Georgetown Public Hospital could offer haemodialysis services as early as March this year, but the cost is expected to limit the number of initial patients who would benefit.
The hospital is building the capacity to offer the service to patients locally and is likely to shortlist some ten persons among the immediate beneficiaries.
Medical Director at the hospital, Dr Madan Rambarran said on Friday that two haemodialysis machines have been pledged to the institution by a Canadian charity. The hospital is partnering with the Doobay Renal Charity to provide the service, he disclosed, adding that the charity has committed to offering the equipment, among other critical supplies.
Given the heavy disease burden in the country, ranging from hypertension, diabetes and cancer, Rambarran said that complications often result in renal damage to patients, who are then in need of renal replacement therapy. The hospital lacked the capacity to treat such patients, he said, but more recently it has been building capacity.
“We are now moving to fill that gap… the cost for these services are high and poses challenges, but this is part of our responsibility to meet this tertiary level care,” Rambarran said during the interview with this newspaper. He observed that the hospital would absorb the cost for treatment, which means patients would not be asked to go into their pockets.
Prior to the GPH move, 5G Dialysis Centre has been offering haemodialysis services over the past six years, and more recently Balwant Singh Hospital introduced its own services. However, both options are costly to the average citizen because a single treatment averages around US$150, and patients are expected to get three treatments weekly.
Rambarran pointed out that the public hospital should have the capacity to offer haemodialysis services by early March that would allow them to treat two patients daily. He said that the bulk of the cost would be borne by the hospital and by extension the government, noting that for the initial period they would be partnering with the Doobay Charity.
The Doobay Renal Charity is also planning to set up its own dialysis centre at an East Coast location some time in the near future. Rambarran said that the plan is to establish a facility with greater capacity; when the centre is set up the hospital intends to offer support with staff and medical supervision. The hospital would also pick up the cost for patients who are referred there.
He said that while the charity has pledged the machines and some of the supplies to go with establishing the services, the public hospital has agreed to provide the space; physical infrastructure; personnel; medical supervision and laboratory testing, among other things. According to him, the hospital had intermittently provided peritoneal dialysis to patients in the past, but is now moving to structure the service.
He disclosed that about four persons are currently on this therapy, noting that it offers the advantage of patients being treated at home and under the supervision of relatives.
For the peritoneal dialysis, the hospital provides the catheters, placement of the catheters and the fluids, he said. The hospital, he added, has plans to advance this programme simultaneously with the haemodialysis programme.
The numbers will go up
Rambarran said that estimates point to around 30 patients who qualify immediately for dialysis treatment, but he believes that more patients would be discovered as the services are rolled out. “We anticipate the numbers will go up,” he said.
He said that that estimated number of patients does not include people who are in need of treatment but are yet to come forward. The hospital will develop registers to monitor the patients on treatment, but Rambarran stressed that it would take them two years to fully understand, “the scale of the problem in the country for renal replacement therapy.”
He said that GPH is also partnering with other groups to provide expertise for the haemodialysis service, noting that expertise is needed to set up the equipment; manage the machine; and supervise the patients, in addition to other clinical aspects of care. The hospital also plans to invest in training staff to make the services sustainable.
“We’re going to build capacity in all aspects of this care to provide a sustainable service to the public,” he added. Rambarran said too that the hospital’s budgetary cost would be increased substantially with the provision of haemodialysis, noting that every single treatment would cost between US$150-US$200.
He said that some of the services would be absorbed by the usual work of the hospital, and this would include the lab test, among other things.
Further, he mentioned that the hospital is paying close attention to water purification, which is important in providing the service. Rambarran noted that the quality of the water used in the dialysis process and infection control is a critical issue which they are addressing.
He added that the water processing equipment would also be provided by the Doobay Charity, in addition to the filters to aid in the purification process.
