levels. I was referred to a nephrologist who, after several tests, confirmed that I was suffering from kidney failure. He advised me to change my lifestyle and to take medication to slow down the progression of kidney failure.

On a personal level, I got married when I was 23, but divorced at 32, two years before developing kidney failure. My first marriage ended, leaving me with overwhelming stress and three children. I was unable to cope with the situation and resorted to drinking alcohol. In 2016, I married my current wife, Neema Chuwa.

In March 2019, I lost my job due to frequent illnesses which my employer could not tolerate. As a result, I also lost my health insurance (National health insurance fund NHIF). Afterward, I started my small business to support my family and my medical problems.

In November 2021, I started hemodialysis, paying USD109 per dialysis session. I subscribed to a health insurance package. However, this package did not cover the dialysis treatment. Due to financial constraints, I was only able to attend two dialysis sessions per week instead of three.

Early this year, in February, I organized a clan meeting to discuss the need to find someone within a clan who could donate a kidney to me. My two brothers went to the Benjamin Mkapa Hospital in Dodoma and the Muhimbili National Hospital in Dar es Salaam to get tested. It turned out that they were both pre-diabetic, and therefore, they were unable to donate. Joyce Chuwa, my cousin’s sister who works in Australia, decided to donate one of her kidneys to me. We started the workup tests on May 20, 2022, and completed them on June 16, 2022. However, we had to wait a long time for the transplant date due to a shortage of consumables for kidney transplants at the hospital.

On October 6, 2022, our local team of doctors at Muhimbili National Hospital performed the transplant successfully.

Knowing that you may never be able to find a kidney donor is a difficult and frightening situation.

Our society lacks proper information on donation issues, causing them to be poorly understood. There are numerous false beliefs and myths about donation. People are still unaware that donating a kidney is safe due to intensive check-ups before donating.

The cost of a kidney transplant at MNH is around $12,000, not including the cost of immunosuppressant medication, which I must take for the rest of my life and costs around $650 per month. Many of us cannot afford this cost, especially if we don’t have health insurance. 

I am thankful to the Muhimbili renal transplant unit for consistently providing donors and their patients with proper donation education. I am also grateful to my family and friends for their unwavering support.

My gratitude goes to the Muhimbili Renal unit and transplant team. To mention a few: Dr. Onesmo Kisanga, Dr. Jonathan Mngumi, Dr. Jacqueline Shoo, Dr. Gudila Shirima, Dr. Kim Njiku and the team of surgeons, Dr. Ester Mtinangi, Dr. Dan Msilanga, Sr Elizabeth Stephen and all renal ICU nurses, Sister Pilly Kidunda, Sister Neema Mpogolo.