A Battle for Life

Emilio Jesús Rodríguez Hernández was 25 years old when he began to suffer from chronic kidney failure, which led him to require a transplant to survive the disease.

After several years of living with the kidney donated by his mother, new complications arose, forcing him to receive hemodialysis services at the Arnaldo Milián Castro Hospital in Santa Clara.

Thus, for 18 consecutive years, every Monday, Wednesday, and Friday, Emilio visits the aforementioned health institution to receive this treatment, on which his very existence depends.

Early in the morning, José Manuel Toboso, the Cubataxi driver in charge of his case, picks him up to take him to the hospital, where a bus led by nurse Ileana Rosa Cruz Gómez, whom everyone considers a true mother, is waiting.

"Imagine, I've spent most of my life here. If I'm telling this story today, it's thanks to the careful care of the doctors and nurses here, who are, to all of us, more than family." This is how Rodríguez Hernández expresses it, acknowledging the efforts of these specialists to overcome the shortcomings and difficulties inherent in these complex times the nation is experiencing.

"These are truly good people, who go out of their way to care for us, because we are very complex patients, a product of the disease itself," acknowledges one of the kidney patients who has been receiving this service in Villa Clara for the longest time.

"We know there are many resource limitations, but with the little that exists, we find solutions so this doesn't fail," says Emilio, who wonders what would have happened to him if he had to pay for this aid, and gives the example of two friends from Caibarién who decided to repatriate from the United States because they didn't have the necessary money to support their treatment.

In this regard, Iliana Rosa Cruz Gómez, who has headed the nursing services in that ward for more than 20 years, speaks highly of the work of the staff there.

"In order to care for the large number of patients who come here every day, we have five shifts, from Monday to Saturday; on Sundays, we only care for emergencies, which we do with great responsibility, because their lives are in our hands," explains Iliana.

"We grew fond of them so much that we suffered their suffering as if they were part of our family," says the experienced nurse in the Hemodialysis ward of the prestigious Santa Clara institution.

Regarding peritoneal dialysis and hemodialysis services in Villa Clara, Dr. Ailyn Machado Soza, head of the Nephrology specialty at the center, commented that this procedure is carried out in Santa Clara, Caibarién, and Sagua la Grande, municipalities where patients come from areas of the province that do not have this type of service.

"In total, 224 patients are receiving artificial kidneys, including three children. Nearly 40 pieces of equipment are already in high use, as are the water treatment plants. Everything works, thanks to the dedication and care of many people committed to the lives of these people," says the doctor.

In the case of Milián Castro, the province's main health institution, it treats the largest number of patients, 149 in total. They have 20 artificial kidneys, plus seven patients receiving peritoneal dialysis in their own homes, some manually and others automated.

THE DAILY CHALLENGE OF ENSURING LIFE

There may be rain, hurricanes, earthquakes, fuel shortages, or lack of funding, among other limitations; however, nothing has been able to prevent the approximately 3,000 patients receiving hemodialysis services and peritoneal dialysis every day from receiving the care they deserve in the extensive network Cuba has to offer, benefiting kidney patients.

In the face of the lack of resources and the policy of suffocation imposed on Cuba, the will of a country that has spared no effort to preserve and extend the lives of these people—including children—is growing, which, under the current conditions on the island, can be considered a true feat.

Keep in mind that the current price of an artificial kidney on the international market is approximately $20,000, and that, worldwide, a hemodialysis process can cost up to $46,000 annually, or about $200 per session.

As part of this effort, there are currently 56 hemodialysis services in the country, where patients needing dialysis attend three times a week. This approach is not only established in the provincial capitals but has also reached several municipalities, benefiting the health of those who previously had to travel long distances for treatment.

Today, Cuba has approximately 700 devices, most of which have been in operation for several years. There are also limitations on water treatment plants and dialyzers, the devices used to filter blood, as well as other supplies that are also in short supply.

To give an idea of the work carried out daily by doctors, nurses, and technicians who care for kidney patients, needless to say that, due to the limitations resulting from the economic blockade the country is experiencing, the purchase of dialyzers is currently being affected, and when they are purchased, they may not always be of the highest quality, which is detrimental to the patient.

Likewise, when proceeding, low-flow dialyzers must often be used, which do not filter the blood as effectively as a higher-flow dialyzer, not to mention the need to reuse them beyond what is established by manufacturers.

According to the literature, and medical standards, an artificial kidney must be used for approximately 30,000 hours; however, in Cuba's case, this period often extends to 60,000, causing the obvious ruptures that so frequently occur. 

Another impact caused by the persecution imposed by the United States through the blockade and more than 240 measures intended to stifle the economy and the services provided to the population is the lack of supplies, including arteriovenous fistula needles, of which two are needed per session and, since they are in short supply, they must be re-sterilized for reuse.

Although these are not the only main shortages, which also influence the current low results in transplant activity, the truth is that this is a service kept against all odds, because in Cuba, life comes first.

Translated by Amilkal Labañino / CubaSi Translation Staff