Mission: Habib Alrahman Charity Foundation (HACF) Kidney Center main mission is help the desperate and miserable patients with kidney diseases in Sudan, especially those needing dialysis and transplantation, by building a charitable comprehensive Kidney Center and providing the necessary services and training. Every day, 11 new cases register for a permanent dialysis chair, and unfortunately, there is at least a 2-month waiting time to find a chair in the capital Khartoum. It is highly possible that most patients will die during this waiting period from the many complications of renal failure, and therefore, the need for help is URGENT. 

The Problem: Kidney failure is very common in Sudan, and currently there are at least 6,000 patients with end stage renal disease (ESRD) requiring dialysis to survive. Worthy of mentioning is that there are no accurate statistics about these patients, and therefore the actual number would likely far exceed 6,000 (16,000-21,000 ESRD patients are expected in Sudan based on global prevalence of chronic kidney disease = CKD). 6000 ESRD patients currently receive dialysis through the national kidney program, with <700 patients receiving dialysis through private centers and hospitals, and the rest (>9000 patients) probably die from renal failure (many potentially undiagnosed). Every day, 11 new ESRD cases register in Khartoum for the need of a dialysis chair, and unfortunately, there is at least a 2-month waiting time to find a dialysis chair in Khartoum (longer in Omdurman), with the waiting time expected to be much longer in other cities. It is highly possible that most patients will die during this waiting time from the many complications of renal failure. To practically help many of these miserable patients,) is currently building a charity center for kidney diseases and transplantation. HACF successfully obtained a 3,000 square meters (m) land in Alhijra, Omdurman from Alaoghaf. Importantly, we also registered HACF Kidney Center as a charity organization in USA and it is tax exempt (IRS-approved 503c3 status).   

The Solution: The long-term plan is to construct a building of 5 stories to be completed through (3) phases depending on availability of funds: 

Phase I: Charity Hemodialysis Center: It is on the ground floor (25 m x 25 m) and will accommodate up to 60 hemodialysis machines (will provide dialysis to 540 ESRD patients, both children and adults) and was planned to be opened on 6/1/2020 with 32 machines (with 28 machines to be added in the near future after completing a small expansion). Due to the significant delays from the recent oil shortage and the ongoing COVID-19 pandemic, the opening plan will be shifted to a future date, which will be dictated by the pandemic, but hopefully no later than 8/1/2020. 

The total cost for this phase is >$860,000 and we need financial support to cover the following remaining items:

• 1. $32,920 towards the remaining cost for the water purification unit. It covers 60 dialysis machines/stations and it costs 71250 Euros ($79087), and we have $46176 in our hands towards its cost.
• 2. $27,000 for a 500 KVA standby electric generator.
• 3. $15,900 for a well to supply pure drinking water for the patients and staff, as well as water for the dialysis machines when there are water shortages (are expected to be occur frequently).
• 4. $73,500 to complete the construction of a large laboratory (10 x 20 m) and obtain the necessary equipment. This aspect is not absolutely needed before opening Phase I.    

Funds we need now: We need 137K to complete Phase 1 (we recently collected 12K through other avenues). I sincerely hope that you can generously support this noble project during these blessed last 10 days of Ramadan. 

Project progress since 10/2019:

Phase II: Charity Kidney Transplant Center: It will be on the first floor (an area of 800 square meters) and it will be completed in the near future. It is urgently needed since transplantation is the optimal treatment for ESRD patients. Importantly, most of our ESRD patients are young and have living donors, which will make transplantation the ideal treatment. We had already spoken with three Sudanese transplant surgeons in USA, who indicated that this will be very achievable (including two operating rooms: 10.5 m x 7.5 m each). We are in communication with a Kwaiti charity organization (and other donors in Sudan) and we are optimistic that they will support the transplant center to hopefully start operating in 2021. Of note is that we will complete phase II building skeleton construction together with phase I.

Phase III: A specialized Charity Hospital for Kidney Diseases and Transplantation: This will be built in the future on the upper three floors (floors 2-4). This phase will provide care for patients with all forms of kidney diseases, CKD care, as well as will accommodate more dialysis and other relevant services. Importantly, we will provide dialysis for patients with acute kidney injury (AKI), who currently receive dialysis in Bahri Hospital and we are under the impression that the majority of these patients permanently end on dialysis due to poor medical care. We will have the opportunity to salvage many of these patients and take them off dialysis. We also plan to provide continuous renal replacement therapy = CRRT (e.g. CVVHD) for dialysis patients (AKI and ESRD) who are hemodynamically unstable (e.g. with low blood pressure) and therefore would not be able to tolerate the standard hemodialysis. CRRT is extremely limited in Sudan. In addition, we will also establish a peritoneal dialysis program, which is really needed. This phase will also accommodate more transplantation and vascular access-related services.

Future look of the complete building:

Dialysis Vascular Access Center: A vascular access is a hemodialysis patient’s lifeline, because it makes life-saving hemodialysis treatments possible. A vascular access lets large amounts of blood flow continuously during hemodialysis treatments to filter as much blood as possible per treatment. A vascular access should be in place weeks or months before the first hemodialysis treatment. They are two types of vascular access designed for long-term use: 1. The arteriovenous (AV) fistula = AVF) 2. The AV graft = AVG). A third type of vascular access-the venous catheter (VC)-is for short-term use. HACF Kidney Center is planning to build a major vascular access center to serve the whole country. Towards this goal, we plan to build and equip (including a C-am Fluoroscopy machine) an operating room in Phase II in the near future since the services that will be provided by this center are urgently needed. Of note is that this operating room will also be used in the future for kidney transplantation after building another operating room since two rooms will be needed. We have room to build a comprehensive vascular access center in Phase III as described above. In addition to serving our own ESRD patients (expected to be several thousand after opening phase III), the vascular center will serve the other >16,000 ESRD patients across the country, in terms of all needed procedures (including declotting of clotted AVG/AVF, a service that is highly and urgently needed).

Transfer of our expertise from USA/Europe to Sudan:

Worthy of note is that we had previously made an agreement with the ministry of health (MOH) to provide the center with the consumables (dialyzer, lines, fluids, etc.) and the center will provide free hemodialysis. The MOH will also provide a monthly running cost for each machine, and the provided funds based on the current structure might cover 40-65% of the operating expenses (fees for nurses, biomedical engineers, electric and water bills, etc.), and HACF will pay the difference (see potential projects described below). Very importantly, the center will be totally run by HACF (a US-trained nephrologist will run the center, and will be assisted by a UK-trained nephrologist and a locally-trained nephrologist), which is crucial for HACF to transfer our expertise from USA/Europe to Sudan (our goal to is to build a model system for the standards of renal care which can help guide other centers in Sudan). Of note is that HACF’s founder is a nephrologist at the University of Chicago and he will work with his nephrology colleagues in USA, Europe, and the gulf area to support (including actual coverage) the center during their visits to Sudan (they had already showed remarkable support for this noble project). Of extreme importance is that there is an absolute zero role for politics in this charity work.

Concluding Remarks:

HACF Kidney Center will provide accessible and free dialysis and vascular access services, as well as future transplant and other renal services to our very needy and miserable renal patients, who are looking for any form of help. We strongly feel that we have a religious, moral, and ethical obligation to help our desperate and miserable renal patients in Sudan, and I sincerely hope that you will join this noble project and make it a great success. HACF is building a comprehensive charity kidney center in a manner which will enable the implementation of the standards of renal care in Sudan through the transfer of knowledge, expertise, and advanced technology from USA, Europe, and the Gulf area to Sudan. Therefore, it will also serve as a reference center to guide other renal centers in Sudan by providing continuous training and education to physicians, nurses, and other ancillary staff. We have plans to bring experts from USA and Europe on a regular basis and already have many who expressed their strong desire to come to Sudan and volunteer in the center for 1-6 weeks.

Please visit the following sites (some of which are still under development) for more information about HACF Kidney center:

Address: 4517 Ferrer Dr. St. Louis, MO 63129

Tel: 1 (314) 764-HACF

Web: www.hacfkidneycenter.org 

Email: hhassan@hacfkidneycenter.org

Facebook: https://www.facebook.com/hacfkidneycenter

LinkedIn: https://www.linkedin.com/company/habib-alrahman-charity-foundation

Twitter: https://twitter.com/HabibCharity 

Instagram: https://www.instagram.com/habibalrhaman/