Government Apathy

Bir Hospital has not been able to resume the kidney transplant after a single surgery that was conducted ten months ago

By THAKUR AMGAI

Even as the news reports of dozens of Nepalis people seeking kidney transplant in Indian hospitals being cheated by frauds continue to hit the newsstands, the government has given no interest to begin the kidney transplant facilities inside the country.

After years of wrangling over legal issues the government had permitted Bir Hospital to conduct the renal replacement surgery in November last year. However, because of the lack of proper homework and preparation, the very first surgery had been unsuccessful.

The Hospital had admitted 12 patients for the renal replacement surgery. But it did not conduct the surgery of eleven patients after the surgery on Pradeep Chadhary did not succeed.

Instead of resuming the service by rectifying the mistakes, the hospital is entangled in its own internal problems forcing the patients to suffer further.

Because of the delay in the resumption of the service thousands of kidney patients and their close relatives have been suffering. While many are waiting for the kidney transplant to resume in the country, others are heading for India to have the surgery.

After the legal issues over the organ transplant was settled last year with the endorsement of Organ Transplant Act and Kidney Transplant Regulations, few private hospitals, too, have shown interest in conducting the renal replacement surgery. But the government has licensed only Bir Hospital to conduct the surgery.

At present, patients with a strong financial position go to India to have their kidney replaced. The Kidney transplant in Indian private hospitals costs up to one million rupees. But most of the patients are left without treatment.

If the kidney transplant surgery could resume in Nepal , it would be cheaper and easier. A larger mass of the population could benefit. Bir Hospital has said that it can conduct the surgery for Rs. 200,000 and private hospitals have claimed that they could provide the service for less than Rs. 400,000.

Kidney transplant surgeons need a special training before they practice it and some doctors from Nepal have received the license. Dr. Ashok Rana and Dr. Arjun Dev Bhatta, both Urologists and licensed Kidney transplant surgeons had conducted the surgery last year. The ministry of health had tried to bring expert doctors from India , but had to give up after the doctors at the Bir Hospital disagreed.

It is not the failure of the first surgery, but the discontinuity of the service that has worried the patients and their relatives. Because of the apathy of the century old government hospital they are bound to spend a large amount of money in foreign land for the service which could have been done in much less price and easily in the country.

Doctors, hospital administrators and patients say that when the licensed hospital has not been able to provide service for ten months, private hospitals which have applied for the license should also get the license. "It is unjustifiable that only one hospital gets the license to conduct the renal replacement surgery. Other hospitals which have applied for the license and have adequate facilities and manpower should be authorized, too. Examples in India have shown that private hospitals can be very successful in conducting renal replacement surgery," said Dr. Rishi Kumar Kafle, leading Nephrologist and the director of National Kidney Center .

Despite the win-win situation in licensing the private hospitals for renal transplant surgery, why the authorities has not licensed them is puzzling.

But, the government has no immediate plans to change this regulation. "As of now, only Bir Hospital is licensed to conduct the renal surgery," said Dr. Hari Nath Acharya, spokesperson of the Ministry of Health. "If it cannot provide the service then it is another matter to provide license to other institutions. But, there are no immediate plans (to do so)."

It is now ten months that Bir Hospital has not been able to provide the service and how long will it take to convince the ministry that it should give license to other health institutions, too, remains to be seen at the cost of the suffering patients.

The patients are also suffering because of the inadequacy of the haemo- dialysis facility in the country. Only two government hospitals Bir Hospital and Tribhuwan Teaching Hospital both in Kathmandu provide the service. In the private sector, National Kidney Treatment Center caters this service to the largest number of patients. Outside Kathmandu valley, the facility is available in only a few cities such as Pokhara,
Nepalgunj and Birgunj.

While, it is estimated that there are about 25,000 kidney patients in Nepal , haemo-dialysis facility is available for only about 300 patients.

A patient with kidney failure needs to continuously undergo haemo-dialysis until the kidney is replaced. The treatment that needs to be done two to three times a week costs about Rs 15,000 in government hospitals and about Rs 35,000 in private hospitals per month.