History in the making... Guyana's first kidney transplant

All is set for 18-year-old Munesh Mangal of Lusignan, East Coast Demerara to undergo kidney transplant surgery at the Georgetown Public Hospital today.

The surgery will hopefully help him to survive the renal failure he suffered years ago because of
hypertension.

The surgery
The surgery will be performed by a team of local and overseas doctors, who will transplant a
kidney from Munesh’s mother, 41-year-old Leelkumarie Nirananjan Mangal, to Munesh. The
overseas medical team is being led by Attending General Surgeon at the Brookdale University
Hospital, Indian-born Dr Rahul Jindal, and includes Dr Edward M. Falta, Transplant Surgeon of
the Walter Reed Army Medical Centre (WRAMC), Washington; Dr Melenie Guerero,
Pulmonary Care Physician, Laura Owens, Transplant Coordinator, and Dr Arthur L. Womble,
attached to the Athens-Limestone Hospital, Athens, Alabama.
They arrived in Guyana last Thursday, and have since met the local supporting team of doctors,
nurses and technical and administrative staff who have been actively involved in the procedure to
fine-tune all details for the surgery.
The local team includes Dr. Ravi Purohit (Surgeon), Dr. Ramsundar Doobay (Consultant,
Internal Medicine), Dr. Anita Florendo (Registrar, Internal Medicine), Dr. Vivienne Amata
(Anaesthesiologist), Dr. Pheona Mohamed-Rambaran (Laboratory Director), Mr. Delon France
(Medical Technologist) and Dr. Wilson (Radiologist).
On Thursday, the teams also met with the patient and donor, who are currently in the High
Dependency Unit (HDU).

The surgery is expected to last for eight hours. Yesterday, preparatory works were done for both
patient and donor, including dialysis.

Munesh’s illness
According to the mother, her child has been sick for most of his childhood, but in 1995 he began
crying out for chest pains and suffering from shortness of breath.
However, his condition took a turn for the worse last year, preventing him from attending classes
at the Apex Academy, where he was preparing to sit the Caribbean Secondary Schools
Examination.
Munesh was diagnosed with End Stage Renal Failure last October while he was a patient at
GPHC’s clinic. It was then that the mother decided to undergo preliminary tests to determine her
chances as a possible donor to her son.
After numerous tests, she was confirmed a positive match, she said, adding that it is a privilege
for her to be able to give her child one of her kidneys.
The single parent noted that, during her child’s illness, life has been difficult because of high cost
of dialysis treatment, which he initially required three times weekly, and now twice weekly. She
was also forced to stop vending in an effort to care for her only son, who in recent times was
reduced to the stage of infancy, as she had to take care of him as she would a baby.
The patient also required special diet. However, she noted, many kind-hearted persons and
corporate entities have assisted her with the cost of treatment.
She said that knowing the surgery will be performed free of cost is a relief, because a financial
burden will be lifted from the family’s shoulders.

Asked about her anticipation of the surgery, the mother of two said she is not worried, but is
praying. She is confident “everything will work out fine for herself and son.” Minister of Health, Dr. Leslie Ramsammy, announced last May that Guyana will have its first kidney transplant done locally on July 12, 2008, marking yet another milestone for the health sector.

According to the minister, this latest step forward will hopefully reduce the number of persons
who have to travel abroad to take care of renal failure (kidney failure).
He noted that many kidney problems result from diabetes, and patients in the past did not have
an option locally once it was determined that dialysis could not work. “We have a dialysis centre
here, but dialysis is a stop-gap. It does not work for some people, and they need transplant,” he
explained.

Minister Ramsammy noted that this new development augurs well for progress in the local health
sector.

“The Ministry of Health has been working to improve the quality of services it provide now, and
also to add new services. This is another history-making event at the GPHC.
“Being able to do our first kidney transplant operation in Guyana provides us with yet more
evidence that the GPHC is being transformed into a world-class hospital,” he said.
On this note, the minister highly commended the overseas medical team, the members of which
have volunteered their services to conduct this surgery, as well as other stakeholders.
“We are grateful to the team of doctors who have made this possible, and to the Guyanese who
have contributed financially to enable the team to come to Guyana,” he added.
Meanwhile, the Chief Executive Officer of GPHC, Michael Khan, said that the institution is once
again proud to be associated with such a defining moment, not only in the health sector but
Guyana’s history.

He assured that the local medical team is fully prepared and ready for the surgery, and he is
optimistic that everything will go according to plan.
Mr. Khan added that the GPHC has been the birthing ground for a lot of firsts for Guyana,
including the first open heart surgery, performed in October 2007, and the first retinal
detachment surgery a few months before.
He expressed appreciation for the overseas team’s generosity in performing the surgery free of
cost, and is looking forward to future collaboration with the group.
The team includes businessman George Subraj and his son, Tony; Lakeram Persaud, Jas Persaud
and Kewan Totaram, as well as Caribbean Airlines, which sponsored the tickets for the visiting
persons.

According to Mr. Khan, the exercise will benefit the local doctors tremendously, and it is hoped
that very soon they will be able to perform such surgeries with little or no outside assistance.
He gave the assurance that Mrs. Mangal and her son will be given the best post-surgery care to
ensure that their road to recovery is smooth and incident free.

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