Insulin cold chain for 14 clinics in Yemen
$13,295
18% funded
Medical
A mobile dialysis unit for northern Nigeria
Four machines in a converted truck, reaching six towns on a fixed rota. For 200 patients it is the difference between treatment and a 300km round trip.
Organised by
Sahel Medical Relief
Three hundred kilometres, three times a week
A patient on haemodialysis needs treatment three times a week, every week, for the rest of their life or until they receive a transplant. In Kano State the machines are concentrated in two city hospitals. For patients in the towns to the north and east, that means a round trip of up to three hundred kilometres, three times a week, on roads that are difficult in the dry season and worse in the wet.
What happens in practice is that people ration their own treatment. They come twice a week instead of three times, then once, and then we see them in an emergency department in fluid overload. Of the 118 patients we have followed in our outreach clinics over two years, thirty-one died, and in at least nineteen of those cases the immediate cause was missed sessions rather than the underlying disease.
What a mobile unit changes
A converted long-wheelbase truck carrying four dialysis stations, its own water treatment plant, a generator and a two-person clinical team. It runs a fixed rota — the same town on the same days every week — so patients can plan their lives around it rather than around a journey. Six towns, four stations, roughly two hundred patients receiving at least two sessions a week within twenty kilometres of home.
- Four dialysis stations with their own reverse-osmosis water treatment on board.
- A fixed weekly rota across six towns, published in advance and not varied.
- Staffed by two dialysis nurses and a technician, all recruited and trained locally.
- Linked to the teaching hospital for escalation, with a referral protocol already agreed.
Where the money goes
This is the largest campaign we have run and the largest single line is the truck. We have quoted everything twice and the full breakdown, including the quotes, is available on request.
- $96,000 — Four dialysis machines and consumables for year one Refurbished machines from a certified European supplier with a service contract, plus the first year of dialysers and lines.
- $71,500 — Vehicle purchase and medical conversion A used long-wheelbase chassis, converted by a firm that has built three mobile clinics for Nigerian operators.
- $28,400 — On-board water treatment plant Two-stage reverse osmosis. Water quality is the thing that makes mobile dialysis genuinely difficult and it is not a place to economise.
- $19,600 — Generator, solar array and power management A dialysis session cannot be interrupted, so the power system is designed with a fully redundant path.
- $16,300 — Clinical staffing, year one Two dialysis nurses, one technician and a driver, at local rates with training included.
- $13,000 — Contingency, insurance, licensing and platform fees Vehicle licensing, medical device registration, insurance and a five per cent contingency.
People do not decide to stop dialysis. They decide they cannot make the journey a third time this week, and then that decision makes itself every week after.
Who is behind this
Sahel Medical Relief is led by Dr Amina Bello, a consultant nephrologist at the teaching hospital in Kano, and has run outreach nephrology clinics in the state since 2019. The mobile unit protocol has been reviewed by the hospital's clinical governance committee and the referral pathway is agreed in writing. Every patient treated will be on the state renal registry, and we publish a cost per session — currently projected at $41 including consumables and staffing — in every annual report.
Risks and challenges
Running dialysis from a vehicle is difficult and we are not going to pretend otherwise. Water quality is the principal clinical risk and the reason nearly thirty thousand dollars of this budget sits in the treatment plant; we will test to AAMI standard before every session and publish the logs. Security along two of the six routes is variable and the rota may need to be adjusted, which is why we have chosen six towns and would rather serve five reliably than six unpredictably. The honest financial risk is year two: consumables run to roughly $58,000 a year, and we are seeking a state health insurance contribution to cover it. If that does not materialise, the unit runs at reduced capacity rather than closing, and we will tell you so.
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