Over 50% of Indian patients are suffering from Chronic Kidney Diseases and dialysis for them becomes a painful life-long process. Mr. Kamal D Shah, Co-founder and Director of Patients services, Nephroplus talks to Gunjan Joshi about situation of dialysis as a treatment in India.
Explain the journey of NephroPlus since its origin?
I have been on dialysis for the last 21 years. I blog regularly on www.kamaldshah.com about my experiences while being on dialysis and tips to live a positive life despite being on this treatment. Vikram Vuppala, an MBA from US came across my blog while researching about dialysis in India. He then sent me an email and suggested that we should work together to change the way dialysis is conducted in India. We both started our journey together and one more individual, Sandeep an MBA from ISB Hyderabad joined us. This is the way, we started NephroPlus. Our aim is to make the rigorous process of dialysis completely patient-centric and ensure that patients lead normal lives despite being on dialysis. We started our first centre in Hyderabad more as a proof of concept. The response from patients and nephrologists was overwhelming.
What is the situation of dialysis as a treatment in India and what is the average cost of the treatment involved?
The cost of a single session of dialysis varies from one place to another. It ranges from Rs. 1000 to 3000 depending on where the process is being conducted. Many dialysis centres are operated with very poor equipments and a lot of patients continue to feel sick despite getting dialysis. Proper precautions are rarely taken at these centres resulting in several patients getting cross infected with viruses like Hepatitis C, B and HIV. Also, the post-treatment care is not given at all and hence these centres are not patient centric. Therefore, patients feel like a burden at such places and most of them even hate to go for their dialysis sessions. This further leads to poor compliance with the treatment and the result are again poor outcomes.
What kind of ordeal a patient suffering from renal disorders has to go through according to you?
Someone having chronic kidney failure has to go through a lot. Typically, patients whose kidney function is almost equivalent to zero and have to undergo dialysis or get a kidney transplant. In a country like India, the number of kidney transplants is abysmally low. This is primarily due to legal implications, lack of awareness and lack of financial resources. Due to this, patients have to undergo dialysis for whole life because of which their lives can be extremely frustrating despite being on dialysis. This is because of the poor quality of treatment and lack of patient centric approach and poor management of staff at various dialysis centres.
What kind of trainings does Nephroplus provides to young medical or non-medical graduates?
NephroPlus provides training to candidates who have passed their 10+2 and nurses to become well-rounded, capable, ethical dialysis professionals. At our centre, the students are rigorously taught theoretical aspects of dialysis in a full-time classroom environment to begin with and then trained in practical aspects of dialysis in an actual dialysis centre.
This is very different from a majority of dialysis academies which do not focus at all on theory and only teach practical. Hence, most of the students who undergo such course do not know why they are doing things in a certain way. They eventually become very mechanical and perform dialysis procedures without any basic understanding of the concepts involved in the process. In NephroPlus’s Enpidia academy, the students are taught extensively ‘why’ of things rather than simply the ‘how’.
Are the students from private or government medical colleges better equipped to conduct dialysis?
There is no distinction between private and government colleges when it comes to conducting dialysis. What is required primarily is a commitment to the well-being of the patient and basic professional ethics. The knowledge imparted by our academy ensures that students receive thorough knowledge of concepts pertaining to dialysis and are fully capable to perform dialysis in the centres.
India has 10 lakh patients who require dialysis on a regular basis and 90 percent of them are dying. What according to you is the reason behind it?
The main reasons for this are the lack of affordability and accessibility. Many patients cannot afford dialysis treatments. The cost can ranges from Rs. 15,000 – 30,000 per month and very few people can afford this. Moreover, this is not a temporary cost. Unless the patient gets a kidney transplant, this has to be done life-long. Also, very few dialysis centres exist in semi-urban and rural areas. This means that the patients have to travel hundreds of kilometers twice of thrice a week just to get dialysis. This makes it impractical for many people to get dialysis regularly.
How can young medical practitioners step up in reducing cost of dialysis and renal transplants?
This problem is multi-faceted and cannot be tackled by a single group of individuals. Only, the government, private industry, doctors, medical professionals and patients should come together and address this problem in an effective manner.