Authorities have failed to increase the minimal facilities for dialysis in J&K while centrally sponsored schemes for establishing district-level dialysis centers extending free dialysis to poor patients have taken off in many states across the country.
Beginning 2016, Union Ministry of Health and Family Welfare under the program implementation plan of National Health Mission sought proposals from states, including J&K for starting dialysis units. However, one year on, there is no sign of these centers, to be established at district hospitals.
The Union Ministry is extending support for establishment of dialysis units at district level, with the provision of providing free of cost dialysis to patients belonging to BPL category and charging others, the basis minimum cost; these centers are far from realization in Kashmir.
While officials in health sector blamed the government of complacency in ensuring affordable or free dialysis to poor patients, implementing agency, National Health Mission, said "official formalities" were being completed. "We are awaiting draft NIT from National Health System Resource Center (NHSRC), in order to be able to issue a fresh tender for the purpose," the Mission Director, National Health Mission, Dr Mohan Singh said.
Asked why there was a delay in issuing tenders, he said that the requirements of Union Health Ministry had changed. "Earlier we had issued tenders for equipment, manpower and consumables. Now we have received communication from GoI that 45 dialysis machines have been donated by a charitable trust," he said. "Consequently, fresh tenders need to be issued," he said.
Many states have already put in place dialysis centers, supported by GoI, or on public-private partnership, at various hospitals, to increase access to this service. Dr Singh, refused to comment on the cause of delay in putting these services in place said, "I cannot comment on what happened before I was here (as Director)."
Union Health Ministry recently approved Rs 200 lakhs for J&K for "provision of free dialysis services to the poor" based on the proposal submitted by state government. The funding is part of Union Budget 2016-17 for starting of 'National Dialysis Programme' under NHM, the Pradhan Mantri National Dialysis Programme was rolled out in 2016.
Doctors have time and against expressed concern over the dearth of dialysis units in Kashmir, a deficiency that they said could be costing someone his or her life. "A dialysis center has to be within the reach of patient. There are insufficient machines, insufficient infrastructure in our case. And that is a concern that needs to be addressed," Dr Mufti Mehmood, senior Urologist at SMHS Hospital said.
Kashmir for long had been banking on just ten dialysis units, two at SMHS Hospital and eight at SKIMS Soura. Last week, eight new dialysis units were added to the infrastructure of Government Medical College Srinagar, at Super-Specialty Hospital, GMC Srinagar officials said. At SKIMS, 12 dialysis machines are "soon to be commissioned", its administration said.
While the addition of 20 new units, which would mean an increase of 200 percent, would certainly reprieve the poor patients who are unable to fetch a slot on government sector dialysis machines and end up spending thousands in private sector, it is still far from adequate. Insufficient number of dialysis units are forcing thousands of patients with Chronic Kidney Disease, unable to afford private dialysis into non-adherence to dialysis protocols, deteriorating their condition further and even risking their life, doctors said. A single dialysis costs between Rs 2500 and Rs 4000 in private sector.