As last dialysis center closes in east Damascus suburbs, patients prepare to die

On Thursday, the only dialysis clinic in the encircled east Damascus suburbs will close, leaving at least 31 acute and chronic kidney failure patients without treatment.

The facility relies on Syrian Arab Red Crescent (SARC) deliveries for dialysis supplies, the last of which occurred in October 2016.

Umm Salah, 60, is a kidney-dialysis patient who lives in Douma, the de facto capital of rebel-held East Ghouta. This week, she says, she began saying good-bye to her family.

Burdened by kidney disease for 13 years, Umm Salah needs dialysis three times a week. Her last session was on Wednesday.

“I don’t have hope that I’ll survive, unless medical supplies are delivered,” Umm Salah tells Syria Direct’s Bahira al-Zarier. “But it’s impossible for that to happen now.”

“The only solution for kidney failure patients is a delivery of dialysis supplies,” says Dr. Najam a-Shami, who works at the clinic that treated Umm Salah.

“Otherwise, we’ll watch them die slowly in front of our eyes.”

Dr. Najam a-Shami is a general practitioner at the hemodialysis clinic at Damascus Countryside Specialized Hospital.

Q: How much longer will the clinic stay in operation? When will you run out of dialysis supplies?

We have enough dialysis supplies to stay open until Thursday. We’ve already reduced the number of dialysis sessions per patient to once a week, so we could stay in operation this week. But after Thursday, we’ll have to close.

 Dialysis clinic at Damascus Countryside Specialized Hospital. Photo courtesy of Douma Medical Center.

Q: Have you contacted international and humanitarian organizations for support? 

We contacted the Damascus countryside branch of the Syrian Arab Red Crescent (SARC) and the Syrian American Medical Society (SAMS) and told them to inform the World Health Organization, which is responsible for deliveries.

Until now, we haven’t received any response regarding when supplies will be delivered.

Q: According to a February 10 Douma Medical Center statement, there were 18 kidney failure patients in East Ghouta who relied on dialysis for treatment as of last October. Today, this number has risen to 31. Is this because of the siege?

Yes, because of the siege, which has caused malnutrition and medicine shortages. Also, some patients are experiencing kidney failure due to shelling-related injuries.

Some shelling injuries cause large bruising on the body, which results in muscle damage. This can lead to acute kidney failure, which becomes chronic due to lack of medicine and our limited ability to perform medical procedures.

Q: You have reduced dialysis sessions to once a week per patient. How might this affect the health of your patients?

Reduced treatment will negatively impact their health. When medical shipments were delayed in the past, some patients died after their health deteriorated.

[Ed.: In February 2016, two patients died of kidney failure after the clinic closed for 10 days, Syria Direct reported at the time.]

Q: How many kidney failure patients are there in East Ghouta? How many are critically ill and could die if dialysis treatment is completely suspended?

As of February 13, there are 151 patients with kidney failure. Only 31 currently need dialysis. The remaining patients, however, need medicine, which isn’t available.

Two patients risk immediate death if we stop dialysis treatment.  

There are no preventative measures for patients, especially those who need dialysis two or three times a week. And now, we’re about to completely cut off treatment.

Unfortunately, the only solution for kidney failure patients is a delivery of dialysis supplies. Otherwise, we’ll watch them die slowly in front of our eyes.

**

Umm Salah, 46, is a kidney-failure patient at Damascus Countryside Specialized Hospital. The mother of four has had kidney failure for 13 years, and needs dialysis treatment three times a week. Due to the shortage, February 15 was her last dialysis session.

Q: When did you start dialysis treatment?

When I first developed kidney failure, I took medication, but it wasn’t that effective and I kept getting shooting pains. I eventually started dialysis treatment in 2013.

This was also when the regime’s siege of Ghouta—and my suffering—began. For four years, I haven’t been guaranteed treatment because of the siege and medical shortages. Each time my doctors tell me that this is the last time they can clean my kidneys, I feel like I’m one step closer to death.

Q: How did you feel when your doctor told you that Wednesday was your last dialysis session?

When the doctor told me that the clinic ran out of dialysis kits, I cried with anguish about my situation. I know that without dialysis, I’ll die.

All the doctors in the clinic grieved about my situation. But they told me not to be sad, and that perhaps another shipment of dialysis kits would be delivered.

Wednesday was my last day of treatment. I started saying goodbye to my children, my husband and my relatives. I don’t have hope that I’ll survive, unless medical supplies are delivered. But it’s impossible for that to happen now.

I felt like the only reason we’re here in Ghouta is to get bombed, fall ill, or die. The sense that death is very near crushes one’s spirit. 

Bahira al-Zarier

Bahira is from Damascus. She studied business and marketing before moving to Jordan in 2013. She did volunteer work in support of many refugee organizations before joining Syria Direct.

Eyad mohammed Madhar

Eyad is from Outer Damascus and graduated with a BA in Philosophy from Damascus University. He worked as teacher in Syria before moving to Jordan in 2012. Eyad was also active in the theater community in Syria.

Shefaa Yasin

Shefaa is 24 years old and studied English Literature in Jordan. She joined Syria Direct to help her people’s voice reach the international community.

Jessica Page, Reporter/Translator

Jessica was a 2013-2014 Georgetown University Qatar Scholarship Program fellow in Doha, Qatar. She received her BA in both Arabic and International & Area Studies from Washington University in St. Louis. She has worked and studied in Jordan, Oman, and Qatar.

Kristen Demilio

Kristen Gillespie Demilio has more than 10 years of experience reporting from the Middle East while based in Amman. She regularly contributed to news outlets including CBS News Radio, NPR, The Jerusalem Report and PBS and is a graduate of Columbia University's Graduate School of Journalism as well as the Institut Français des Etudes Arabes in Damascus.