| Gabriel is a college-level teacher from Chapala (62 kilometers from Guadalajara). He was diagnosed with kidney disease in 2008 and put on peritoneal dialysis (PD). For this, his family constructed an extra room from plywood within the existing space of their living room, at great personal cost. This had to be specially painted, kept immaculately clean and equipped with microwave, weighing scales and countless boxes of dialysate solution.Gabriel's teaching job should guarantee IMSS insurance but he was told he would not be covered as his CKD was pre-existing. This, however, was not correctly communicated, but instead reflected a failure within his school to understand and explain adequately his level of social protection. To assist with the ensuing costs, support was provided by a relative who ran a local clinical laboratory, and gave them credit on medical tests. Further help was given by families, who had lost a member due to CKD, by establishing an informal distribution network of unused solution, disinfectant and medications.After three years on PD, in June 2011, Gabriel received a kidney from his mother, but rejected the graft only a few weeks prior to our interview. He was back on PD and awaiting a cadaveric organ. Rejection was explained as a result of a miscommunication regarding the amount and type of immunosuppressants he would need. The family had, previously, raised the money for the transplant from fundraisers and family in the US, but were not prepared for the cost of immunosuppression. His mother, who cried when she talked of the kidney rejecting, explained that travelling to the hospital leaves no money to buy food as everything went to pay for routine check-ups, consultations and the bus fare. A few weeks prior, they were offered the chance of a cadaveric kidney. His mother explained:“They (doctors) said come today, you can pay tomorrow, but I explained it isn't that easy. He (doctor) said you need only $365 USD for the cross-match tests. I said, but we know how much everything really costs, so we said no, we will wait until we have the money. He said, are you going to waste the opportunity, and we said, yes. A transplant … for everything … is somewhere between $3,600–4,380 USD. Everything has to be bought, even the material for stitching the wound. It is too much for a family. … And Seguro Popular, we don't have it. For us, it only covers consultations and one or two pills. Even the doctors complain about it. It doesn't make sense, there is no point in it. It's just a government lie”. |
