Critical kidney patients face deadly supply crisis

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Poor people facing kidney failure are at a greater risk of dying from lack of treatment because the state's lone specialist hospital dealing with kidney diseases offer no free dialysis kits, reports bdnews24.com.
At the National Institute of Kidney Diseases & Urology (NIKDU) all patients-the bulk of whom are poor- admitted under the non-paying category must now purchase their own dialysis sets.
Dialysers or artificial kidneys and AV line sets are supposed to be free of cost at such state hospitals.
But the free sets have been out of stock for five months, officials said.
The reason that crucial life-saving medical supplies were not purchased for the economically most marginal patients with End Stage Renal Disease (ESRD) seems to be due to a procedural problem in securing funds from the government.
NIKDU director Shamim Ahmed acknowledged the problem and said that poor patients were suffering.
The NIKDU and the health ministry had exchanged several letters to obtain fund to buy medical accessories.
By the time the hospital had received an approval for Tk 4.9 million from the ministry, the time period to spend the money had expired for the June 2006/2007 fiscal.
The approval from the ministry for Tk 4.9 million was received on June 13, 2007.
But on June 26 the ministry ordered NIKDU to surrender the entire amount to the national exchequer.
And so NIKDU had to return the money and forward a fresh request for funds.
"We've sought fresh funds to purchase the medical accessories on an urgent basis," said Shamim, adding, "We express the hope to receive the money shortly and hopefully the suffering of poor dialysis patients will soon be over."
The main treatment for kidney failure, the characteristic feature of End Stage Renal Disease, is haemodialysis.
Over 60 per cent of kidney failure patients in Bangladesh survive on this procedure.
Because the costly devices required for dialysis is available free at NIKDU, the waiting list for the treatment is very long.
Now that the vital dialyses kits are unavailable, poor patients who cannot afford to buy dialyses (each costing about Tk 900 on the open market) are forced to forego treatment.
Because haemodialysis is a recurring procedure, the cost of treatment is prohibitively high.
Hosne Ara (60), a patient from Narayanganj who comes at least twice a week to perform dialysis at NIKDU, has been hit hard by the situation.
Her daughter, Saathi said, "Every time we come to the hospital we have to buy a dialyser and AV line set, which comes to about Tk 1000."
"We have already sold our ancestral land to continue my mother's treatment."
Nazma Begum (67) from Mirpur also comes to the hospital at least twice a week for dialysis. Like the others, she is also forced to buy dialysis sets.
Her daughter, Yasmin, standing next to her mother at the dialysis ward said, "We have to buy the sets but it is becoming difficult for us to afford it.
"We thought the hospital would provide the sets free of cost. When we registered here three months ago we heard that dialysers and AV line sets were out of stock."
Ehsan Ibn Zia, assistant registrar of NIKDU said, on an average the hospital receives 20 to 25 patients a day, all of whom are chronic kidney failure cases.
He said patients were regularly referred from other hospitals for immediate hospitalisation at NIKDU.
"We face tremendous pressure for admission or dialysis. Sometime it is beyond our capacity. We try our best," said Zia.
In its demand list for medical accessories, NIKDU has requested funds to buy 500 dialysers, 500 AV line sets and 500 fistula needle sets this fiscal.