ONLY 148 dialysis centres, with about 135 of them being in the private hands, in Bangladesh and about 20 million people suffering from kidney diseases, with 40,000 needing regular dialysis or transplantation, are a strong indicator of how poor the government’s preparedness is as far as kidney diseases are concerned. An estimated 35,000 people lose kidneys every year and most of them only wait for death in the absence of adequate posthumous kidney donation, a major source of kidneys for transplantation. About 100 kidneys are, according to the Kidney Foundation Bangladesh, transplanted every year against the yearly demand for the transplantation of 20,000 kidneys. Such a poor preparedness is likely to stand the government in more trouble especially in view of a growing prevalence of diabetes and hypertension, which are regarded as major causes of kidney diseases. There are about eight million people with diabetes and they are 40 per cent at more risk of contracting kidney diseases and 20 million people suffer from hypertension, which entails 60 per cent more risk of contracting kidney diseases. All the factors together are likely to expose national health to a serious risk and burden more the national healthcare expenditure.
Kidney diseases, which are ranked, according to the National Health Bulletin 2016, sixth among the causes of death in the country’s medical college hospitals in 2015, are also placed in the seventh among the causes of death in district-level hospitals that year. With an extremely inadequate facilities for the treatment of kidney diseases, and mostly with high cost that dialysis centres in the private hands involve, it is almost impossible to attend to the issue effectively. A single session of dialysis in government-run centres costs about Tk 400 while the cost increases up to the Tk 1,600–Tk 5,000 ranges in private healthcare hospitals. A single patient in need of generally two to three sessions of dialysis a week, only 15 to 20 per cent of the 40,000 patients who need regular dialysis can afford the treatment. This leaves the government with no option but to expand dialysis facilities at a lower cost and equip upazila health complexes and 15,000 community clinics with screening facilities for kidney diseases as people above 40 years of age should be tested for the diseases twice a year. The government, along with all this, should also run a massive awareness campaign so that people go for screening as often people with kidney complaints see physicians when 70 per cent of the kidney is damaged.
The government, under the circumstances, must lower the cost of dialysis, by setting up more dialysis centres in the public sector and by lowering taxes on the import of dialysis machines and related equipment for private healthcare facilities. It must run awareness campaign for screening and promote a healthy way of life involving more physical activities and checking against obesity and overweight to prevent the spread of non-communicable diseases. It must also promote posthumous kidney donation and address any legal issues that could stand in the way.
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