ISN Voices: The Caribbean
Some Caribbean states still have no nephrologists or nephrology services. Meeting and collaborating with colleagues in scientific research and enhancing training programs is why Everard Barton joined ISN.
“In Jamaica, there are only nine adult and two pediatric nephrologists. To help more patients, the Caribbean Institute of Nephrology, through the Department of Medicine at the University of the West Indies in Jamaica, has established outreach clinics to help rural patients. The focus is on recognizing kidney disease early and slowing progression to end stage renal disease.
The Caribbean Institute of Nephrology conducts screening programs and forums to educate the public. The Annual International Conference on Nephrology and Hypertension also brings together healthcare professionals from the Caribbean and the world, where ISN has sponsored speakers to attend. The Institute was instrumental in getting funding to start a dialysis unit in the central and southern part of the island, where there was no public unit. Some consultative assistance was given to other islands including Cayman, British Virgin, and Tobago.
In Jamaica, there is a predominance of hemodialysis treatment with a small number of patients on peritoneal dialysis. Home peritoneal dialysis (PD) is encouraged. More patients could be on PD if there was a more certain supply of consumables (fluids and lines). There are public dialysis units in Antigua and Barbuda, Anguilla, Barbados, St. Lucia, Cayman Islands, British Virgin Islands, Bahamas, Turks and Caicos. There are private units also in some of these areas. However, there is no transplantation and PD is non-existent or minimal.
Kidney transplants are carried out in Trinidad and Tobago, where peritoneal dialysis is also available. However, they are carried out sporadically in Jamaica. We hope to develop a sister transplant program since there is already an ISN Sister Program with the University of Michigan. This did not involve transplants.
The Caribbean Institute of Nephrology, through the University of the West Indies, has started a clinical training program in nephrology, with five nephrologists graduating since 2010. Assistance was given here through the ISN Sister Program with the University of Michigan. Dr. Davlin Dewar from Guyana trained in PD and transplantation in Australia in 2015 through the ISN Fellowship Program. So did ISN Fellow Kyaw Hoe who trained in PD in Mexico in 2014. ISN has also assisted two pediatric fellows from Jamaica to pursue nephrology training in Canada.
By developing a Caribbean Renal Registry, hypertension and diabetes have been highlighted as the leading causes of chronic kidney disease. More resources are now needed to engage regular data collection and personnel to enter the information.”
ISN Voices is updated weekly and showcases what ISN members are doing in their daily work, their opinions on specific topics, and how they are contributing to ISN’s vision of advancing kidney care worldwide.
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