The Hindu : Kidney patients seek subsidised treatment

Online edition of India's National Newspaper
Tuesday, Sep 23, 2003

Southern States

Southern States - Andhra Pradesh-Hyderabad

Kidney patients seek subsidised treatment

By K.V.S. Madhav

Hyderabad Sept. 22. It's a cost they cannot afford to pay. More often, they pay it with their lives failing to protect their damaged kidneys from getting worse. The steep costs involved in sustaining them by way of dialysis - this is the easiest way out for them to lead a near-normal life unlike the near-impossible and complex kidney transplantation given the monetary, physical and legal hurdles - and the lack of sufficient infrastructure in Government hospitals have sounded the death knell for the poor and middle class people suffering from renal failure.

"It is unfortunate, but the hard reality," noted nephrologists, K.S. Nayak, pointed out. "While heart and liver failures are death sentences, renal failure does not mean the end of the road. Even with kidney failure, people can survive, thanks to latest medical advances. Yet, they reach barely a few of the millions suffering from renal failure," he says.

Specialists have warned that end-stage kidney failure is increasing every year in the State. Already, hundreds are on dialysis and some living with transplanted kidneys, but those who cannot afford even the basic dialysis treatment far outnumber those getting it. According to an estimate, 200 new patients out of every million in the State are added to the number of renal failure patients every year mostly because of increased risk due to diabetes, high blood pressure and other risk factors.

While almost all the private hospitals provide the dialysis service, of course at a cost, the dialysis units at the two major Government hospitals in the City - Gandhi and Osmania - are earmarked exclusively for those who have related donors for kidney transplants. Each dialysis session costs about Rs. 1,000 to Rs. 1,200 and many patients need two to three sessions per week. "Add the cost of medicines to it and the monthly bill comes to around Rs. 18,000 per patient. Forget the poor, even for the middle class this is an astronomical amount," point out M. Suryanarayana and A. Yellaiah Goud, both renal patients and pensioners who formed an association to highlight the problems of renal patients. Kidney transplantation costs nothing less than a few lakh rupees, that is if the patients are lucky enough to find donors.

The patients and families have no other go but to graft themselves to the struggle - despite help in the form of dialysis, visits to the hospital are a must - and it is a consistent, ongoing, lifelong reality besides the financial burden. The Continuous Ambulatory Peritoneal Dialysis, an easy-to-use home dialysis unit, which can be operated by the patients themselves, reduces the trips to hospital, but is costly too.

"Only the rich can afford both these facilities on a continuous basis. Those who cannot die," Goud says wryly. While those availing CGHS facility have been lucky enough to be reimbursed for dialysis, the ESI subscribers too have been brought into its ambit recently. "That still leaves out a majority of patients who cannot afford to take the treatment regularly", the duo says.

The Government, they insist, has seldom paid attention to dialysis, the very lifeline for many. "This is criminal. Vexed with its indifference, we have come together to further the cause of renal patients. Our effort is to raise finances from philanthropists and voluntary bodies to have an independent dialysis facility that provides service at subsidised costs," they say.

"Every person, irrespective of his social status, has the right to live with the help of survival treatment available. The need of the hour is the Government coming out with a viable model for a CAPD programme in consonance with insurance companies so that treatment is subsidised. It could be made mandatory to all, but with a very low premium and the Government can chip in its bit too.

Ideally, patients should pay 20 per cent of the existing treatment costs," suggests Dr. Nayak who is also the president of CAPD Society of India.

Anyone listening?

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