Different challenges, same mission

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ISN Educational Ambassador brings Colombia and India together to raise awareness about CKD prevention.

The ISN Global Outreach (GO) Educational Ambassadors Program now counts 123 “ambassadors” who willingly share their expertise with medical communities across the developing world. María Elvira Martínez from Colombia recently traveled half way around the globe to teach clinical nephrology to doctors and nurses in India.

In many countries, dialysis is simply unaffordable so María is committed to raising awareness about prevention. In January 2013, she became an ISN Educational Ambassador. She paired up with Leni Kumar from the Christian Fellowship Hospital in Oddanchatram. They had worked together via e-mail for almost three years. In March, it was time to finally meet her colleague and together train local doctors and nurses at his hospital.

She soon found out that daily challenges differed from those she encounters back home in her native Colombia at the Fundaciòn Universitaria de Ciencias de la Salud. “The hospital in Oddanchatram is located in a very poor rural area. Many patients suffer from renal tubular acidosis and electrolyte disorders. The causes are unknown, but we suspect they may have some relation with the use of some pesticides and/or poisonous weeds.”

María found the Indian doctors and nurses to be very dedicated: “They were eager to learn, attend lectures in nephrology, make rounds and participate in practical sessions on acid-base and electrolyte disorders.”

Her visit generated a great eagerness to find the causes of renal disease in patients with renal tubular acidosis, electrolyte disorders, proteinuria and chronic kidney disease (CKD). In addition, house officers realized the importance of calculating body mass index and eGFR to prescribe treatment for CKD in its different stages.

“There is not always a nephrologist available for consultation and dialysis is not available in many developing countries. Nevertheless, General Physicians, family practice and internal medicine doctors can manage many of these patients if they have adequate training,” she adds.

In a region of Colombia near the Pacific coast, María is helping set up program a CKD prevention program for patients with high blood pressure and diabetes. In this area, 90% of the population is black, with a high incidence of obesity and high blood pressure. The same issues are apparent in the native Colombian population on the country’s frontier with Brazil.

“It is heartbreaking to see so many patients with end-stage renal disease who have no possibility of renal replacement therapy due to a lack of funds. But, this reinforces my determination to work even harder on prevention,” she concludes.