Madaya doctor: 25 cases of acute kidney failure as a result of malnutrition

Ali Ghussun doesn’t have much time left. Four months ago, the 30-year-old Madaya resident began complaining of hip pain and difficulty urinating. When the few remaining medical workers in the besieged town northwest of Damascus ran tests, they handed Ali a grim diagnosis: kidney failure.

“The doctors say his days are numbered,” his sister, 31-year-old Rula Ghussun, tells Syria Direct’s Bahira al-Zarier. “They expect both of his kidneys to fail.”

Now, the former store owner lays in bed all day, too weak to move, and vomits constantly, Ghussun says. An intravenous drip pumps basic nutrients into Ali’s body, prolonging a painful existence.

Ali is one of 25 people in the past month to develop kidney failure, a consequence of severe malnutrition brought on by months of crippling siege, Dr. Mohammad Darwish tells Syria Direct. Darwish, interviewed below, is one of the last trained medical professionals serving the 40,000 people trapped in Madaya, surrounded by regime and Hezbollah forces.

Ali Ghussun. Photo courtesy of Mohammad Abd al-Wahhab. 

With landmines and barbed wire surrounding the town, precious few supplies can enter, and only with the regime’s authorization. Kidney failure, which left untreated is deadly but otherwise easily preventable, is now the latest effect of the blockade.

“The kidney needs vitamins, salts and proteins to continue functioning. Unfortunately, we don’t have these, and we now depend on beans, bulgur, rice and chickpeas for nutrients,” says Darwish.

For Rula, also interviewed below, this means she must watch hopelessly as her brother, the family’s sole breadwinner, dies. 

“We feel powerless to help him in any way.”

Dr. Mohammad Darwish, a dentist in Madaya and the town’s leading medical professional.

Q: When did the kidney failure outbreak begin? What caused it?

This outbreak didn’t begin in Madaya until about a month ago. We were unable to solve the problem before 25 people started getting kidney failure.

The large number of kidney failure cases was caused by the lack of nutrients here, and people’s weak immune systems. The kidney needs vitamins, salts and proteins to continue functioning. Unfortunately, we don’t have these, and we now depend on beans, bulgur, rice and hummus for nutrients.

When the kidney doesn’t have the nutrients it needs, it can’t function properly.

Q: What are the symptoms of kidney failure?

The symptoms of the illness are a reduced urination, and reduced ability of the kidneys to rid the body of water waste. This happens when the kidney doesn’t receive enough nutrients.  

The people who are suffering from this illness right now were initially suffering from kidney problems such as difficulty urinating and hip pain. We tell them to come in for tests and we try to treat them to the best of our abilities. There are some who improve and some who don’t get any better.

Q: What is the medical committee in Madaya able to do to help those with kidney failure, considering the siege?

We do whatever we can to help them. We give diuretics and catheters to help people who can’t urinate. We aren’t able to do any major [treatments]. However, improvement of the symptoms doesn’t usually mean they will get much better.

Q: Has the medical committee called on international aid organizations for help in getting the sick people out of Madaya? What has their response been? What will happen to people suffering kidney failure if they can’t leave?

We have called on many international aid organizations such as the Red Cross, Red Crescent and UNICEF.

They responded by saying they would look into the situation.

Without any response to our demands, the situation will be tragic. This is a life-threatening illness. It stops the kidney from functioning, which leads to death.

Rula Ghussun, 31, a woman living in Madaya whose 30-year-old brother Ali Ghussun, a store owner, is suffering kidney failure due to malnutrition.

Q: When did your brother begin to suffer from kidney failure?

The illness began four months ago, but he did not tell us until several days had passed.

Q: How did you find out it was kidney failure?

We did blood, urine and creatine [an acid that supplies energy to the body’s cells] tests with Madaya’s medical committee, then we sent a photo of the results to specialists outside this area through WhatsApp.

Q: How is the Madaya medical committee handling the situation? How did the doctors help your brother? Have they visited him?

The doctors are visiting him every morning and evening. There is nothing else they can do for him. There is no equipment to find out how much danger he is in, only that his creatine analysis says his situation is getting worse.

Because of the siege, he doesn’t have enough nutrients to improve his immune system, and we are under a lot of psychological pressure. There aren’t enough medical supplies coming into Madaya because of the security situation.

Q: What is the cause of the health crisis [in Madaya]?

The lack of aid due to the siege.

Q: How is your brother doing right now?

Today he is doing very badly. He is constantly vomiting and he hasn’t been able to hold down food for two weeks. For nutrients, he depends on an intravenous drip.

We feel powerless to help him in any way. We are suffering psychological trauma because of our powerlessness. I wish that he and others in the same situation could get into medical clinics for specialized treatment.

Q: What will happen to him if he can’t leave Madaya or get into a medical clinic?

He will have complete kidney failure, which means he we lose one of his kidneys. The doctors say his days are numbered, and he needs urgent help for his condition.

There is no equipment to fix his situation. They expect both of his kidneys to fail. 

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.

Madeline Edwards

Madeline Edwards graduated from the College of Charleston with a bachelor’s degree in International Studies and Political Science in 2016. She was a Critical Language Scholarship (CLS) recipient in Arabic in 2013. Her studies have brought her to Jordan, Palestine and Turkey.

Mohammed al-Aseel

Mohammad was a law student at Damascus University when the revolution began. Originally from Daraa, he moved to Jordan in 2013.