My First Dialysis Treatment

My First Dialysis Treatment in Mercy Clinic

The first time I came to Africa, I fell in love with a place. It seemed like there were so many opportunities. Accra Ghana is the capital city of the country of Ghana. I first went there in 2009 on a journey with my friend. At that time, I was working in hemodialysis as a biomedical technician. I had been involved in many aspects of hemodialysis for some time and I knew it well. Naturally, I wondered what kind of dialysis facilities they had in Accra. I went looking around for a dialysis clinic.

I found one,  it was primitive at best, but it was functioning. It was old, and probably not the safest for lots of reasons. But it was functional and people were getting treated. It seemed to me that a well run safe clean dialysis clinic was needed very much in Ghana so I put my mind to how I could make this happen.

After a lot of planning work and effort, I was able to get everything needed together to have a simple dialysis clinic. I acquired used dialysis equipment and refurbished it in my own workshop. Reverse osmosis machines, Dialysis machines, Sensors, filters, safety equipment. I put all my equipment neatly in crates, boxes, barrels and pallets then put it into a shipping container travel to Accra, Ghana by sea. 

The  clinic was to  be placed in a small hospital called Mercy clinic located in urban Accra. They were willing to partner with me.  Additionally, the medical director and owner Dr. A was an end stage renal disease patient. He did his own dialysis. He was excited to have me.

When all of the equipment finally arrived at the clinic, I took great care to put everything together safely. Water treatment, Plumbing, monitoring systems, chemical mixing, was put in place by me personally to American standards. It was safe, hygienic, and all equipment was approved for use in the USA, Ghana had no safety standards for hemodialysis treatments  so I brought the standards I used in America. 

Once all construction was completed and everything was assembled and tested, it was time to run Dr. A first dialysis treatment on my set up.  I became very nervous when the time came close.  I thought to myself, Alex you are about to suck this man's blood out of his body and return it back to him in a system that you built entirely on your own. If anything happens to this man, it's your fault. 

I told Dr. A about my trepidations and fears. I told him that I was nervous. He just laughed at me and smiled and said “everything will be fine.” He was not worried at all. I mean what I had was way better than what he was currently using. I am sure he was not worried at all. I was scared. 

I thanked him kindly for his support and genuine trust in me. I said “Doc, can it just be you and I in the treatment room and one nurse?”  I said i”f anything happens, I wanna be able to deal with it quickly and we don't need tons of people in there.” Doctor A chuckled as he normally did and said no problem. He assured me that it would just be him, myself and his private dialysis technician. He would make sure no one was there.

The docs' confidence in me made me feel better, but I was still pretty terrified. I think to myself who does this, am I crazy? Why did I tackle this endevor? What the hell was driving me? What am I doing here? 

Dr. A ran the hospital. He was a respected man in his country. He had even been a member of Parliament. He was a somewhat important guy. He trusted me implicitly and he told me that I should never worry he would be just fine. I was thinking to myself, if anything happens to this man on my machine, they might beat me to death right there. Dr. A feeds a lot of people. 

I had faith in myself so as time approached to do Dr. A's first dialysis treatment I calmed down. I have been running all of the equipment all day. All of the technical parameters, conductivity, pH, Bio, purity were safe. I said no big deal. I know my equipment is safe. 

I began thinking again Dr. A has been on dialysis for a while. He's an older man and he's not in the best of health. Even if my machines and equipment are working just fine. What if he had a heart attack or something on the machine. I was scared to death. My only comforting thought was that it would just be he and I and his Tech in the room. If anything happened, I could probably deal with it. 

Nervous as I could be, scared, I walked down the hall that led to the dialysis treatment room. My palms were sweating so bad. When I reached out to open the door of the dialysis clinic, my hands were trembling like a bridge in an earthquake. as I clumsily opened the door my sweating palms made my hand slip off the knob, I almost fell into the room..

As I entered the room, I looked around. There were about 20 Ghanians standing around waiting to watch. They were very excited to see Dr. A's first treatment on the new dialysis equipment I had brought. Word had gotten out about Dr. A's treatment. People were very excited, this was big news over there. 

Again, I peered around the room. My glance was greeted by many faces.  When my eyes connected with the eyes in one of these faces, There was a sensation of warmth and acceptance. I felt no fear or bad energy from anyone.  These people trusted me and these people had faith in me. They had complete confidence in what I had built. 

In the weeks leading up to this day, as I was building the clinic, I was out and about in the neighborhood of Mataheko, I met many people. I made friends with the people who sold me lunch. I made friends with the people who ran the spot down the street. People knew me. They knew what I was doing at their old neighborhood Mercy clinic. They were excited. 

Nervously, but now somehow reassured, I walked over to Dr. A’s treatment chair. He was sitting in the chair, smiling happily as he was ready to receive his treatment. I said “Doc what happened to our plan?” I said “I thought we weren't gonna have many people in here.” He just smiled his unique smile, and laughed and said “don't worry everything will be fine. Everyone's excited to see you work!!” 

Again, I looked around at the crowd. The room was not big. If any shit hit the fan, there would not be room to do much. I did not have complete control over the scene and there was nothing I could do about it. So I said to myself OK this is it.

Dr A’s private technician had already cannulated the doc's fistula. He was ready to go. Everything was ready to go. All the final checks were done on the machine. Everything was OK and he was ready to go.

As the technician hooked Dr. A to the machine and turned the blood pump,  slowly I watched Dr. A's blood leave his body and enter the saline filled blood lines then into the artificial kidney, finally back into the body from the bottom of the kidney.  It seemed like it was so slow. As I watched the artificial kidney turn gradually from clear to bright crimson. My heart was beating out of my chest. I was so scared. 

I had literally performed thousands of dialysis treatments, I’d seen this process a lot, but this was the first one I've done on my own. As the kidney slowly changed color from clear saline to crimson red of blood, Dr. A sat in his chair, still smiling. A few minutes had passed, we turned the blood pump Dr. A was fine. Everyone in the room clapped and cheered. Everyone in the room wanted to touch me and pat me on the back. I wanted to vomit, but all was well. 

All of the people in the room were impressed and very happy. 

Dr A’s treatment went wonderfully. After his treatment was over, he told me how much better he felt using our equipment and machine machines then he did using his own stuff. He said he could tell it was cleaner and smoother. He said he felt really good.

Everything went well all was well, from then we performed over 2000 dialysis treatments in sub-Saharan Africa. The environment was brutal resources are scarce, but we did over 2000 dialysis treatments!!