Wake up with a better quality of life.
At 8 a.m. on a Friday morning, Heidy Valeska Mazariegos, accompanied by her mother, Florencia Mazariegos Macario, comes for her monthly check-up at the clinic for renal care, located in the city of Quetzaltenango. Heidy and Mrs. Florencia are from the municipality of Olintepeque, located 7 km from the departmental capital of Quetzaltenango, the second largest city in Guatemala, about 210 km from the country's capital city. Heidy is a single daughter, she married when she was 19, and soon became pregnant, but her pregnancy had severe complications and she suffered from pre-eclampsia on her sixth month of pregnancy.
“I was rushed to the hospital, and then I had an emergency C-section. My baby only lived four days and then died. As a result, the doctors told me that I had been left with chronic kidney failure”
Heidy's medical diagnosis was very complicated, when she was referred from an external IGSS nephrology consultation, she had severe hypertension disorder and seizures that occurred during her pregnancy, causing severe kidney damage. According to Dr. Jorge Luna Guerra, nephrologist, and director of the peritoneal dialysis program of Medicina Corporativa de Dialisis, S.A., Mrs. Florencia states that the news caused them great concern and sadness.
“Because one thinks that such a young girl, with the right to live, a young girl doomed to that situation, so difficult to accept. No mother or father wants their child to go through that experience” - Mrs. Florencia
Chronic Kidney Disease (CKD) means that the kidneys are affected and cannot filter the blood as they should. Currently, in our country, there are about 13,000 patients being treated for CKD and approximately 1.3 million people have not been diagnosed. A common cause of acute kidney failure in pregnancy is associated with preeclampsia. “As I had no discomfort at first, it was difficult to accept that I needed kidney treatment. But later, I began to feel a lot of discomfort, nausea, I had no appetite, I felt very tired, it made me sleepy, and I began to swell, that's when I realized that I needed treatment”, Heidy states. Initially, the patient began treatment with pills for almost two years. But,because of her deteriorating health, doctors told her that hemodialysis or peritoneal dialysis was necessary. In 2018, the Mazariegos family decided to start the treatment with peritoneal dialysis.
Treatment and innovations.
There are several types of treatments for CKD, including hemodialysis, which is a medical procedure that removes wastes from the blood using access to the circulatory system through a connection in the veins or through a catheter. Each session lasts three hours and takes place about three times a week. On the other hand, peritoneal dialysis is a treatment that uses the lining of the patient's abdomen or belly to filter blood into the body (peritoneal membrane). Heidy is treated with Ambulatory Ongoing Peritoneal Dialysis. This therapy consists of using this membrane and a dialysis solution is introduced through a catheter to remove impurities.
“This procedure, having fluid in the abdomen, draining it, and infusing a new solution is repeated in this modality specifically 4 times a day, 7 days a week. The patient can continue with normal activities and can perform the procedure at home” Dr. Luna emphasizes.
As part of the process of improving health services, the Guatemalan Social Security Institute (IGSS) has been leading an initiative since 2018. With the support of the United Nations, through the United Nations Office for Project Services (UNOPS) to incorporate innovations on kidney treatment.
“The Institute is promoting different services to improve the quality and coverage of accessibility for our renal patients. We have been working with seven highly specialized suppliers, our role in this process is to monitor that the services that are being delivered are of the best quality and on time. This inspection work is carried out with the support of UNOPS”, explains Lic. Ricardo Segura, Director of the IGSS SITA Administrative Integrity and Transparency Management Department.
Mrs. Florencia states that a couple of years ago, the treatment for her daughter was very expensive. “We had to go three times a month to Guatemala City. Sometimes for them to do us a favor and drop us off at the bus. We would leave the house at 1:30 in the morning, so that they would take us to downtown Quetzaltenango, to wait for the chicken bus to come by
because it was the only one that left early. Then, well, we went to therapy. Coming back home was the same thing” - Mrs. Florencia.
In the actions lead by IGSS is decentralizing these services. The goal of the Institute up to 2022 is to expand the coverage to 54 specialized centers or clinics, adds Lic. Segura from IGSS. The regionalization effort has the commitment of different specialized Social Security suppliers. One of them is company Medicina Corporativa de Diálisis, S.A., responsible for the Clinic in Quetzaltenango. Lic. Luis Pineda, General Manager of Medicorp states that “decentralization of these treatments is a great challenge for the companies that provide these services to IGSS. To this end, we have strengthened our main center in Guatemala City and have so far installed seven peripheral centers throughout the country. Innovations such as telemedicine and automated peritoneal dialysis have also been incorporated.”
“We started to embroider because the shirts are very expensive, the cheapest cost about Q1,200.00. Then, I decided to do my own. I bought the cloth and started embroidering. This is a hobby because I am also studying beauty and barber for haircuts, at the end of this year, I will be graduating. But my greatest interest is my health” - Heidy Valeska.
Heidy and Florencia are women entrepreneurs, they are known in their locality because they make handmade blouses. Doña Florencia is very grateful to Social Security because “it is an entity that works for humanity, with quality of life and service benefits. Moreover, thanks to the IGSS my daughter is alive.” The secret of the Mazariegos family is based on perseverance.
According to official data, there are 70 nephrologists in Guatemala to serve a population
of 19.6 million inhabitants. In addition, Guatemala has one of the highest rates in the world in the prevalence of CKD. This disease is characterized by its high levels of morbidity and mortality, and excessive socio-economic cost for the countries. Hiring hemodialysis and dialysis services, carried out by IGSS through UNOPS and the United Nations system, has been implemented since 2018, through four phases through 2023: benefiting 2,500 renal patients in 24 clinics and/or care centers nationwide.