Sunday, September 22, 2019 | ePaper

Kidney dialysis still a major challenge

Review in transplantation law sought: Gonoshasthaya Kendra sets example of affordable care

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Kidney patients are undergoing dialysis sessions at the Gonoshasthya Kendra Dialysis Centre (GKDC) at Dhanmondi in Dhaka.

Kazi Zahidul Hasan :
Kidney patients are struggling to get proper access to medicare in absence of adequate facilities at state-run hospitals and high cost of dialysis.   
This has increased the deaths from various complications related to kidney problems, experts said.
There is no official statistics of kidney patients in the country, but unofficial reports suggest that about 20 million people currently suffer from some kind of kidney diseases. Of them, nearly 800,000 are affected by Chronic Kidney Disease (CKD) and require regular dialysis every week.
There are only 13 government run-dialysis centres and 135 private facilities in the country to deal with the huge number of kidney patients.
"Kidney patients are facing hardship in getting regular dialysis due to lack of government facilities and high cost in private health centres," said Prof Dr Harun -Ur-Rashid, President of Bangladesh Kidney Foundation.
He said, at least 1000 dialysis centres are needed to provide medicare to the large number of patients.
"Though the number of kidney patients is big, only 15 to 20 per cent can only afford dialysis. Others are not able to receive dialysis due to financial constraints," said Prof Harun.
A single dialysis costs about Tk 400 to Tk 500 at the government run centres, while Tk 1,500 to 5,000 at private facilities.
Prof Harun, a renowned nephrologist of the country, said, "Patients affected by CKD require two to three dialyses in a week. Most of them requiring this service are poor and cannot afford such high treatment cost. So, many of them are dying from complications," noted Prof Harun.
He also said that the government should set up at least two dialyses centres in every district or offer tax rebate on import of medical devises and other equipment so that private facilities can offer low-cost dialysis.
"Otherwise, the country will face enormous burden of kidney patients in the days to come," he added.
Prof Harun mentioned that the country's people were increasingly becoming vulnerable to kidney diseases, fuelled by growing rates of diabetes and hypertension.
"Diabetes has a 40 per cent more risk and hypertension has 25 per cent more risk to kidney disease. Early detection could delay the deadly disease and 60 per cent of the disease could be prevented maintaining healthy lifestyle," he said.
When asked, Dr Nur Mohammad, Director for Non-communicable Disease at the Directorate General of Health Services (DGHS) told The New Nation yesterday that there is no government statistics of kidney patients. We will conduct a national level research in this regard soon.
He said the government has already moved forward to increase facilities at public hospitals for ensuring treatment of CKD affected patients.
"Kidney treatment is quite costly due to the need for the specialized facilities through repeated dialysis sessions," said Dr Zafrullah Chowdhury, founder of the Gonoshasthaya Kendra. He said access to treatment is difficult due to limited facilities at private public hospitals and high cost involved in treatment adding to the woes of the patients and disease burden.
Considering their woes, Gonoshasthaya Kendra installed Gonoshasthaya Kendra Dialysis Centre (GKDC) in the capital's Dhanmondi area to provide treatment facilities at affordable rates (Tk 800 to Tk 3,000 for per dialysis) for the kidney patients of various income groups.
GKDC's double shift 100-bed facility attends 200 patients daily, equipped with necessary doctors, nurses and technicians.
"It is the largest centre in the subcontinent with American standard," claimed Dr Zafrullah, adding, "We make dialysis facilities available for all at the centre."
A patient usually requires three dialysis sessions a week, which is a replacement therapy after the kidney fails. Through this method, the toxic substances are removed from the blood through a machine.
"We are running the facility with subsidy. Most of our funding comes from donations. Now, the centre is running with a monthly deficit of Tk 25 lakh. If we can get support from the government, we can run it smoothly," said Dr Zafrullah.
He noted that the service could be made available and cheaper for all patients if the government exempts taxes on import of apparatus and chemicals used for dialysis and government subsidy. "Patients could also be better served through increasing facilities at the public hospitals."
"The annual demand for the kidney transplantation in Bangladesh right now is estimated to be 10,000, but only around 100 people can manage kidneys from their relatives to undergo transplants. The existing law related to organ transplantation has made the situation difficult for kidney transplant patients," said Dr Zafrullah.
Under the prevailing law, he said, people with close relationships can donate kidneys to patients, but non-relatives are not entitled to do so making the situation complex for kidney transplantation.     
"The law should be amended allowing the non-relatives as donors.  Such a move can save many of the kidney patients from premature death and bring a revolution in kidney treatment in the country.

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