Patients’ life put at risk at dialysis centres

Srinagar: One of the life saving process ‘haemodialysis’ is being compromised in most of the private dialysis centres. The centres operate mostly with the availability of specialist Nephrologist and a trained dialysis technician.

According to the guidelines set by the Directorate General of Health Services, Government of India, there has to be a qualified Nephrologist available at the dialysis centre, who will be monitoring the functioning and the patient care at the centre and in absence of a qualified Nephrologist, there has to be a certified trained physician available to take care of the patient.

“A qualified Nephrologist shall be the head of the centre. In areas where there is a no qualified Nephrologist, a certified dialysis physician shall be the head of the centre,” the guidelines read.

However, what is being observed on ground is a total contrast, as there is a total absence of a regular Nephrologist as well as the certified dialysis physician at various ‘haemodialysis centres’ functioning in Srinagar.

This reporter visited several dialysis centres in Srinagar, where there was no Nephrologist available, and even a certified dialysis physician was also missing on ground as general technicians are handling the delicate process of dialysis.

“These centres are literally putting patient care at grave risk,” said a Doctor.

Notably, the absence of specialists, and trained physicians, is now making the plight of patients even worse, with patients who were undergoing dialysis at several centres, have now started testing positive for Hepatitis B and Hepatitis C.

A private dialysis centre where around 12 patients were undergoing dialysis, out of 12, 6 patients have tested positive for Hepatitis C. The records validating the fact are lying with ‘Kashmir Vision.’

What is even more shocking—is the total absence of screening process of patients at these centres—patients who have undergo dialysis for the first time and those who can be potential carriers of dangerous infections with 100 per cent chances of infecting other patients.

“Even the technicians available in the centres can be affected by the infections,” the doctor said.

“What happens actually is that when there is no screening done initially, the infections, as the mechanism is all intravenous, spreads within the machinery and when the another patient is brought for dialysis, the infection spreads, even if the patient was negative for the all the infections before,” said a consultant Nephrologist.

Importantly, according to a study that involved the database of more than 13000 haemodialysis patient in United States, revealed that HCV (Hepatitis C) infection was more strongly associated with all the causes of mortality than with HCV-negative status. 

The study concluded that in haemodialysis patients the presence of HCV-antibodies is an independent risk factor for death, because of increased risk of cirrhosis and hepatocellur carcinoma.

Notably, there is, as of now no regulation from the government to keep a check on the functioning of these centres which could have made it sure that the set guidelines are followed and patient lives are not put at risk.

What sources are telling this reporter is that during the process of registration, the centres are bound to show that they are having a full time Nephrologist, and a trained dialysis physician available at their centre. “However, these facilities are missing in most of the centres,” said, another doctor.

“There are many specialists who are associated with various dialysis centres as nephrologists. These specialists visit the centres for an hour or so and in some cases, once in a fortnight, which is a sheer violation of rules, to which the centres have agreed at the time of registration,” sources said.

Experts are questioning the very process of providing these centres with registration in the total absence of specialized and required manpower to run these centres.

Dr Suhail Naik, President DAK said that the Health Department has miserably failed in making sure there is a proper sterilization taking place at such centres, which is leading to diseases such as Hepatitis C.

“It is the job of people at Department of Health Services to keep a constant check, because diseases like Hepatitis C is a blood borne one, and can be fatal in patients with renal ailments,” he said, adding “the department should come up with a comprehensive plan to tackle the menace.”

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