LAHORE: The first largest public sector nephrology and dialysis unit of the Shaikh Zayed Hospital Lahore is on the verge of going dysfunctional as the federal government has stopped its annual grant and pharmaceutical companies’ refused supply of life-saving and essential disposables to the facility.

The situation has forced the facility management to refuse free treatment even to the patients enrolled under prime minister’s directive after the essential disposables, including dialysis filter, tubes, needles, concentrate (necessary chemical for the process) etc ran out of stock.

The facility had 50 dialysis machines where hundreds of serious patients were undergoing the life-saving procedure in three shifts.

Recently, the institute borrowed a sum of Rs2 million to purchase some disposables to perform dialysis of the patients, but given their large number the amount proved sufficient only for two days to run the expenses. The annual requirement of the facility for such purchases totals up to more than Rs50 million, besides hefty funds.

Pharmas refuse further supplies over ‘outstanding payments’

Hospital sources say that no annual grant has been released by the federal government to the institute during the 2020-21 fiscal so far.

The doctors have warned that if denied the procedure, many of the poor patients with multiple complications, who had been undergoing dialysis three times a week, may lose their lives in the coming weeks.

Chairman & Dean of Shaik Zayed Postgraduate Medical Institute, Lahore, Prof Mateen Izhar, in a letter to the federal government, has drawn a dismal picture of the facility in general, and of nephrology / dialysis department in particular.

The official correspondence between the chairman of the institute, head of the nephrology unit, and the pharma companies supplying disposables, itself shows the gravity of the issue.

It unveils that the largest healthcare facility in a public sector teaching hospital of the country, is heading towards a “blind alley”.

The chairman wrote to the joint secretary (technical), Ministry of National Health Services, Regulations & Coordination, Islamabad, on Nov 13 that the unit was now unable to function because of lack of funds, disposables and human resource.

“This is with reference to the letters of two [pharma] firms dated Nov 4 and Nov 10, respectively, wherein it is informed that they are unable to provide further supplies of disposables due to the outstanding bills.”

He said the nephrology unit was dealing with emergency cases not only from all over Punjab, but also other provinces and even from abroad.

“Our registered patients are getting haemo dialysis done six days a week in three shifts, regardless of national holidays”, reads the letter.

It says that more than 120 dialysis sessions were being conducted in the unit per day.

“We have done over 30,000 dialysis sessions, which is the biggest number of haemo dialysis in Punjab”, the chairman said, adding that free dialysis treatment was being provided to more than 300 kidney patients under the prime minister’s directive (No 2384) and the government was providing a grant in aid amounting to Rs50 million (per year) for the purpose.

“In present scenario, we will not be able to provide free dialysis facility to the poor patients because of non-payment [of outstanding dues] to the [pharma] companies”, reads the letter.

It was pertinent to mention that these patients could not survive without haemodialysis, warned the SZH chairman.

“It is requested that the annual grant in aid amounting to Rs50 million may be released immediately,” the letter urges.

He also appealed to the federal government to increase the grant so that the free treatment of ailing patients could be continued uninterrupted.

“We now have Rs26.3 million as pending payment and have received yet another purchase order to supply dialysis kits worth Rs14.1 million, making the total of approximately Rs40.4 million”, the Eastern Medical Care company wrote to the head of the institute.

Refusing further supply of the life-saving and essential disposables, the company told the institute management n Nov 10 that “we are feeling incapacitated to maintain our zeal”.

Another company -- 3N-LIFEMED Pharmaceuticals -- on the same date wrote to the SZH administrator that the it was already facing financial constraints because of nonpayment of its pending bills of Rs39m, while it received another purchase order amounting to Rs6592,500 for the disposables’ supply.

“We have requested you time and again to clear our pending amount so that we will be able to arrange further supply orders which are with us at this movement”, reads the ‘last warning’ letter of the company.

meanwhile, SZH nephrology unit head Prof Waqar Ahmed, in a letter addressed to the secretary of federal health ministry, said that a the facility had also been facing an acute shortage of faculty members.

Seeking immediate help, he said unfortunately due to a lack of funds, faculty members and essential supplies, the performance of the largest renal unit could be compromised.

Only half a decade ago, the SZH nephrology department was being manned by 10 consultants and 20 (level-III) postgraduate students, Prof Waqar informed the secretary.

Published in Dawn, November 22nd, 2020