Bringing aid to Mexico

(Edmonton) It took one trip to Guadalajara for Marcello Tonelli, associate professor and Canada Research Chair in optimal care for people with chronic kidney disease, in the Faculty of Medicine & Dentistry at the University of Alberta, to realize he needed to try and help people in the region who were suffering from kidney disease.

Tonelli says that non-communicable diseases like diabetes and heart disease, which often lead to kidney failure, are the biggest health problems facing developing countries. These problems are especially severe in Mexico, which has some of the highest rates of obesity and diabetes in the world.

In response to these problems, Tonelli partnered with fellow kidney doctor Guillermo Garcia at the Hospital Civil in Guadalajara to start an initiative aimed at helping these patients.

With money from the University of Alberta and the Hospital Civil Foundation in Guadalajara they bought and equipped a van to travel to remote areas and set up kidney disease screening clinics. So far, more than 10,000 people have been screened.

“[Mobile clinic health care workers] do blood work, check blood pressure and other screening tests,” said Tonelli. “If they find an abnormality then nurses refer the patient in for care at the clinic.”

This is where Tonelli’s expertise comes in. As a kidney specialist himself, he was already familiar with renal clinics in Northern Alberta, which are run by nurses in an effort to prevent further progress of kidney disease. Along with Garcia, the team translated treatment protocols into Spanish and trained nurses to look after patients in prevention of kidney disease, who now run the clinics like their Alberta renal clinic counterparts.

“This clinic has made a lot of difference in the care of chronic kidney disease patients,” said Garcia, who is making his first trip to Edmonton and the University of Alberta this week. “It is led by a nurse rather than a doctor, which is unthinkable in Mexico, but we get a good response. The nurses get the best reports regarding patient satisfaction.”

Garcia is currently in Edmonton for a week and will meet with other kidney specialists and administrators in the U of A community. He has already sent seven of his residents north for training, of whom Ricardo Orozco Castellanos is one, and he just wrapped up his fellowship this summer.

“It is very interesting to see the whole treatment go through because in Mexico the government cannot afford to sponsor the treatments,” said Castellanos. “You cannot see the whole process in Mexico.”

“They come here and see what prevention looks like,” said Tonelli. “They come here and see patients that are healthier because they’re not at death’s door when they come in. They see how nurses are empowered to run things on their own without input from a physician. They see a focus on prevention as opposed to end stage disease care.”

Tonelli’s work will continue with Garcia and the group at Hospital Civil. They’re currently working on converting one of the screening vans into a mobile clinic that can provide treatment on-site because Tonelli says that many people are found to have kidney disease but cannot afford to travel into the city to receive care. They’ll also do research to study efficacy of these mobile clinics.

“It may seem that research has no part in this initiative—but research that demonstrates the value of the clinics is a key part of getting buy in from local decision makers,” said Tonelli.

For Garcia, the hope is his partnership with the U of A can expand to other specialties like infectious disease or oncology.

“The International Society of Nephrology has listed the 10 leading nephrology programs in Latin America and one of them is my program; I think I owe that to the partnership with the University of Alberta.

“I’m really thankful and grateful to the U of A for the last six years,” said Garcia.