‘They need this in order to live.' For kidney patients, the Jackson water crisis has especially high stakes

by Isabelle Taft, Mississippi Today
August 31, 2022

Thousands of Jacksonians with kidney failure rely on clean water to power the dialysis treatments that keep them alive. As the city's water system collapses, dialysis providers have brought in tanker trucks full of water to ensure patients don't have to miss their treatment.

Lack of access to clean water also creates risks for patients who perform their dialysis treatments at home– and puts kidney patients at greater danger of health consequences from impure water.

On Tuesday afternoon, Derek Whitaker pulled into the parking lot of the Jackson Medical Mall, towing a 6,000 gallon tank full of water from Broussard, Louisiana. A tanker truck from Missouri was already hooked up to a pump that was delivering water into the mall, which houses a dialysis unit.

Whitaker, who works with the disaster response company Macro, has traveled the country providing relief after hurricanes and tornadoes. Now, he and at least two colleagues have come to Jackson to deliver life's most basic necessity – and one that is even more essential for people with kidney failure.

One dialysis nurse told Mississippi Today that about six weeks ago, her clinic brought in a tanker truck full of water because of pressure fluctuations. The dialysis process requires about 10 gallons a minute, she said. The clinic first needed to use the tanker truck about two weeks ago.

“They need this in order to live,” said the nurse, who requested not to be identified by name because she was not authorized to speak to the media. “And they would not live more than—some people a few days, some a week without dialysis … to have a city that doesn't have water is just unconscionable to me. I don't understand how it ever got to that.”

Mississippi has one of the country's highest rates of kidney failure. More than 9,000 Mississippians are living with end-stage kidney disease, meaning their kidneys have essentially stopped functioning. Black Americans are roughly three times likelier than white Americans to develop kidney failure.  

In Jackson, the rate of kidney disease is 26% higher than the national average, according to the Mississippi Kidney Foundation. And Mississippians have the highest mortality rate from chronic kidney disease of any state in the country, according to the Centers for Disease Control and Prevention.

Dialysis is a medical procedure that acts as an artificial kidney. The patient's blood is diverted into a machine where it passes through membranes that remove waste before returning it to the body. Patients can do dialysis at home after they have been trained in the process, or visit a clinic or hospital three times a week for about four hours.

A reliable water source is generally essential for dialysis, which can require 300 to 600 liters of ultra-clean water during a single week. The filtration systems clean the water – ordinary tap water isn't clean enough for the process – but if the local water source isn't producing water quickly enough, the process can't work.

According to the health department, no dialysis centers in Jackson have had to close as of Wednesday. But almost all of them have had to make costly adjustments to continue operating. On Tuesday afternoon, officials said it still wasn't clear when Jackson will have clean, abundant drinking water.

Fresenius Medical Care, the largest dialysis company in the city with four Jackson locations providing in-center treatment, said it had brought in tanker trucks for three of their facilities. At its southwest Jackson location, the truck has been in place for about a month or longer because of issues with water quality and pressure, said Richi Lesley, Mississippi regional vice president.

“It comes at a great expense,” he said. “The resources of getting a tanker truck in place, getting the tanker truck filled, having them on-site for the hours to set and support –  when you do think about in terms of how many shifts we're operating at each of the facilities and each individual patient shift is normally around four hours, so it's a lot of water.”

Lesley declined to specify how much each truck costs the company.

“If we gave the number, I think a lot of people would be running out trying to get in the tanker truck business,” he said.

The north Jackson Fresenius location still has water, he added, but a tanker truck is in position in case that changes.

A fourth Fresenius facility located inside St. Dominic Memorial Hospital uses the hospital's independent water system.

Fresenius serves 500 to 600 patients in Jackson, Lesley said.

DaVita, Inc. operates three Jackson locations, two of which have been affected by the water crisis, said Chris Price, division vice president at DaVita, who oversees Mississippi operations. The company implemented “emergency water solutions” on Tuesday morning.

“These solutions include water from sources outside of Jackson that will remain subject to our full treatment and quality testing procedures,” Price said. “We will keep these emergency measures in place until confidence in the reliability of city water sources is restored.”

The water crisis also threatens Jacksonians' ability to safely access dialysis at home because that process requires careful attention to hygiene, said TJ Mayfield, executive director of the Mississippi Kidney Foundation. Mayfield is a former dialysis patient who received a kidney transplant in 2019.

“If you don't have water to flush, if you don't have water to drain out your dialysis that you're doing overnight or home dialysis, how do you clean it properly?” Mayfield said. “How do you make sure you wash your hands properly so that you don't catch an infection? All of that plays a large factor into home dialysis.”

Mayfield said clean drinking water is critical for people with kidney conditions — and to ensure healthy people don't develop kidney issues. When clean drinking water isn't available or costs the same as soda, he pointed out, people are likelier to choose sugary drinks. He is working to distribute bottled water to dialysis patients in Jackson.

Valerie Bailey, a nurse practitioner with more than a decade of experience working with kidney patients in Jackson, said people with kidney issues are also more vulnerable to health problems from unclean water.

“Any renal patient has to be extremely diligent about keeping up with their fluid intake, because their kidneys are unable to properly filter out excess fluids,” Bailey said. “If they do not have clean water, then their body, their kidneys are not going to be able to filter out those impurities in the contaminated water, like a normally functioning kidney might be able to.”

Dialysis providers who spoke with Mississippi Today said they are experienced in disaster response, not only because industry standards require it, but also because Jackson has seen this before.

During the 2021 ice storm that crippled the city's water system, Fresenius worked with Mississippi Emergency Management Agency (MEMA) to ensure tanker trucks full of water could reach their clinics.

Whitaker, who came to the Medical Mall from Louisiana with the water tanker, drove around southern Louisiana after Hurricane Ida and to Kentucky after the devastating tornadoes earlier this year. The combat veteran often carries fuel to help people power generators after losing power.

“We kind of get out and see the countryside a little bit when there's a disaster,” he said. He didn't think much about the nature of the disaster — long-running and manmade — that had brought him to the mall parking lot.

“To me, it's my job,” he said.

Whitaker said he doesn't know how long he will be in Jackson. He'll sleep in his truck and shower at the facility where he will refill the tanker, somewhere outside of town.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.