The Ministry of Health has recently decided to provide free dialysis to patients with double kidney failure at all government dialysis centers, while also reimbursing private health institutions that agree to government conditions for their dialysis services. In case of severe kidney failure, a patient has only two options: kidney transplant or regular dialysis. A kidney transplant can be very expensive, the cheapest in Nepal costing more than Rs. 250,000, a sum that is hard to raise at once for many in Nepal.
As a result, many patients opt for regular dialysis, but since dialysis is also expensive, and needs to be administered frequently (twice every week), the cumulative cost of regular dialyses can add up to more than the cost of a transplant. At Rs. 3,000 per session apart from an injection costing more than Rs. 1,000, dialyses have been known to make patients and families bankrupt before eventually killing the patient. Hence, the government’s decision to provide free dialysis comes as a welcome relief for renal patients, especially to those with low incomes. To avail of this service, patients will just have to bring a recommendation letter from the District Public Health Office.
The history of treatment for severe kidney diseases is relatively new in Nepal. Kidney transplant was unavailable in Nepal until 2008, and the best alternative was going to India for a transplant, which could cost up to Rs. 500,000. The other option, dialysis, was also unavailable until 1997. After 1997, it was available in select government institutions, and patients had to wait for months for their turn. New patients were provided the service only when old patients died or received a transplant, by which time the disease could turn fatal. After the advent of private dialysis centers and transplant facilities at Bir Hospital and other health institutions, treatment became much more accessible to a large section of the populace. But still, it was too expensive for most. Now, the promise of free dialysis has the potential to benefit all sections of the population.
We hope free dialysis initiative is a success and contributes to improving public health.
The latest initiative by the Health Ministry is amongst many that have helped the health sector of Nepal make great strides in the recent past, despite the lack of infrastructure and sophisticated medical equipments to begin with. In successive census, Nepal has made progress in several key health indictors like life expectancy at birth (which has increased), and infant and maternal mortality rates (which have decreased). Even though the health sector is besieged by many omnipresent problems of Nepal like corruption, lack of resources and infrastructure, electricity shortage (operators of dialysis centers, for example, have complained how it hinders service delivery), many initiatives like the eradication of polio, smallpox, and other preventable diseases have been effective despite these deterrents.
We hope that the free dialysis turns out to be another such successful initiative and contributes to improvement of public health. People have been persistently let down by their elected representatives, in virtually all spheres of life. If noble initiatives like free dialysis can have the desired effect, people’s faith in democratic rule can be restored to a degree.
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