Rezaul Hassan, a 21-year-old private car driver, has been visiting the Gonoshasthaya Kendra Dialysis Centre (GKDC), for around three months. The dialysis sessions take up to four hours a day, three days a week from him.
During the first month, Rezaul had failed to attend the sessions on time because of his job. The centre’s authority stepped in to help and convinced his employer, after informing them about the patient’s health. Now, Rezaul gets to receive his dialysis and remain employed.
“At the beginning, I thought my son wouldn’t be able to keep his job due to the long dialysis sessions. But with help of the centre’s authorities, he can both receive his dialysis on time and earn a living for his family and his treatment,” said Fatema Begum, Rezaul’s mother, to the Dhaka Tribune.
“Dialysis is a replacement therapy after the kidney fails. Through this method, the toxic substances are removed from the blood through a machine. If not done very carefully, patients may die of a stroke or heart attack during dialysis. Therefore, we constantly remain at high alert,” said GKDC nephrologist Dr Mohammad Abdul Hamid.
Around 800,000 people in Bangladesh require dialysis as a substitute for many of the normal functions of a kidney. But it is a challenge for poor people due to its high costs.
GKDC in Dhaka’s Dhanmondi area provides facilities at affordable rates for people of various financial backgrounds, along with free-of-cost services for the ultra poor.
The double shift 100-bed facility centre attends 200 patients daily, and offers services ranging from Tk800 to Tk1,500, possibly the lowest cost for medical services in Bangladesh.
Since its inauguration on May 13, the centre has already provided dialysis to 36,400 patients.
“There are two medical procedures if someone’s kidney becomes dysfunctional – dialysis, or kidney transplant. However, the number of kidneys available for transplant is very low. So, dialysis remains the only option for a patient to stay alive until a transplant,” said Dr Mohib Ullah Khondoker, coordinator at GKDC.
In Bangladesh, around 20 million people currently suffer from some kind of kidney disease, among which, 800,000 require dialysis. Yet, only about 30,000 of them are able to receive dialysis due to financial constraints.
There are 101 dialysis centres across Bangladesh but the number is very low. At least 1,000 such centres are needed to treat the large number of patients.
According to an estimated data, there are around 1,300 to 1,500 non-functional dialysis machines at these centres.
Dr Zafrullah Chowdhury, founder of the Gonoshasthaya Kendra, told the Dhaka Tribune that they aim to make dialysis facilities available for all at the centre.
“We think not enough patients come to the centre as not many are aware of such little-to-no cost treatment facilities here. Many do not possess the ability to bear the costs of treatment outside Dhaka. We hope to provide dialysis to at least 200 poor patients a year, free of cost,” said Dr Zafrullah, also a public health activist.
Before registering for dialysis, the patient must go through an assessment conducted by GKDC that determines their financial condition.
A patient usually requires three dialysis sessions a week with each session lasting up to four hours.
The centre provides free-of-cost dialysis facilities to 5% of the patients in each of its sessions.
Poor patients can receive the first two dialysis at Tk800 per session, availing the third session for free per week.
People with slightly better financial capability can receive dialysis at Tk1,100 per session.
People from middle to upper-middle financial background can receive treatment at Tk1,500 per session.
GSDK spends Tk2,300 on each dialysis sessions, but sells its services for Tk800 to Tk1,500 as a subsidy to help the poor afford the treatment.
“Most of our funding comes from donations. If we can get support from the government, we could increase the number of services provided. It is very important that the government exempts different taxes to make the healthcare service available for all patients,” said Dr Hamid.
“If the government reduces the bills and taxes on electricity, water and medical equipment, it would be possible to provide healthcare facilitates at a much lower cost," said Zafrullah.