Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Science and Society
  • Published:

Kidney care in Haiti—the role of partnerships

Nature Reviews Nephrology volume 11, pages 183–188 (2015)Cite this article

Subjects

Abstract

Establishing a programme for the prevention and treatment of acute kidney injury, chronic kidney disease and end-stage renal disease in a developing country involves unique challenges. We became involved in a collaborative effort to improve nephrology care in Haiti after participating in the emergency response to the 2010 earthquake. The focus of this ongoing project is overcoming barriers to implementation with the goal of improving training and resources for Haitian health-care workers and developing programmes for renal disease prevention and treatment in a setting of limited resources. Here, we offer practical advice for nephrologists who would like to help to advance medical care in developing countries. Rather than technical issues related to the prevention and treatment of renal disease, we focus on collaboration, education and the building of partnerships.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: The first patient to undergo dialysis at Hôpital St Therese, Hinche, Haiti, during the 2010 earthquake response.

References

  1. Portilla, D. et al. Lessons from Haiti on disaster relief. Clin. J. Am. Soc. Nephrol. 5, 2122–2129 (2010).

    Article  PubMed  Google Scholar 

  2. Gibney, R. T., Sever, M. S. & Vanholder, R. C. Disaster nephrology: crush injury and beyond. Kidney Int. 85, 1049–1057 (2014).

    Article  PubMed  Google Scholar 

  3. Vanholder, R. et al. Renal Disaster Relief Task Force in Haiti earthquake. Lancet 375, 1162–1163 (2010).

    Article  PubMed  Google Scholar 

  4. Vanholder, R. et al. When the earth trembles in the Americas: the experience of Haiti and Chile. Nephron Clin. Pract. 117, c184–c197 (2010).

    Article  PubMed  Google Scholar 

  5. Bartal, C. et al. Crush syndrome: saving more lives in disasters: lessons learned from the early-response phase in Haiti. Arch. Intern. Med. 171, 694–696 (2011).

    Article  PubMed  Google Scholar 

  6. Dartmouth Haiti Response. dartmouth.edu [online] (2010).

  7. Alasia, D. D., Emem-Chioma P. & Wokoma, F. S. A single-center 7-year experience with end-stage renal disease care in Nigeria—a surrogate for the poor state of ESRD care in Nigeria and other sub-Saharan African countries: advocacy for a global fund for ESRD care program in sub-Saharan African countries. Int. J. Nephrol. 2012, 639653 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Callegari, J. et al. Peritoneal dialysis as a mode of treatment for acute kidney injury in sub-Saharan Africa. Blood Purif. 36, 226–230 (2013).

    Article  PubMed  Google Scholar 

  9. Carter, M. et al. Acute peritoneal dialysis treatment programs for countries of the East African community. Blood Purif. 33, 149–152 (2012).

    Article  PubMed  Google Scholar 

  10. Chitalia, V. C. et al. Is peritoneal dialysis adequate for hypercatabolic acute renal failure in developing countries? Kidney Int. 61, 747–757 (2002).

    Article  PubMed  Google Scholar 

  11. Feehally, J. et al. Nephrology in developing countries: the ISN's story. Lancet 383, 1271–1272 (2014).

    Article  PubMed  Google Scholar 

  12. Finkelstein, F. O. et al. Peritoneal dialysis in the developing world: recommendations from a symposium at the ISPD meeting 2008. Perit. Dial. Int. 29, 618–622 (2009).

    PubMed  Google Scholar 

  13. Kilonzo, K. G. et al. Outcome of acute peritoneal dialysis in northern Tanzania. Perit. Dial. Int. 32, 261–266 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mahdavi-Mazdeh, M. The Iranian model of living renal transplantation. Kidney Int. 82, 627–634 (2012).

    Article  PubMed  Google Scholar 

  15. Muller, E., White, S. & Delmonico, F. Regional perspective: developing organ transplantation in sub-Saharan Africa. Transplantation 97, 975–976 (2014).

    Article  PubMed  Google Scholar 

  16. Okpechi, I. G., Rayner, B. L. & Swanepoel, C. R. Peritoneal dialysis in Cape Town, South Africa. Perit. Dial. Int. 32, 254–260 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  17. Perovic, S. & Jankovic, S. Renal transplantation vs hemodialysis: cost-effectiveness analysis. Vojnosanit Pregl. 66, 639–644 (2009).

    Article  PubMed  Google Scholar 

  18. Rizvi, S. A. et al. A renal transplantation model for developing countries. Am. J. Transplant. 11, 2302–2307 (2011).

    Article  CAS  PubMed  Google Scholar 

  19. Shaheen, F. A. Organ donation in the Middle East countries. Ethn. Dis. 19 (Suppl. 1), S1-16-7 (2009).

    PubMed  Google Scholar 

  20. Xiaoming, P. et al. Cost of two different therapies for end-stage renal disease in northwest China. J. Med. Coll. PLA 27, 80–86 (2012).

    Article  Google Scholar 

  21. Ministère de la Santé Publique et de la Population. mspp.gouv.ht [online] (2014).

  22. Jean-Baptiste, E. D. et al. Glucose intolerance and other cardiovascular risk factors in Haiti (PREDIAH). Diabetes Metab. 32, 443–451 (2006).

    Article  CAS  PubMed  Google Scholar 

  23. Jean-Charles, R. R. Challenges in hypertension: the Haiti experience. J. Clin. Hypertens. (Greenwich) 16, 97–98 (2014).

    Article  Google Scholar 

  24. Metayer, A. Du diagnostic a la prise en charge de l'insuffisance renale en Haïti en 2013. chamihaiti.org [online] (2013).

    Google Scholar 

  25. Reyes-Corcho, A. et al. Cholera gravis associated with acute renal failure in a traveler from Haiti to the United States. Travel Med. Infect. Dis. 10, 236–239 (2012).

    Article  PubMed  Google Scholar 

  26. Lameire, N. H. et al. Acute kidney injury: an increasing global concern. Lancet 382, 170–179 (2013).

    Article  PubMed  Google Scholar 

  27. Remuzzi, G. et al. Kidney failure: aims for the next 10 years and barriers to success. Lancet 382, 353–362 (2013).

    Article  PubMed  Google Scholar 

  28. Remuzzi, G. & Horton, R. Acute renal failure: an unacceptable death sentence globally. Lancet 382, 2041–2042 (2013).

    Article  PubMed  Google Scholar 

  29. Li, P. K. et al. Acute kidney injury: global health alert. Nat. Rev. Nephrol. 9, 133–135 (2013).

    Article  PubMed  Google Scholar 

  30. Chawla, L. S. et al. Acute kidney injury and chronic kidney disease as interconnected syndromes. N. Engl. J. Med. 371, 58–66 (2014).

    Article  PubMed  Google Scholar 

  31. Farmer, P. E. Shattuck Lecture. Chronic infectious disease and the future of health care delivery. N. Engl. J. Med. 369, 2424–2436 (2013).

    Article  CAS  PubMed  Google Scholar 

  32. The Dartmouth Atlas Project. Understanding of the efficiency and effectiveness of the health care system. The Dartmouth Atlas of Health Care [online] (2014).

  33. Partners in Health. Mirebalais: Hospital Construction Complete. pih.org [online] (2012).

  34. Luyckx, V. A., Naicker, S. & McKee, M. Equity and economics of kidney disease in sub-Saharan Africa. Lancet, 382, 103–104 (2013).

    Article  PubMed  Google Scholar 

  35. [No authors listed] The global issue of kidney disease. Lancet 382, 101 (2013).

  36. Kaushal, G. P. & Shah, S. V. Challenges and advances in the treatment of AKI. J. Am. Soc. Nephrol. 25, 877–883 (2014).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Zarjou, A. et al. Enabling innovative translational research in acute kidney injury. Clin. Transl. Sci. 5, 93–101 (2012).

    Article  PubMed  Google Scholar 

  38. Terzic, A. & Nelson, T. J. Regenerative medicine primer. Mayo Clin. Proc. 88, 766–775 (2013).

    Article  PubMed  Google Scholar 

  39. Turka, L. A., Wood, K. & Bluestone, J. A. Bringing transplantation tolerance into the clinic: lessons from the ITN and RISET for the Establishment of Tolerance consortia. Curr. Opin. Organ Transplant 15, 441–448 (2010).

    Article  PubMed  Google Scholar 

  40. Rastogi, A. & Nissenson, A. R. Technological advances in renal replacement therapy: five years and beyond. Clin. J. Am. Soc. Nephrol. 4 (Suppl. 1), S132–S136 (2009).

    Article  PubMed  Google Scholar 

  41. International Society of Nephrology. 0by25—an ISN human rights initiative. 0by25.org [online] (2014).

  42. Ackerman, M. & Locatis, C. Advanced networks and computing in healthcare. J. Am. Med. Inform. Assoc. 18, 523–528 (2011).

    Article  PubMed  PubMed Central  Google Scholar 

  43. Haiti Medical Education (HME) Project [online] (2014).

  44. Stimpson, J. P., Li, T., Shiyanbola, O. O., Jacobson, J. J. Financial sustainability of academic health centers: identifying challenges and strategic responses. Acad. Med. 89, 853–857 (2014).

    Article  PubMed  Google Scholar 

  45. Crisp, N. & Chen, L. Global supply of health professionals. N. Engl. J. Med. 370, 950–957 (2014).

    Article  CAS  PubMed  Google Scholar 

  46. Partners in Health. Haiti. pih.org [online] (2014).

  47. Binagwaho, A. et al. The human resources for health program in Rwanda—new partnership. New Engl. J. Med. 369, 2054–2059 (2013).

    Article  CAS  PubMed  Google Scholar 

  48. Docquier, F., Lohest, O. & Marfouk, A. Brain drain in developing countries. World Bank Economic Review 21, 193–218 (2007).

    Article  Google Scholar 

  49. Docquier, F. The brain drain from developing countries. IZA World of Labor [online] (2014).

    Google Scholar 

  50. Joseph, W. The effects of brain drain on Haiti. Digital Repository at the University of Maryland [online] (2011).

    Google Scholar 

  51. Soucy, L. PIH Haiti earthquake recovery—October2013 update: Young Haitian doctors begin medical residencies at University Hospital. Justgiving [online] (2013).

    Google Scholar 

  52. Ferris, E. Haiti three years on: overpromised and underdelivered. Brookings [online] (2013).

  53. PEPFAR. The United States President's Emergency Plan for AIDS Relief [online] (2014).

  54. Kickstarter, Inc. Kickstarter [online] (2014).

  55. United States Renal Data System. Annual Data Report 2013. Chapter 11: Cost of ESRD. USRDS [online] (2013).

  56. Singh, P. & Bhandari, M. Renal replacement therapy options from an Indian perspective: dialysis versus transplantation. Transplant Proc. 36, 2013–2014 (2004).

    Article  CAS  PubMed  Google Scholar 

  57. Alfred, J. P. What is the real cost of universal health care in Haiti? [French]. Sante Publique 24, 453–458 (2012).

    Article  PubMed  Google Scholar 

  58. Fink, H. A. et al. Screening for, monitoring, and treatment of chronic kidney disease stages 1 to 3: a systematic review for the U.S. Preventive Services Task Force and for an American College of Physicians Clinical Practice Guideline. Ann. Intern. Med. 156, 570–581 (2012).

    Article  PubMed  Google Scholar 

  59. Komenda, P. et al. Cost-effectiveness of primary screening for CKD: a systematic review. Am. J. Kidney Dis. 63, 789–797 (2014).

    Article  PubMed  Google Scholar 

  60. MSPP. Ministere de la Sante Publique et de la Population [online] (2014).

  61. Kenerson, J. G. Hypertension in Haiti: the challenge of best possible practice. J. Clin. Hypertens. (Greenwich) 16, 107–114 (2014).

    Article  Google Scholar 

  62. U.S. Department of Health and Human Services. Read the law: Affordable Care Act. HHS [online] (2014).

  63. Govindarajan, V. & Trimble, C. Reverse Innovation (Harvard Business Review Press, 2012).

    Book  Google Scholar 

  64. Dartmouth-Hitchcock. What is Population Health? Dartmouth-Hitchcock [online] (2014).

  65. Blumenthal, D. & Collins, S. R. Health care coverage under the Affordable Care Act—a progress report. N. Engl. J. Med. 371, 275–281 (2014).

    Article  CAS  PubMed  Google Scholar 

  66. PEPFAR. The United States Government Global Health Initiative Strategy. [online] (2011).

Download references

Acknowledgements

We would like to thank James C. Leiter, M.D., Geisel School of Medicine at Dartmouth, NH, USA, and Elaine L. Fleming, M.D., Dartmouth Hitchcock Medical Center, NH, USA, for their review of this manuscript and editorial assistance.

Author information

Authors and Affiliations

  1. Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, 03756, NH, USA

    Brian D. Remillard

  2. Faculté de Médecine et de Pharmacie, Université d'État d'Haïti, Polyclinique 17–19, 17 Chemin des Dalles, Port-au-Prince, HT6110, Haïti

    Jean H. Buteau

  3. Département de Médecine Interne, Hôpital Universitaire de Mirebalais, Route Départmentale 11, Mirebalais, Haïti

    Philip Cléophat

Authors
  1. Brian D. Remillard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jean H. Buteau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Philip Cléophat
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

B.D.R. and P.C. wrote the manuscript. All authors researched the data, contributed to discussions of the article content and reviewed and/or edited the manuscript before submission.

Corresponding author

Correspondence to Brian D. Remillard.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

PowerPoint slides

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Remillard, B., Buteau, J. & Cléophat, P. Kidney care in Haiti—the role of partnerships. Nat Rev Nephrol 11, 183–188 (2015). https://doi.org/10.1038/nrneph.2014.239

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2014.239

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing