Ongwediva is the place this week in Northern Namibia, a forum of doctors and dentists, the event within a plethora of rich scientific presentations, a small lacuna for a motivational talk.
Billed to speak is Dr Tsali Lithete,the Managing Director of Ongwediva MediPark Hospital, the private hospital that in March 2016, performed Namibia’s first kidney transplant surgical operation. But the journey started more than 15 months earlier, by which time, MediPark had grown its list of patients suffering from chronic renal failure and on renal dialysis from six to 40. A renal dialysis unit had already been set up through a partnership with Fresenius International, but both the patients and the leadership of MediPark brooded over what they called, the lack of an exit plan for these patients.
Subsequently, doctors of the hospital decided to venture into kidney transplant surgery, little realising that this would be the first such surgery in the country. Further, they would decide, perhaps, as a matter of pride, to make history by performing the operation not in the capital Windhoek, but in Ongwediva, home to 27, 000 people and district capital in the Oshana Region in the North of Namibia.
The staff
As it turns out, MediPark has a complement of 26 resident specialists in the following disciplines: Internal Medicine, Obstetrics & Gynaecology, Pediatrics, General Surgery, Anaesthesia, Radiology, Emergency Medicine, Neurosurgery, Orthopedics, Dermatology, Ophthalmology, Urology, and Plastic Surgery. Two local surgeons at MediPark, Drs Kaikai and Brown, with previous transplant experience in South Africa, proved to be catalysts to the whole idea, moving it from the realm of unattainable imagination into concrete reality.
Preparation
For starters, MediPark set up a transplant coordination team made up of a coordinator, physicians, surgeons, Radiologists, Pharmacists, Nuclear medicine, nursing, laboratories, psychologist, advocate, accountant, and staff from administration. In 2015, this team established a Renal Transplant Unit supported by SA Transplant at University of Witwatersrand Donald Gordon Medical Centre. This then ushered MediPark into a 15- month preparatory phase.
As part of the preparations, MediPark would fly a team to South Africa to join major transplant operations, while a team from the University of Witwatersrand Donald Gordon Medical Centre in South Africa would also visit to conduct periodic assessments and make recommendations for the systems that would support the planned kidney transplant. In due course, with technical expertise built, supporting equipment and supplies in place and an unquenchable will to proceed, MediPark was ready to execute.
Which Patient?
Selecting a patient out of its list of 40 was itself an interesting process, as being the first such surgery, the team was careful to set itself up for success by choosing a patient with minimal comorbidities.
In the end, they selected a 59- year- oldman who had suffered from chronic renal failure for ten years, including the last three on dialysis. This man received a kidney from his 29 -year -old son, whose kidney was harvested laparoscopically in a minimal invasive procedure that saw him going home after three days. Within 30 minutes of harvesting the kidney, the transplant operation was on in a carefully co-ordinated sequencing of events.
Post operation, the patient stayed in the hospital for a total of two and half weeks, and five months after surgery, both father and son are well and grateful. Currently, the hospital has lined up two more patients to be operated upon over the next three weeks.
Lessons
Among key lessons mentioned by Dr Lithete were the following; teamwork, need for public private partnership as MediPark signed cooperation agreements with the University of Namibia, Ministry of Health and Social Sciences and the Health Professionals Regulatory Agency of Namibia, among others. Dr Lithete expressed appreciation to the transplant coordination team, Professors from Wits University Donald Goldon Medical Centre in South Africa, local surgeons from Medipark Ongwediva, Drs Kaikai and Brown, Professor Amaambo and Dr A. Munyika from Onandjokwe Lutheran Hospital.
