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When Samuel Kumwanje was diagnosed with a kidney disorder in 2004, his home country Malawi had only one dialysis unit located in the capital Lilongwe, about 330 km from the city of Balaka where he lived.

“This is the time I learned that affordability of dialysis services is limited for Malawians,” Samuel writes in the NCD Diaries project, an initiative launched by the NCD Alliance.

NCDs (short for noncommunicable diseases) are diseases that are not transmissible from person to person. They are the first cause of death and disability worldwide, accounting for 74% of all deaths and more than three out of four years lived with a disability.

NCDs are also a sustainable development issue. They have a disproportionate impact on people living in low- and middle-income countries and are both a cause and a consequence of poverty.

NCD Alliance leads and coordinates global advocacy efforts to maintain political momentum and action, and sustain focus on NCDs.

Born in 1976 in rural Malawi, Samuel started to suffer from problematic symptoms when he was 12. The symptoms included body pain, loss of appetite and vomiting, yet no one could understand the cause.

“A district hospital referred me for a checkup at a public hospital (at which services are provided free of charge), and my results were sent to the UK for further investigation,” he recalls. “However, no diagnosis was made because tests related to kidney performance were not conducted – an indication of lack of focus on kidney disorder in our health system.”

As a result, Samuel’s symptoms worsened.

“Without a diagnosis, I turned to herbals from the local communities that my father sourced,” he says. “I believe that these herbs may have worsened rather than solved my kidney condition.”

For years, the man continued to be misdiagnosed and prescribed the wrong treatments.

“Finally at NGO-run Likuni Mission Hospital, they diagnosed me with kidney failure because one of my sisters-in-law, who is a nurse, advised me to request a check of my kidney performance,” he remarks. “This was a private service covered by my Medical Aid Society of Malawi medical insurance, made available through my employer.”

Afterward, Samuel started to commute for dialysis. At that point, the Kamuzu Central Hospital, a government-run hospital in Lilongwe, only had four machines. As the number of patients in need of dialysis in Malawi increased, accessibility to treatment became an issue.

At that point Samuel and other patients decided to take action.

“We formed the Kidney Foundation – Malawi, an association to amplify the needs of people in the dialysis unit,” he says. “Among several objectives guiding the association, advocating with the Malawi Ministry of Health to prioritize renal conditions was one.”

While things for patients with chronic kidney conditions in Malawi have improved, there is still much work to be done. Currently, there are only two public hospitals in the country that offer free dialysis services, with few machines for many patients. Malawi has a population of about twenty million people.

“It’s not easy to live with kidney disorder when you are the breadwinner of the family, and it’s challenging when you are employed because you need to satisfy your boss while at the same time adhering to dialysis sessions,” Samuel says. “My goal is to shed light on the challenges that myself and people living with NCDs in Malawi face when it comes to affording care, in the hope for positive change around Universal Health Coverage.”

Read Samuel Kumwanje full NCD Diary.
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Image Credits: Courtesy of NCD Alliance.