SRINAGAR: The J&K Health department Monday inaugurated its first free dialysis center under National Dialysis Programme in Kashmir at the Anantnag district hospital.
However, sources said, the facility has been opened in a hotchpotch manner, violating the guidelines of the prestigious programme. No dialysis technicians and paramedical staff are available in the hospital to handle the machine and patients professionally, they said.
The dialysis center was e-inaugurated by Chief Minister Mehbooba Mufti. The Health department claimed the center is the state-of-the-art facility which would benefit around 500 patients in south Kashmir.
“This is a step to provide highly specialized quality medicare facility to renal patients of far-flung areas at their doorstep,” an official statement issued here said.
However, sources said that the center has come up in an unregulated manner.
“There is no trained dialysis technician available in the hospital to run this sensitive facility. Some paramedics from unrelated branch were asked to handle the machines after they attended a simple hands-on training from SKIMS Soura. An experienced private partner is also not involved in the programme which is a clear violation of NDP,” a source told Kashmir Reader.
According to the NDP’s operational guidelines, the dialysis services should be run by district hospitals under the Public-Private Partnership (PPP) mode with trained manpower to run the facility without any hassle or risk of infections.
“The direct provisioning by the governments would be time-consuming and likely to be costly and risky,” the guideline reads.
It says the private service provider has to provide a trained human resource, a dialysis machine along with RO water plant infrastructure, dialyzer, and consumables.
“Payer Government should provide space in District Hospitals, drugs, power and water supply and pay for the cost of dialysis for the poor patients,” it adds.
An official privy to developments said the health department went ahead with the project, even though no private party was involved to run it smoothly and involve trained professionals.
The tenders for running dialysis centers were floated in June 2017 but due to the poor response from private companies, the scheme couldn’t be started last year.
“No bidder or company came forward to participate in the repeated tenders floated by NHM as the notices were flawed,” the official said.
The program is also aimed to involve skilled unemployed youth in the productive work.
Sources said the breach of the procedure started when National Health Mission was involved to issue the tenders because J&K Medical Supplies Corporation Limited (JKMSCL) is the dedicated agency meant for the purpose.
“The other reason is poor knowledge of the subject matter and incompetence. The non-availability of trained technicians and nephrologists are the other pertinent reasons behind the poor response,” the official said.
The NDP operational guidelines recommended that the dialysis center should be headed by a qualified nephrologist or MD Medicine with one-year dialysis training from recognized center performing one visit every fortnight and clinical review for all patients. Other staff requirement includes medical officers (on duty) – one doctor per shift for a maximum of 10 machines; Dialysis technicians/ nurses – One technician for every 3 machines and one dedicated for dialysis machine for patients with blood-borne infections per shift; Dietician (optional); sweepers 1 for every five machine per shift and hospital attendant 1 for every five machines per shift.
The guidelines also provide for adequate space area, ensuring privacy of patients, a separate hemodialysis area solely for use of Hepatitis B patients, a nursing station in an area that allows adequate surveillance of patients on Heamodialysis machines, besides other space for equipment and washing.
However, the area designated for the free dialysis centers is a crumbled space within the existing infrastructure
“No separate building was constructed for these centers. Small areas have been designated for the trial facility at District Hospital Anantnag,” said a doctor working with NHM.
He said the dedicated space of 120sq.ft. per dialysis machine is must to run the facility smoothly.
“There must be dedicated space of 120 sq. ft. per machine and the service provider should make complete arrangements to make the dialysis facility working along with the required infrastructure, trained nephrologists, medical officers, nurses, technicians, supportive infrastructure, dialyser and all other consumables, working and maintenance cost of the project including consumables and facility for pediatric patients,” the doctor said.
Mission Director, NHM Dr Yashpal Sharma admitted that the program was not started as per the set rules. However, he justified the present status of the programme saying that they didn’t get private player through tendering process.
“No private player came forward to partner with us in the NDP. Then we decided to go ahead with the programme without them,” he said.
Asked why separate trained staff has not been recruited to run the free dialysis center, Dr Sharma said the start would have been delayed.
“We are sending a fresh proposal to Government of India for sanction of dedicated staff. As soon as we get the approval we will revamp the center and give responsibility to related people. As of now the existing staff is sufficient,” he said.said.