KARACHI: Govt urged to provide free dialysis facility
By Our Staff Reporter
KARACHI, March 8: The Sindh Institute of Urology and Transplantation, which at present performs three transplant operations a week, could carry out at least four transplant surgeries a day if the burden of dialysis patients is taken off the kidney institute.
This was stated by the SIUT director, Prof S. Adibul Hasan Rizvi, at a press briefing on Saturday afternoon at the Dewan Farooq Medical Complex.
Prof Rizvi explained that the only two modes of renal replacement therapy were haemodialysis or kidney transplantation. “Both facilities are offered at the SIUT free of charge. The SIUT provides dialysis facilities to 22 per cent of renal failure patients of the country which includes 37 per cent of cases from Sindh and 57 per cent of all cases dialyzed in the government sector. In the last two years, the number of patients requiring dialysis has increased overwhelmingly. For instance, in 1997, 856 patients were registered for haemodialysis. By 2000, this figure had risen to 1,423 patients. In 2002, the SIUT registered 2,200 patients for dialysis.”
Dialysis is a process by which, when the kidneys have failed, the blood is cleaned by a machine in a four-hour session which the patient has to undergo twice or thrice a week. Transplantation is the surgical replacement of irreparably damaged kidneys by putting a healthy kidney in the recipient donated by a living or cadaver donor.
Prof Rizvi said that if the burden of dialysis patients was taken off the SIUT, it would not only be able to increase transplant operations but would also be able to go into operations of liver transplant and bone marrow transplant in a big way.
Answering a question, Prof Rizvi said many factors were responsible for failure of kidney transplant operations. “The internationally accepted figures are 85 per cent survival rate of five years and 90 per cent survival rate of one year. Interestingly, the survival rate of liver and heart transplant is higher than that of renal transplant.”
He added that the reason why the SIUT was reluctant to go for liver and bone marrow transplant operations in a big way was that it would not be sustainable. “At SIUT we ensure that programmes once initiated should be sustainable in such a way that they do not peter out in time.”
Answering another question, Prof Rizvi stressed that the SIUT offered all services free. “It is important to emphasize this point because these days a lot of expressions are being used, such as no-profit-no-loss etc. After a transplant operation, a patient needs medicine for the rest of his life. The cost of these medicines ranges from Rs7,000 a month to Rs19,000 a month. The SIUT has been giving free medicines to a large number of patients for the past 17 to 18 years.”
With the help of a computer presentation, Prof Anwer Naqvi said that at the SIUT about 250,000 patients were given free treatment every year. “Equipped with top-of-the-line equipment for all forms of dialysis, the SIUT’s 80-station haemodialysis unit and 20 station peritoneal dialysis unit carry out more than 60,000 haemodialysis and over 2,000 peritoneal dialysis sessions a year.”
He added that the SIUT had arried out more than 1,000 kidney transplants by early 2002. “With three transplant surgeries every week, the success rate is comparable with that of any other leading transplant centre in the world.”
Prof Naqvi put forward a suggestion to take the burden of dialysis patients off the SIUT. “Medical colleges are located all over the country according to population density. If dialysis infrastructure is set up at these medical colleges, patients would not have to travel more than 100 kilometres to get treatment. This would naturally take the burden off the SIUT.”
He noted that it was a pity that only 11 per cent of Zakat funds was spent on health care. “The amount spent on health care is not properly utilized. If this amount is properly utilized, dialysis facilities at medical colleges could be set up.”
death law: The delay in the passage of ‘Brain death law’ in Pakistan continues to deny thousands of end-stage renal failure patients, mainly falling in the age group of 20 to 40 years, an opportunity of quality survival, adds APP.
The misery of these patients is assuming serious proportions owing to an acute shortage of dialysis units in government sector units across the country, compelling many to visit either private hospitals or tertiary-care hospitals in urban centres, incurring expenses often beyond their means.
Haemodialysis, an expensive option also required to be undertaken at regular intervals, prevents many from acquiring facility as this also means additional expenses for board and lodging besides availing the facility itself, which comes to an estimated amount of Rs1,500 to Rs3,000 per session.
The SIUT providing the facility free is in dire need of additional support on part of both the community and the government as the number of patients acquiring the therapy reached 2,200 in the year 2002.
Saying that it was taking a considerable chunk of the SIUT’s budget and that many of patients coming from remote parts of the country also found difficult to make regular visits, the SIUT director proposed that urgent measures be taken to establish a chain of dialysis centres at all public sector teaching hospitals.
