Need for accessible care for kidney failure patients led Nurse Olive Sinclair to start dialysis centres

By Lakhram Bhagirat

Nurse Olive Sinclair has been in the medical profession for over 32 years now and over the years she has worked in almost every aspect of the hospital system. She has a vast knowledge of the inner workings in the system as well as the needs of patients.

It was the knowledge of the needs of patients that moved Nurse Sinclair to establish Biomed Energy Enterprise Dialysis Clinic in December of 2015. She saw a void in providing quality care for kidney failure patients and sought to fill that gap.
Sinclair – a registered nurse – joined the medical profession almost immediately after she left school and worked in the Laboratory, X-ray and Pharmaceutical Departments at two hospitals. However, she soon felt as though those positions did not present her with a challenge so, in 1991, she applied for the Nursing Programme.
In 1994, she graduated from the programme as a Registered Nurse and was attached to the New Amsterdam Hospital in Berbice.
During her years as an RN, Sinclair worked in almost every department of the hospital but was originally trained as an Operating Room Nurse. After a few years of working at the New Amsterdam Hospital, she took the bold step to move to Georgetown and took up a post at the Georgetown Public Hospital.
“At the Georgetown Hospital I was placed in the OR again and literally I wrote a letter asking to be removed and I was sent to ICU. I worked the regular ICU, the Cardiac ICU,” she recounted.
However, something was still missing for her and she believed that a bigger challenge was needed. She took up employment with a private clinic but that did not work out so she went back to the GPHC. In 2011, she got a challenge when she was recommended as a nurse to work in the Doobay Dialysis Centre on the East Coast of Demerara.
She was interviewed and appointed to serve as the Registered Nurse/Administrator at the clinic. There she was further trained and worked for 4 years. However, circumstances would cause her to part ways with the centre and in 2015 she decided to start her own dialysis unit since she already had the experience in the field.
She had co-founded Biomed Energy Enterprise back in 2013 and was setting up dialysis units, water systems, machines as well as servicing and maintaining them. She played a part in setting up the Doobay and GPHC units as well as some private institutions.
“I was financially stable to start (my own unit) and we started with one machine and as the months went by, I saw the need to have at least two more and Biomed Energy Enterprise grew from there. Presently I have two locations, one at Woodlands (Hospital in Georgetown) with 14 machines and one at Anamayah (Memorial Hospital in Berbice) with 4 machines,” Nurse Sinclair said.
Now she would travel to Berbice three days per week and the other four would be spent in Georgetown dialysing patients.
For a dialysis centre to become operational it requires far more planning and execution that just having patients. It needs to have a water system which is the reverse osmosis water system then you need special pipes for that water to go to the dialysis machine. You would need the dialysis machines and operators for them. Technical personnel are also required to ensure that the machines are calibrated correctly, serviced and maintained for optimal functioning.
Sinclair and her Canadian business partner serve as that dynamic duo since he has over 40 years of experience in the dialysis arena and is responsible for all the technical work while she takes care of the clinical aspects of the operations.
Dialysis is one line of treatment for persons whose kidney would have failed. A person can have acute renal failure which starts within 1-7 days, it happens within a short period of time and then the kidney kicks back in within three months to a year.
In chronic renal failure, the kidneys lose their function and for that individual to survive, they need hemodialysis. The process of hemodialysis is where the blood is removed from the patient, passed through a machine, through a filter or dialyser which acts or does some of the functions which the kidney does and then that clean blood is returned to the patient.
For that procedure to happen the patient must have an access – to the blood that flows around in that individual. There are three types of access. There is the AV Fistula where an artery is connected to a vein and then allowed to heal for 6 weeks to three months before it can be used. There is the option where a graft is surgically inserted between an artery and a vein and the other type of access is the catheter.

The catheters are widely used in Guyana because most of the patients are diagnosed with renal failure when they show all the signs and symptoms – that is the retention of fluid, bad taste in their mouths, a smelly breath and low blood count. The disadvantage of that catheter is that it is infection-prone.
Nurse Sinclair has been conducting her own research to determine the needs of every region in Guyana for access to dialysis care. Thus far, she has found that there are about 175 or more kidney failure patients in Guyana with most dialysis centres located in the city.
She would have, under the previous Administration, submitted proposals for the setting up of dialysis units – through a public-private partnership – in 6 of the 10 Administrations but that never materialised. She said that there are plans in the pipeline for expansion to other regions but noted that she prefers to set those units up within the regional hospital system for a number of reasons.
“One of the advantages of having a dialysis unit within a hospital environment is that it takes away a lot of literal supervisory burden from you when it comes to the medical waste disposal. (In the hospital setting) The blood work can be readily done. If there is an emergency there is always doctors within the hospital, access to the ICU is very easy, medication is readily available within the hospital setting. The hospital also does like the laundry, the attendants will move the patients from point A to point B and there are always cleaners available to keep the environment clean. It also takes away a financial burden to some extent even though you pay for that within your rent and utilities fees,” she posited.
Another one of the driving forces for her decision to set up dialysis units in the hospital setting is the fact that there is always power. The Guyana Power and Light is notorious for its blackouts so it is critical that her units have a steady power supply.
Nurse Sinclair’s research has found the need for a dialysis unit in Region Three (Essequibo Islands-West Demerara) since she has patients travelling from as far as the Essequibo Coast to access dialysis services in Georgetown. She is hoping that she will be able to meet them halfway with a unit in Region Three so that it cuts their commute as well as brings some financial relief since dialysis sessions are in itself a huge financial burden.
Sinclair said that if she is given the permission to set up dialysis units at the regional hospitals then she can have them up and running in 14 days while noting that it is over a year now since the Linden Hospital Complex was supposed to have a unit set up by another firm and it is yet to happen.
Over the past five years, she has interacted with a number of persons and had the chance to hear of their burdens as it relates to accessing care for their kidney failure. She said that the common complaint is that of access to transportation and its cost.
“Some patients can go to work after dialysis, I have patients who start dialysis at 05:30 am, they leave at 9:30 am and then they go to work. But then there are some patients after dialysis that need to relax, to go home and relax for an hour, have something to eat before they can get around to do their regular daily chores. So, it is very fatiguing on the patient’s body travelling those long distances and then cost for travelling is also a burden,” the experienced nurse said.
She is also advocating for more preventative testing to be done for those with diabetes and hypertension so that there may be early intervention for potential kidney failure patients. This, she said, will result in early acceptance of the condition and treatment as well.
Sinclair is hopeful of seeing dialysis access in every region, access to medication and more importantly more inspections of dialysis units. The Biomed Energy Enterprise Dialysis Unit has a qualified Nephrologist on staff along with ancillary staff qualified in various fields of functioning.