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