Barriers to kidney transplants in Indonesia : a literature review

Background: People living with chronic kidney disease will require renal dialysis or a kidney transplant to maintain life. Although Indonesia has a developing healthcare industry, Indonesia's kidney transplant rates are lower than comparable nations.

Purpose: To explore the healthcare literature to identify barriers to kidney transplants in particular in relation to Indonesia.

Methods: Healthcare databases were searched (CINAHL, Medline, EBSCOhostEJS, Blackwell Synergy, Web of Science, PubMed, Google Scholar and Proquest 5000) using the search terms: transplant, kidney disease, renal, dialysis, haemodialysis, Indonesia and nursing. The search was limited to English and Indonesian language data sources from 1997 to 2007. Reference lists of salient academic articles were hand searched.

Results: The results of our search identified six articles that met our criteria. Costs are the major barrier to kidney transplant in Indonesia, followed by cultural beliefs, perception of the law, lack of information and lack of infrastructure. In addition, kidney disease prevention strategies are required.

Conclusions: There are many complex socio-economic, geographical, legal, cultural and religious factors that contribute to low kidney transplant rates in Indonesia. Although an increase in transplantation rates will require strategies from various agencies, healthcare professionals, including nurses, can play a role in overcoming some barriers. Community education programmes, improving their own education levels and by increasing empowerment in nursing we may contribute to improved kidney transplant rates in Indonesia.

‘Coded in a code of the world' : minor literature and the time-image hidden in Janet Frame’s late fiction?

This article seeks to demonstrate how Janet Frame’s late fiction can be read as a theoretical engagement with the conceptual investigations of Gilles Deleuze and Félix Guattari, especially the notions of minor literature and the in her late novels Living in the Maniototo (1981) and The Carpathians (1989). For this reason, my approach must be sharply distinguished from a more commonplace analogical framing of Frame or a simple one-to-one translation of her fiction into alternative terms. By weaving theory through her fiction, Frame makes a significant contribution to literature that responds to the still-emerging field of Deleuzean literary critical theory.