Elias Nambaje, a resident of Gasabo District in the City of Kigali, began experiencing unexplained health problems in 2003. He suffered from weight loss, loss of appetite, and swelling in his feet, symptoms that doctors initially struggled to diagnose. ALSO READ: Over 40 kidney transplants, over 500 heart surgeries performed in Rwanda As his condition worsened, he visited several health centres and was eventually told he had an amoebic infection, a parasitic gut infection believed to be responsible for his weight loss. By 2005, the father of three noticed he was having difficulty breathing, especially at night, and realised the problem was serious. He went to King Faisal Hospital for a checkup. ALSO READ: Dealing with chronic kidney disease Doctors found that his blood pressure was very high. He was admitted, underwent various tests, and after two weeks was told that both his kidneys had failed. He was informed that he urgently needed a replacement. “I started peritoneal dialysis, a treatment where a special fluid is introduced into the abdominal cavity to filter waste from the blood,” he recalled. Unlike hemodialysis, it doesn’t require a machine; patients exchange the fluid manually using sterile bags, usually several times a day. “The treatment was expensive. Although I had coverage through the Rwanda Medical Insurance Scheme (RAMA), it didn’t cover dialysis itself, only other hospital costs and medications,” Nambaje said. He noted that by the time he left the hospital, he had been charged Rwf 2 million. During his stay, he frequently developed infections, which were a constant threat while on dialysis. “The experience was physically draining and psychologically worrying because I had never heard of a kidney transplant being done here. I only knew about it from developed countries,” he said. The 57-year-old was advised to find a kidney donor. Several siblings volunteered, and three were tested for compatibility. Only one brother matched. Nambaje noted that the government supported the transplant through a referral board at King Faisal Hospital, while family and friends covered travel and additional expenses. He explained that he traveled to India in December 2005, and the transplant was performed in February 2006. Nambaje remained in the hospital for one and a half months afterward, while his brother was discharged after two weeks. “We are both okay. All previous symptoms disappeared after the transplant. I feel normal, though I occasionally experience high blood pressure, which I treat promptly.” To protect the donated kidney, Nambaje takes immunosuppressant medication daily, including cyclosporine, microfluoride, and prednisolone. He will continue on medication for life. His post-transplant drugs cost about Rwf 200,000 per month, which he covered himself until the Community-Based Health Insurance (Mutuelle de santé) began covering kidney treatment, easing his financial burden. He said that he changed his lifestyle, limiting fried foods and salt, eating more fruits and vegetables, and exercising regularly. Nambaje raises awareness about kidney disease. He noted that treatment is still expensive, with machine dialysis costing about Rwf 70,000 per session, three times a week. Even with Mutuelle de santé covering most costs, some patients struggle to pay the remaining 10 per cent. “After developing these conditions, many people lose their jobs. For those who are elderly or retired, covering treatment costs becomes even more difficult,” he said. Screening, treatment In an interview with The New Times, Dr. Florence Sibomana, a senior programme officer on Non-communicable diseases (NCDs) at PATH, an NGO promoting health equity, she noted that kidney health is vital for everyone, regardless of where they live or their resources. In Rwanda, community health workers now screen people for hypertension and diabetes, allowing early management and reducing the risk of kidney complications. “If you know you have hypertension or diabetes and receive proper care, you can reduce your risk of developing chronic kidney disease,” she said. Dr. Sibomana shared the story of a driver who had to leave his job after developing diabetes because frequent urination made work impossible. She noted the need for more trained healthcare professionals and diagnostic tools across the country, so care reaches people in their communities. “With strong commitment from the Rwanda health system, we can provide services at lower cost and make them accessible to everyone,” she said. Dr. Sibomana called for greater awareness about lifestyle risks, including alcohol, smoking, obesity, and unhealthy diets, and for sustainable screening and treatment systems. She explained that early detection is crucial, and it requires awareness, accessible services, trained healthcare professionals, and timely treatment to prevent patients from reaching kidney failure and needing dialysis or a transplant. According to the Rwanda Biomedical Centre, about 10 per cent of Rwandans may have severe kidney disease, while roughly 40 per cent may have a treatable or curable type. “We have many patients with non-communicable diseases. At the moment, we monitor about 450 patients with hypertension, around 30 with asthma, and about 20 with type 1 diabetes,” said Bienvenue Bazimaziki, a NCDs nurse at Biryogo Health Centre. Bazimaziki explained that patients with diabetes are routinely screened for kidney disease through urine tests that detect protein (proteinuria). “Two patients were recently referred to big hospitals after screening showed severe complications. One of them, a child with type 1 diabetes, unfortunately died before receiving dialysis. In November 2025, we screened about 350 people in the community, and two had serious results and were referred for further care,” she said.
