Call for more dialysis centres

BY LOH FOON FONG

PETALING JAYA: Nephrologists are urging the Health Ministry not to stop issuing licences to NGOs to set up haemodialysis centres in rural areas as peritoneal dialysis (PD) services cannot meet demands there.

National Nephrology Services head Datuk Dr Ghazali Ahmad said there were more than enough haemodialysis centres in the west coast of the Peninsular Malaysia but they were most inadequate in states such as Terengganu, Sabah and Sarawak.

“Not all patients were able to use PD and the Ministry should be more balanced in its policy in providing haemodialysis besides PD,” he said.

PD is a treatment for patients with severe chronic kidney disease that makes use of the patient’s peritoneum in the abdomen as the membrane to filter out waste.

However, it needs a high degree of commitment and discipline from the patient as infections can still arise if things are not properly handled.

On Tuesday, The Star carried an exclusive report on the ministry announcing that it was not issuing any more license for haemodialysis centres, and is closing down in stages, centres that did not meet its requirements.

The following day, its deputy health director-general Datuk Dr S. Jeyaindran said that it would focus more on PD than haemodialysis.

According to the ministry, as many as 5,000 Malaysians suffer end-stage kidney failures each year due to poor lifestyle habits.

Dr Ghazali said that he welcomed the shutting down of non-compliant centres as they disrupt the services in established centres by taking away trained doctors and nurses who are currently in short supply nationwide.

However, Sabah Kidney Society nephrologist Dr Liew Boon said the ministry should make exceptions for non-profit organisations in less served states.

He said that PD is unsuitable for the remote communities in Sabah because many of them did not have clean water and electricity.

“They use water from wells and there is no guarantee that they can clean their hands properly for them to handle PD,” he said, adding that low levels of hygiene could lead to infections.

He also questioned whether the ministry had the capacity to send eight litres of dialysate (a liquid needed for PD) to homes that are only accessible by boats and four-wheel drives on a weekly basis.

Dr Liew added that the ministry should not only allow some NGO-run haemodialysis centres that did not comply with staffing requirement to continue operating in underserved areas, but to lend its staff to help these centres as they desperately sort out their manpower problems.

Related story:
Minister: We are not closing our doors

Higher risk at illegal centres

THE STAR

BY LOH FOON FONG
foonfong@thestar.com.my

PETALING JAYA: The survival rate of patients is less than 50% after one year of dialysing in some unlicensed haemodialysis centres.

This is much lower than the national average of more than 80%, said a senior nephrologist.

“We do not have details as to why this is happening but we are concerned,” said the nephrologist, who declined to be named. He was responding to a report in The Staron Tuesday of the Health Ministry’s plan to close down – in stages – haemodialysis centres which did not meet requirements.

The report quoted National Kidney Foundation chairman Datuk Dr Zaki Morad as urging the ministry to approve applications for haemodialysis centres in rural areas.

Consultant nephrologist Dr Ong Loke Meng, said he was not aware of any centre with a less than 50% survival rate but, he said, some centres with a high death rate might have taken older and very ill patients.

He said the Health Ministry had, in the past, temporarily suspended centres where the patients were found to have contracted Hepatitis C. Deputy Health director-general Datuk Dr S. Jeyaindran said that the ministry was clamping down hard on centres that did not meet the requirements.

He said to make it easy for patients to check the approval status of any centre, the ministry was coming up with certificates with serial numbers that will be displayed at haemodialysis centres.

He said currently, the centres were only issued letters of approval.

Dr Jeyaindran also said that the ministry would focus more on peritoneal dialysis (PD) treatment than setting up new haemodialysis centres to make treatment more accessible to patients, especially those in rural areas.

“We are not in favour of having more haemodialysis centres because we already have an excess of capacity and they are also more expensive to maintain,” he said.

Meanwhile, the Penang Welfare, Caring Society and Environment Committee chairman Phee Boon Poh said it had obtained all the necessary approvals for the state’s CAT Dialysis Centre at the Balik Pulau market complex.

The centre is said to be the first state-run dialysis centre in the country.

For enquiries, call 04-262 0860.

Ministry says no to new dialysis centres

the star

BY LOH FOON FONG

PUTRAJAYA: The Health Ministry has stopped issuing new licences for dialysis centres and will close down existing ones that do not meet requirements and endanger patients’ safety.

There are now 560 haemodialysis centres nationwide run by NGOs and private firms but only 326 have licences from the ministry.

Deputy Health director-general Datuk Dr S. Jeyaindran said the centres that failed to meet standards would be closed down in stages after being given enough time for compliance.

The ministry would also find suitable alternative centres to relocate patients.

“Two haemodialysis centres, one in Kuala Lumpur and the other in Penang, were closed down recently,” he said.

Health woes: A patient receiving haemodialysis treatment at the CAT Dialysis Centre in Balik Pulau, Penang. 

Out of the 234 unlicensed centres, 114 had structural problems, were run without proper policies and did not submit applications for approval.

The issuance of licences to 80 centres was deferred because the operators did not comply with requirements as promised while another 40 centres did not have trained staff.

The pinching of staff also meant that some centres, whose employees had left, were unable to meet the requirements.

Operating licences of haemodialysis centres are renewable every two years, subject to meeting the ministry’s criteria.

Last month, The Star highlighted the plight of haemodialysis patients whose approvals for a government subsidy of RM600 per month were delayed.

An estimated 5,000 new kidney patients were diagnosed with end-stage kidney failure each year over the last three years. About half the patients going to NGO-run centres need treatment subsidy from the Government.

Dr Jeyaindran said the ministry had given out almost RM45mil (RM2mil in subsidy for dialysis and RM21mil in subsidy for erythropoietin injections each year), not including aid given by other government agencies.

Erythropoietin is a hormone produced by the kidneys and controls red blood cell production.

Click on graphic for larger view. 

He said the ministry was looking for companies to donate dialysis machines to ensure that the lower income group also received haemodialysis treatment with patient safety adhered to, as done by Maybank and Tabung Haji.

“We have the capacity for 1,700 dialysis slots but we only have 1,500 machines and need 200 more,” he said.

He said sponsorship from non-government entities was in keeping with the Prime Minister’s call for a public-private partnership, which encouraged optimum utilisation of resources.

On the training of renal staff, he said the ministry and the Malaysian Society of Nephrology had started a 200-hour programme on dialysis management for 60 doctors and also increased the number of renal nurses being trained.

There will be three more programmes to ensure an adequate number of trained doctors and nurses by the end of next year.

Related story:

Group: Government should set up new kidney dialysis centres in rural areas

BY RAZAK AHMAD AND RUBEN SARIO

PETALING JAYA: The National Kidney Foundation chairman Datuk Dr Zaki Morad called upon the Health Ministry to approve applications to set up new kidney dialysis centres in rural areas

“In rural areas, patients need to travel long distances, up to three times a week, to the nearest dialysis centre and this is a burden for many.

“We need more centres in smaller populated rural locations, especially in Sabah and Sarawak,” said Dr Zaki.

He said investors would not be interested in setting up dialysis centres in many rural locations because it was not possible to turn in a profit with the sparse populations.

“We should consider setting up more centres via partnerships between the government and non-profit organisations,” said Dr Zaki, adding that the centres must also be run efficiently, using the machines to treat more people.

He said that although one machine could cater to six patients, many centres only served three to four patients per machine.

For three patients in Sabah, getting to haemodialysis treatment is a two-hour boat ride followed by another two hours on a four-wheel drive vehicle to the nearest district hospital.

The patients, including an 11-year-old child from the remote interior settlement of Pagalungan in the Pensiangan district undergo this process each time they need treatment.

State Assistant Minister of Agriculture and Food Industry Datuk Sairin Karno said they would have to take a boat to Sapulut before hopping on board a four-wheel drive vehicle to the Keningau district hospital, adding that the journey was only possible if the weather was fine.

Sairin, who is Liawan assemblyman, said the Keningau hospital had six haemodialysis machines but they were insufficient.

“We have asked the authorities to provide machines to smaller hospitals such as the one in Nabawan.

“This will make the treatment more accessible to rural folk,” he said.

He said the Welfare Department should also provide financial aid to kidney patients from remote areas who have to travel to towns to get haemodialysis treatment.

Blind entrepreneur receives recognition from Govt for providing jobs to the disabled

the star

BY LOH FOON FONG

Founder of Koko Minda Food Industries (M) Sdn Bhd Salim Salleh.

SERDANG: Blind entrepreneur Salim Salleh was all smiles when he received a trophy, certificate of appreciation and a bouquet of flowers from the Government for providing jobs to the disabled.

While most disabled persons beg for jobs, Salim, 56, decided to be an employer.

Salim, who became blind in 2008 because of diabetes went on early retirement from the Anti-drug Agency and started a business producing cocoa drink with added herbs and fruits the following year.

He started his company Koko Minda Food Industries (M) Sdn Bhd and began mixing the products manually and produce 1,000 boxes (15 powder sachets per box) of the drink a month but now with mixer provided by the Department, he could produce 1,000 boxes a day.

“I did not expect to receive this recognition on a National and International Day of People with Disability,” said the elated Salim after the National Day of People with Disability yesterday.

He said that those with disabilities could compete with able bodied people and he hoped that his achievement would motivate others with disabilities to use their talent for the country.

Being a diabetic, Salim wanted to create something healthy for people and liked the cocoa drink, which contains high anti-oxidants.

He decided to mix cocoa with ginkgo biloba and brought it to the Malaysian Agricultural Research and Development Institute (Mardi) and Sirim for advice.

Mardi then advised him to add in the pegaga leaves (pennywort), dates, raisins and honey.

“I took their advice and I made the concoction and fed it to my four-year-old son and was surprised that he began to be more attentive, learned quickly, talk more and even read,” he said.

That motivated him to start developing the business with assistance provided the Human Resource Department and the Small and Medium Enterprise Corporations.

He said that when he left the Government service, he was earning RM4,000 a month but now earns RM30,000 a month, something which he did not expect.

Salim said that the Department had offered assistance to him with the agreement that he would hire other disabled people and he agreed.

He said that he pays the workers RM900 as minimum wage and more if they could be as efficient or almost as efficient as a normal bodied person.

“We pay according to their abilities and the hours they want or is able to work,” he said.

He said that the Department would be helping him order another RM500,000 mixer to increase productivity and export the products to Singapore, Indonesia and the Philippines.

Salim said that customers had told him that the nutritious drink had helped them with their health in one way or another.

A recipient on academic excellence award, wheel-chair bound Loh Xin Yee, 13, who received 7As for her UPSR in 2012 said, “If we put our minds to the things we want to achieve, it can be done,” she said who received a trophy, certificate, a bouquet of flowers and RM300.

Her mother beautician Susan Ng, 33, said that her daughter was an intelligent and dertermine child and would work towards her goals.

In her speech, Women, Family and Community Development Minister Datuk Seri Rohani Abdul Karim urged employers to offer employment opportunities and provide suitable amenities to the disabled.

“People with disabilities should not be seen as a weak group or often expecting sympathy from people but as people with potentials that could be built and polished,” she said.

She said the Human Resource Department’s records in the Peninsular Malaysia showed that from 1990 to August 2013 as many as 13,973 people with disabilities had registered for job opportunities in the private sector through the People with Disabilities Job System.

From the numbers, 9,176 (66%) people with disabilities had managed to get jobs and were placed in various sectors.

The Public Services Department showed that there were 1,754 public servants with disabilities working in various ministries, departments and government agencies, she said.

Lawyer: Say no to child marriages

The Star

PETALING JAYA: United Nation’s Committee on the Rights of the Child member Yasmeen Shariff has urged the Syariah Court not to be too quick in granting consent for underage marriages.

Yasmeen, a child rights lawyer, said children’s groups rejected underage marriage as most teens were not mature enough for the responsibilities and it deprived them of education.

Yasmeen also urged the Women, Family and Community Development Ministry to provide support and proper counselling to parents on underage marriage.

Help for diabetics to prevent complications

the star

BY LOH FOON FONG

Taking precautions: Dr Jeyaindran launching the workshop on diabetes prevention and management by Diabetes Malaysia.

PETALING JAYA: The Health Ministry will soon kickstart a programme to educate diabetics about their condition to prevent the onset of complications.

Health deputy director-general Datuk Dr S. Jeyaindran said awareness on the complications such as kidney failure, blindness or limb amputation was still low.

“The main reason why many Malaysians suffer from those complications is the lack of awareness on the need to control the disease,” he said during the 2013 Diabetes and Management Workshop yesterday.

Dr Jeyaindran said the team of educators would include doctors, nurses, physiotherapists, occupational therapists, dieticians and pharmacists who would send out the same message to patients so they would get the message “loud and clear”.

“Patients need to be educated early on that diabetes is a slow killer,” he said.

He said diabetes cases were increasing at an alarming rate at 11% of the population in 2005 to 15% in 2011 and were likely to be one in four in the near future.

Dr Jeyaindran said the ministry was also working with the Community Development Depart­ment under the Rural and Regional Development Ministry to educate some 500,000 women on providing healthy food for their families.

Asked about a study by a Malaysian endocrinologist in Newcastle University who managed to get patients’ blood sugar levels back to normal through a diet of 600 calories per day for two months, Dr Jeyaindran advised caution.

He said the amount would not provide adequate energy for the day as people needed 1,500 to 2,000 calories per day. The diet, over a long term, could lead to starvation and even coma.

Dr Jeyaindran said that those at the pre-diabetic stage could control their condition through diet but once the disease was full blown, it would require diet, medicine and exercise.

Five groups to work on unity

the star

BY LOH FOON FONG

PETALING JAYA: Five working groups will be set up to address various unity-related issues when the National Unity Consultative Council members meet for the first time next month.

Its president Tan Sri Samsudin Osman said that the working groups comprise legal and the promotion of national harmonious policies, national building and cross-cultural understanding, inclusive development, youth and unity, and national integration.

“The members in the council are made up of a diverse group, with people of various backgrounds and age groups who are rich in experience,” he said yesterday.

Prime Minister Datuk Seri Najib Tun Razak announced the launch of the council on Monday to replace the National Unity Advisory Panel which ceased to function after the Emergency Ordinance was abolished.

Samsudin said that a lot of work had been done by the Prime Minister’s Department in collaboration with Institut Kajian Etnik of Universiti Kebangsaan Malaysia (UKM) and the council would work closely with them.

On critics doubting the council would have enough bite to carry through its recommendations, Samsudin said: “We are hopeful. The PM (Prime Minister) has given his assurance.

“The recommendations will be looked at by the Cabinet. We need to come up with policies that are pragmatic and can be implemented.”

Council member Associate Prof Dr Madeline Berma from the UKM’s Tun Fatimah Hashim Women’s Leadership Centre said she was glad the Government was putting a serious effort in uniting the various ethnic groups.

“I hope the work we do is not confined to consultative efforts. We want action,” said Dr Madeline, an Iban from Sarawak.

Another council member Audrey Goh, a life member of the Sarawak Federation of Women’s Institute said she saw her role in the council as a “bridge builder”.

She said she would use skills of advocacy and inquiry to engage and enlighten the community on unity and encourage participation and “bridge building” initiatives.

Another council member Zubedy (M) Sdn Bhd managing director Anas Zubedy said it was important for the council to create “bridge builders”, including people or system processes that bring people together.

He said it was important for all of society to play a role in unity efforts so that the negative action by a few would be diluted by the good most people promote.

Another council member Lim Chee Wee said the hostile discourse on race and religion over the past few years required the participation of as many people as possible to reduce the tension.

“The biggest challenge is to reach a consensus on steps that would be effective for achieving national unity while the ultimate test is whether the Government and people will accept and carry them into effect,” added the former Bar Council chairman.

NGOs: Consultative council should be more open

PETALING JAYA: NGOs want the National Unity Consultative Council (NUCC) to be allowed to be more open and transparent in its approach.

Global Movement of Moderates Foundation chief executive officer Datuk Saifuddin Abdullah said the council needed to be more open and transparent if it wanted to get the public to buy in to their efforts.

Saifuddin, who is also a council member, said the council must also start with moving from race-based policies to needs-based policies.

“Proposals for unity goals must be based on this,” he said, adding that the council must be bold in taking on issues relating to equality in citizenship and good governance.

Malaysian Consultative Council of Buddhism, Christianity, Hinduism, Sikhism and Taoism president Sardar Jagir Singh said the council should be more open except for sensitive issues, where they could get the stakeholders to attend the closed-door meetings to provide feedback.

Jagir, who is also a council member, said its objectives were noble and if its efforts were to be carried out properly, it would bring about more harmonious living and greater peace.

Jaringan Melayu Malaysia president Azwanddin Hamzah welcomed the setting up of the council.

He said the council must engage NGOs as well, so that it could be effective.

“The disunity that has seeped into society has to be taken seriously and addressed. We need to educate the young to respect one another,” he said.

DPM: Nation must focus on human capital growth

The star

BY LOH FOON FONG AND MAZWIN NIK ANIS

KUALA LUMPUR: It is important for Malaysia to prioritise its human capital development and address income and wealth inequalities, Deputy Prime Minister Tan Sri Muhyiddin Yassin said.

He said the 21st century had been referred to as “The Asian Century” due to astounding growth and the Asian Development Bank had projected that by 2050, it could double its share to account for half of the global GDP.

However, the Asian era is not just one of economic success but also great political, cultural and civilisational influence, he said.

As such, he said, Malaysia must prioritise its human capital development, strengthen its governance institutions and address income and wealth inequalities, as well as arrest environmental degradation.

Muhyiddin said this during the launch of the MIDA Forum 2013 “Asian Era: Malaysian Perspective” yesterday.

“As the world economy recovers, Asia is set to lead the way in reforms and transformations towards higher income levels,” he said.

“Asia’s rise offers many opportunities that we must take, as well as significant challenges that we must overcome.”

Earlier yesterday, Muhyiddin said Umno members would be given greater freedom to raise issues of their concern during debates at the coming general assembly as the party leadership wanted to hear what was in their hearts and minds.

The Umno deputy president said that with the party polls over, delegates could shift their focus on debating issues that “are of concern to the nation and race”.

“We want to know if they are happy, satisfied, frustrated or otherwise. Allowing Umno members to speak is a good way to measure how they feel about what is happening in the party and Government.

“It is also a good opportunity for us to tap ideas and views on how we can progress and improve, be it in Umno or the Government,” he said after opening the International Palm Oil Congress 2013.

Muhyiddin said that among issues which he expected delegates to raise would be the recent party election and the outcome of the May 5 General Election.

The Umno general assembly will be held from Dec 2 to Dec 7 while the party elections, following amendment to its constitution, saw the participation of 150,000 members for the first time. The party elections concluded on Oct 21.

Don't attempt childbirth at home without medical supervision, says expert

The star

BY LOH FOON FONG
foonfong@thestar.com.my

PETALING JAYA: Childbirth is a serious and potentially dangerous matter and pregnant mothers must not attempt unsupervised birth at home, the Obstetrical & Gynaecological Society of Malaysia warns following the death of Ang Lay Chin who has opted for homebirth.

Hitting out at pro-homebirth groups for advocating homebirth without medical supervision, president Dr Tang Boon Nee said that it was unfortunate that the advice often went unheeded.

“The seminars on various pro home-childbirths were often conducted by mothers themselves who had gone through homebirths and believe that every other births should be the same.

“As it is unfortunately evident, mothers can die from childbirth, especially one which is assisted by unqualified assistants who have only seen few births, and do not recognise the signs of problems,” she said in a press statement yesterday.

Dr Tang was commenting after the death of Ang, 40, who had suffered excessive blood loss after giving birth to her first child in her house in Sri Kembangan, Selangor, on Nov 13, the Kwong Wah Yit Poh reported.

She said that medical supervision in childbirth was needed as complications could arise, resulting in devastating outcomes.

“In the event of excessive bleeding after childbirth, we have a ‘window of opportunity’ to stop the bleeding, using intravenous drip, medication to contract the uterus and physical maneuvres to reduce bleeding,” she said.

In the event of vaginal tears causing bleeding, to bring the patient into operating theatre to repair tears and stem bleeding, she added.

“Unfortunately, if the bleeding has gone on for some time, that window of opportunity is lost, resulting in the loss of a life,” she said.

Dr Tang said that a lot of homebirth advocates were not qualified nurses or doctors, and had not seen the complications that can arise from childbirth.

She said that Malaysia was seen as a model as a forerunner in reducing maternal mortality.

The doctors and nurses in Malaysia had worked tirelessly to reduce maternal mortality from childbirth to 28 per 100,000 from hundreds per 100,000 many years ago and was saddened to hear of another maternal death, she said.

“One of the most important aspects of this effort is to make available safe environments for childbirths, be it in a district, state, general or private hospitals, supervised by qualified medical and nursing staff,” she said.

Dr Tang said that childbirth educators must have the necessary qualifications if they were to conduct homebirth classes.

NKF: Surplus needed in case funding is cut

The Star

BY LOH FOON FONG

PETALING JAYA: The National Kidney Foundation said it has been subsidising poor patients and that its reserves are just adequate for contingencies and expansion plans.

 

Its chairman Datuk Dr Zaki Morad (pic) said the cost of haemodialysis per session for NGOs was RM150, but patients were charged only RM100 at NKF as it absorbs RM50 of the cost.

He said some patients were subsidised by the Social Security Organisation or other government agencies but others who were not, also received RM50 subsidy from the Government.

However, he said, even after the RM50 subsidy, there were patients who were unable to fork out the remainder and the NKF would also absorb this payment, providing them free haemodialysis.

Apart from that, he said the foundation would also pick the tab for patients who were still waiting for the RM50 subsidy from the Government.

“The reserves that we have is being spent. It is true that we have a surplus, but we need to keep it in the event funding sources are cut,” he said.

Dr Zaki was responding to The Star’s report on Friday where a life member and a staff member of NKF had said that it had a surplus income of RM5.644mil and other savings as of January last year and hence, should pick up the haemodialysis tab for poor patients, even if the Health Ministry had not approved their subsidies.

This follows The Star’s front page report Thursday highlighting the plight of haemodialysis patients in NGO-run centres who had not received approvals for government subsidy.

The problem became acute since mid last year and approvals became negligible this year. Some applications have yet to be approved since 2011.

On NKF accumulated savings of more than RM50mil, Dr Zaki said its board of directors had decided to keep a financial reserve that would sustain two years of operations should all sources of income stop.

This is based on an estimation that it would take about two or more years for the foundation to place all its patients in other centres that would be willing to accept them should their funding be cut.

Dr Zaki also said that NKF had also kept the reserves for the setting up of new haemodialysis centres, maintaining current ones, carrying out kidney screenings as well as awareness campaigns.

It costs NKF RM2mil to set up a centre and they have been opening two to three centres a year, targeting states with low rates of treatment such as Sabah, Sarawak, Kelantan, Terengganu, Kedah, Perlis and Pahang.

He said that NKF’s annual operating expenditure was between RM32mil to RM35mil a year, of which the cost of the haemodialysis programme was RM25mil.

Doc: NFK’s surplus just isn’t enough to cope

the star

(no byline but follow-up exclusive by me)

PETALING JAYA: A nephrologist who volunteers at a haemodialysis centre has refuted claims that RM5mil is a huge surplus for the National Kidney Foundation (NKF).

Dr Liew Boon Seng, who has been providing his service to two NGO haemodialysis centres in Sabah, said the surplus reserve was not much in view of the foundation’s 1,557 patients.

He said if NKF picked up the Government’s tab of RM50 subsidy per session and 13 sessions per month for each of the 200 patients still waiting for the subsidy approvals, it would cost it RM1.56mil a year, not including the cost of Erythropoietin injection.

“How long should NKF fill the void while waiting for subsidy approvals? What if the approvals never come or the applications are rejected?”

Dr Liew was responding to The Star’s report on Friday where a life member of NKF had pointed out that the foundation had surplus income of RM5.644mil as of January last year and hence, should pick up the haemodialysis tab for their poor patients, even if the Health Ministry had not approved the subsidies.

This follows The Star’s front page report Thursday highlighting the plight of haemodialysis patients in NGO-run centres who had not received approvals for government subsidy.

The problem became acute since mid-last year and approvals became negligible this year. Some applications have yet to be approved since 2011.

On NKF’s accumulated savings, he said that NGO centres also faced increasing number of patients and to set up 20-chair hemodialysis centre in any cities would cost up to RM4mil.

Meanwhile, in response to the Ministry’s reply to the front page story that it had not stopped funding for the poor in NGO-run centres, MAA Medicare Kidney Charity Fund senior vice-president Aliyah Karen said it should respond to patients’ application forms quickly.

Health director-general Datuk Dr Noor Hisham said rejected and pending haemodialysis subsidy applications were mainly due to incomplete supporting documents relating to socio-economic status or that the NGO or private centre had not been approved by the ministry.

Ministry denies stopping subsidy

the star

BY LOH FOON FONG

PETALING JAYA: The Health Ministry has denied that it has stopped giving subsidy for haemodialysis treatment to poor patients seeking treatment at NGO-run centres.

Health director-general Datuk Dr Noor Hisham Abdullah said the rejected and pending cases were mainly due to incomplete supporting documents relating to socio-economic status or that the NGO or private centre had not been approved by the ministry.

“The Government has never stopped providing subsidy for haemodialysis treatment and injections provided by the NGOs,” he said in response to The Star’s front-page story on Thursday highlighting the plight of haemodialysis patients who said they had not received approvals for government subsidy.

NGO centres said that the problem became acute from mid-last year. They claimed that approvals were negligible this year and some had not been approved since 2011.

Dr Noor Hisham said that each year the Government spends RM31mil on dialysis treatment and Erythropoietin injection subsidies at RM1,040 per month or RM12,480 a year for each patient.

This year, the ministry received 458 subsidy applications; 141 were approved, 81 rejected and 236 pending approval, compared with a total of 824 applications last year when 488 of them were approved, 102 rejected and 234 still pend-ing.

In 2011, of the 954 applications, 730 applications were approved and 61 rejected.

Since 2001, the ministry had spent RM231.2mil in subsidy on haemodialysis patients and another RM41.6mil on Erythropoietin injection which has benefited 3,048 patients since 2009.

Dr Noor Hisham said that the ministry was reviewing the status of dialysis centres and might close down those that did not meet the standards to ensure patients’ safety.

“But before such action is taken, the ministry will take proactive measures to ensure the affected patients will continue to receive dialysis treatment at other licensed centres located near their house or at the ministry’s facilities,” he said.

He said that in view of the challenges arising from dialysis treatment as a form of renal replacement therapy, the ministry had moved towards Continuous Ambulatory Peritoneal Dialysis (CAPD) as the preferred choice of therapy.

Recently, Prime Minister Datuk Seri Najib Tun Razak announced that CAPD would be provided to about 1,000 patients beginning next year.

Pick up dialysis tab of the poor, NKF urged

The Star

BY LOH FOON FONG

PETALING JAYA: New kidney patients will be given priority for the RM600 monthly subsidy for haemodialysis treatment, the Health Ministry said.

“Our pool of funds is focused towards new patients as they have never had treatment and may require dialysis urgently,” said Health director general Datuk Dr Noor Hisham Abdullah.

However, he added, patients already undergoing haemodialysis would not be neglected and would be given assistance as announced in Budget 2014.

Prime Minister Datuk Seri Najib Tun Razak had announced free treatment kits, or Continuous Ambulatory Peritoneal Dialysis costing RM19,000 each for patients with end stage kidney failure to enable them to do the treatment at their own home.

An estimated 5,000 new kidney patients were diagnosed with end-stage kidney failure each year over the last three years, with 26.9% likely to be seeking treatment from 53 NGO centres. On average, half the patients needed subsidy from the Government.

Dr Noor Hisham told The Star that the ministry was reviewing its funding for haemodialysis treatment to make it more cost effective, among other reasons.

“Although our budget allocation increased this year, emoluments are taking up the bulk of it.

“Our development allocation has decreased from RM1.6bil last year to RM1.3bil this year to make way for the emoluments, such as employing more doctors,” he added.

Dialysis subsidy drying up

The Star

BY LOH FOON FONG

Published: Thursday November 7, 2013 MYT 12:00:00 AM
Updated: Friday November 8, 2013 MYT 9:37:24 AM

Saving lives: The Fo Yi-NKF Dialysis Centre in George Town, Penang. There is an estimated 5,000 new kidney patients each year requiring haemodialysis.

KUALA LUMPUR: Thousands of kidney patients are facing a tough time as the Health Ministry has not approved subsidies for haemodialysis treatment thus far this year. Some are reported to have waited for as long as three years for the nod.

The number of approvals for the RM600 monthly subsidy began to decrease in 2011, and became minimal from mid-2012.

NGO-run haemodialysis centres said they were told by the Health Minitry to source for funds elsewhere as it was focusing on new patients.

They also said that some patients had waited for the subsidy approval for as long as three years, instead of the usual one to three months.

 In Malaysia, the poor receive heavily subsidised dialysis treatment but due to the shortage of government-run centres many turned to those managed by non-profit NGOs.

Through these NGO-run centres they could apply for RM600 dialysis subsidy (RM50 per dialysis) per month and free injections.

A random check revealed that the National Kidney Foundation had 200 patients still waiting for subsidy, 50 patients in St John’s Pt Selangor in Klang, 40 in dialysis centres run by a religious body that declined to be named, 22 at Pontian Rotary Haemodialysis Centre, and five patients in KL Lions Renal Centre.

The actual number of the affected poor was not known but it could be in the thousands going by the estimated 5,000 new kidney patients diagnosed with end-stage kidney failure each year in the last three years.

Patients affected appear to be from NGO haemodialysis centres as those in private and government dialysis centres did not have to deal with subsidy applications.

According to the National Kidney Foundation, treatment for a patient who undergoes haemodialysis at an NGO or a private clinic costs between RM150 and RM250 per session.

The Malaysian Registry of Dialysis and Transplants said that as many as 7,088 (26.9%) end-stage renal failure patients had haemodialysis treatment at NGO centres out of 26,404 patients receiving dialysis treatment last year.

The remaining 13,159 patients (49.8%) sought treatment at private dialysis centres and 6,157 patients (23.3%) at public facilities under the Health Ministry, university hospitals and Defence Ministry hospitals.

A nurse who declined to be named said that Muslims had less issues with getting the subsidy as they could apply for aid from the Baitumal or zakat foundation.

Some NGO haemodialysis centres were not happy that the Government had pushed patients to them without providing the needed subsidy.

The halt in subsidy was also depleting the rolling fund of the centres since some NGOs help to pay for their patients’ dialysis treatments, a dialysis centre manager said.

“If they make it difficult for patients to get the subsidy, they should just get the patients to do it at government dialysis centres,” she said, adding that such centres were limited.

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BY LOH FOON FONG

I'm afraid I'll die without the money, says kidney patient

PETALING JAYA: Former tombstone engraver Foo Kwai Wah, whose kidneys failed early this year, has exhausted all his savings and is worried about whether he can continue with dialysis treatment.

Foo, 57, whose wife died in 1999 during child delivery, said he had been waiting for government subsidy for dialysis treatment, which included RM600 per month plus free injections, since March 21 and sought aid from NGOs.

“I am afraid that without government subsidy, I will die because I have no more funds,” he said, adding that he had to support two teenage children who were still studying.

At RM100 per session at the Nat­ional Kidney Foundation, Foo said the dialysis cost him RM1,300 per month while injections cost RM325.

Although an NGO gave him RM500 a month, he still has to pay RM1,125.

He hoped the Government would use the funds from abolishing the sugar subsidy to help patients like him.

Foo also appealed to corporations to contribute funds to poor patients.

Housewife Ng Lai Leng, 44, from Selayang, has been on dialysis since July last year and has been waiting for government subsidy since Nov 8 last year.

Her husband Wong Kok Chai, a vegetable seller, said he earned RM2,500 a month and it was difficult to make ends meet especially now that his business was not doing well.

“My wife feels sad about the long wait,” said Wong who spoke on behalf of Ng, who cannot speak Malay or English.

A dialysis centre manager, who declined to be named, said the extra medical costs were a burden to the lower income group and some couples had got into heated arguments over the lack of funds.

Selangor state commander of St John Ambulance Malaysia Datuk Burnard Yeo said SJAM had persuaded some donors to sponsor poor patients while waiting for government subsidy to be approved.

“Some of these patients are jobless and cannot even pay for their rentals,” he said adding that the Health Ministry had informed them that it did not have enough funds.

“Some patients even wanted to cut the treatment to only once a week, but we discourage them from doing so as it could lead to complications or death,” he said.

By  LOSHANA K. SHAGAR

(Please note that the average cost for each NGO dialysis is RM150. For private sector is RM250. In the usual scenario for NGO-run haemodialysis centre, RM50 for each treatment is absorbed by NGO, RM100 paid by patients and if they could not afford it, they could get RM50 subsidy from the Government, hence, they only pay RM50)

New kidney patients get priority for the RM600 aid

PETALING JAYA: New kidney patients will be given priority for the RM600 monthly subsidy for haemodialysis treatment, the Health Ministry said.

“Our pool of funds is focused towards new patients as they have never had treatment and may require dialysis urgently,” said Health director general Datuk Dr Noor Hisham Abdullah.

However, he added, patients already undergoing haemodialysis would not be neglected and would be given assistance as announced in Budget 2014.

Prime Minister Datuk Seri Najib Tun Razak had announced free treatment kits, or Continuous Ambulatory Peritoneal Dialysis costing RM19,000 each for patients with end stage kidney failure to enable them to do the treatment at their own home.

An estimated 5,000 new kidney patients were diagnosed with end-stage kidney failure each year over the last three years, with 26.9% likely to be seeking treatment from 53 NGO centres. On average, half the patients needed subsidy from the Government.

Dr Noor Hisham told The Star that the ministry was reviewing its funding for haemodialysis treatment to make it more cost effective, among other reasons.

“Although our budget allocation increased this year, emoluments are taking up the bulk of it.

“Our development allocation has decreased from RM1.6bil last year to RM1.3bil this year to make way for the emoluments, such as employing more doctors,” he added.