END STAGE: DIALYSIS PATIENTS IN INDIA
End Stage: Dialysis Patients in India
Chronic kidney disease, or CKD, is a scourge of the rich world generally caused by diabetes, high blood pressure or obesity. An alternative form of CKD however, is finding it’s way into the developing world. Known as chronic kidney disease of non-traditional causes, or CKDnt, victims are mainly agricultural workers, low wage earners and rural folk. This growing epidemic is thought to be occupational and environmental, not lifestyle caused, and it’s creating an alarming new medical problem that doctors around the world are barely aware of, have not figured out the cause of or found a way to prevent it.
In Central America alone, more than 20,000 people have died or contracted this illness over the past two decades. I recently went to southeast India with a team of researchers to the states of Andhra Pradesh and Tamil Nadu, to investigate if this illness is occurring there. What we found was that it not only exists but that it may go largely undetected. And often by the time it is diagnosed in a patient, it’s too late. They face a shortened life, surviving only on dialysis, which causes a reverberation through the family and community.
While the Indian government and private doctors, clinics and hospitals are trying to expand the number and geographic scope of dialysis centers in the affected areas, it’s often inadequate. More troubling is the economic impact and stigma associated with this disease, often rendering a family helpless while trying to keep their loved one, often a man and the breadwinner, alive at all costs. We witnessed their children’s dreams of education dashed with the burdens of paying for dialysis, in turn often forcing them into work to support the family.
End Stage is a series of “portraits” of patients in dialysis clinics that I encountered during my recent trip to India. They represent the poor people that are being victimized by this pernicious disease, which is probably multi-causal but clearly associated with the rural working class.
This series purposely does not include the names of the people or any identifying information. Only that they share the same fate, end-stage kidney disease, which makes them dependent on dialysis to stay alive, injures their families and loved ones and ultimately is a death sentence.