KATHMANDU: The government initiatives targeted to help kidney patients ease their struggle for life seem catalytic in bringing them to the hospital though the medical requirement of the patients seems still far from being addressed.
The government of Nepal has been providing various medical subsidies to the patients of 8 diseases labeled as the most chronic turning the amount thus spent to Rs 2 billion.
The government has been providing financial aid to various patients suffering from either of the 8 diseases it has labelled as chronic under the Fund for the Medical Treatment of the Deprived Citizens.
The diseases thus labeled include kidney, heart, Parkinson’s, Alzheimer’s, spinal injury, head injury, and sickle-cell and anemia. This year alone the government has allocated Rs 2.20 billion for the purpose.
According to Mahendra Dhoj Adhikari, the head of the department, Rs 2.18 billion of the allocated budget will be spent on the treatment and health facilities of the patients whereas Rs 1.85 billion rupees go to the management of the fund.
With the government’s subsidies, the patient’s pressure in the hospital seems growing. Kidney related diseases are also among one of the 8 diseases listed in the chronic ones.
Out of 3 million kidney patients in Nepal, nearly 3,000 suffer from kidney failure every year, the nephrologists claim.
The kidney patients get the support worth Rs 25 hundred to 500 thousand for transplantation, dialysis or for medical treatment.
The government has been providing the patients requiring kidney transplantation the support worth Rs 400 thousand.
Similarly, the government provides Rs 100 thousand to the kidney patients with the short term malfunctioning patients, whereas the patients who need not or cannot (due to fragile health) go for transplantation or dialysis due to the failure of both kidneys get Rs 100 thousand as the medication and laboratory cost.
Likewise, after the transplantation, they get Rs 100 thousand for medication. The government has arranged for the discount worth Rs 50 thousand in the laboratory charge of the donor and receiver of the kidney.
In the same way, patients suffering from kidney failure and required to go through dialysis two or more than two times get a discount worth Rs 2,500 in one dialysis, whereas the patients with infection caused by kidney problems get a discount worth Rs 4,000 per session as the support for dialysis.
More than 4 thousand receive hemodialysis service
The records at the Nursing and Social Security Division at the Department of Health Services show the rise in the number of kidney patients receiving support provided by the government.
The statistics at the Division show that the number of such patients has gone up remarkably in the last 4 years.
According to it, 1,939 people received hemodialysis service in FY 2072/73 whereas the number reached to 2,197 in the fiscal year 2073/74.
Similarly, the number nearly doubled making it 4,110 in the fiscal year 2074/75 and had a slight rise in the fiscal year 2075/76 when the hemodialysis service receivers reached 4,140, the statistics provided by the Division show.
In 4 years, 819 patients received the offer after transplantation
The government has made the provision of providing kidney patients Rs. 100 thousand after the transplantation and 50 thousand before transplantation.
The discount offered before the transplantation is meant to facilitate the laboratory charge for the donor and the receiver’s medical checkup mandatory before transplantation.
For the medical treatment after the transplantation and the medical check-up prior to transplantation, 819 people have benefitted themselves from the government’s scheme in the last four years.
To be more specific, 255 people had received Rs 25.5 million at the rate of Rs 100 thousand per-person in FY 2073/74, when 274 received Rs 35.8 million at the rate of Rs 150 thousand per person in the year 2075/75.
Similarly, 263 people benefitted from Rs 39.45 million at the rate of Rs 150 thousand per person in 2075/76 and since Mid-July 27 kidney transplantation patients have received 4.05 million at the rate of Rs 150 thousand per person, the data provided by the Nursing and Social Security Division claims.
So far, Sahid Dharmabhakta National Transplant Center and Maharajgunj based TU Teaching Hospital have been transplanting kidneys in Nepal.
However, Mahendra Dhoj Adhikari, the head of the Social Health Security Section, confessed that there much to be done to ensure the easy medical checkup of the donor and the receiver of the kidney and also to make all required medicines available in the pharmacy.
He added that after receiving a complaint about not getting a chance for a complete health checkup and medication from the transplanting hospitals, the government has started providing Rs 150 thousand to the patients after the transplantation.
“The patients willing to undergo transplantation get the service from Maharajgunj-based TU Teaching Hospital and Sahid Dharmabhakta National Transplant Center,” Adhikari said. “However, the sum of Rs 150 thousand promised is provided from the Division when they come to us.”
The amount deemed to be provided by the Medical Treatment of Deprived Citizens, under the Social Health Security Division, is provided to the hospital after transplantation.
Complaints about not getting timely service
Seventy-two hospitals of Nepal are enlisted as hospitals eligible to provide financial support the government has decided to provide to the kidney patients.
The patients get support and free treatment facilities provided they entertained the medical service from those hospitals.
On submission of the list of the beneficiaries from the hospitals, the hospitals are compensated with the cost they bore for the treatment or free checkup of the patients.
Another requirement for getting financial support is the document made by the municipality or the rural municipality verifying the ‘economic backwardness’ of the patients.
Those who do not get the support despite the documents reach to knock the door at the Social Health Security Division stationed at Teku, Kathmandu.
“It could be due to the government’s financial support, the kidney patient’s flow to the hospital is increasing,” Adhikari said. He added that several patients flock to the Division complaining that they did not get the turn for dialysis.
Transplantation queue at TUTH: Patients wait for more than two months
Maharajgunj based TUTH, one of the hospitals providing dialysis and transplantation service to the kidney patients, is undergoing much pressure due to the flocking of the kidney patients.
“There is the queue for two months for kidney transplantation here,” Dr. Mahesh Sigdel, an associate Professor, at the Department of Nephrology and Transplantation at TUTH said. “The new patients waiting for dialysis hardly get the chance due to the old ones striving for their turn,” he added.
According to Dr. Sigdel, 10 dialysis machines at TUTH have been providing 40-50 sessions a day in contrast to the requirements for hundreds of such sessions.
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