By Mellica McPherson-Ganda
Dialysis treatment remains a costly hospital service, and the diabetes link formed the basis for the November appeal by Minister for Health and Social Development Hon. Ronnie Skelton. In his message in observation of the 2015 Diabetes Awareness Month Mr. Skelton lamented once again that the cost of dialysis treatment is in the millions.
The Minister who continues to bemoan the tie between chronic diseases such as diabetes and the need for dialysis treatment pleaded again for healthy lifestyle changes: “Diabetes is also one of the main contributing factors to kidney failure. A hemodialysis programme was started in 2000 with six stations and 7 dialysis patients. The programme now has eleven stations and accommodates 45 patients ranging in age from 24 to 80; at an annual cost of some $4 million,” Hon. Skelton said.
The cost of dialysis treatment in the BVI is unaffordable for many. In fact Alexander Robertson, the Credit and Collection Supervisor at the BVIHSA, told The Island Sun newspaper in September that dialysis treatment is so expensive that the Unit intends to propose fundraising as a means to supplement or fund the procedure.
Mr. Robertson who mentioned that unpaid dialysis bills were part of the backlog bills the hospital has incurred explained how the expense of the treatment was creating debtors. “Dialysis is expensive and can cost as much as a 150,000 per person. Even persons with insurance were nowhere near even covering half of the cost, and to be honest these persons we can’t expect them to make much of a contribution to the bill because you are about in the region of $14,000 a month for one dialysis patient,” he said.
In 2014, the burdensome cost of dialysis treatment was bemoaned at the launch of the BVI Run Walk for Health campaign. The campaign was launched on 8 September, as a means of promoting a healthy BVI through a partnership between the Inter-Departmental Technical Working Group (TWG) headed by At Large Representative, Hon. Archibald Christian, and the BVI Health and Wellness Council.
The point about the rising cost of dialysis treatment was made by Chair of the Physical Activity Committee for the BVI Health and Wellness Council, Paul Hewlett who explained that the objective of the Run Walk for Health was to improve health and reduce non communicable diseases.
In his remarks, Mr. Hewlett told the gathering: “Needless to say statistics have shown that the cost to the Territory of the present dialysis machines is over two million dollars in health care, and should we continue with our present eating habits combined with lack of exercise, these cases will be doubled within the next five years and the cost to the Territory will be astronomical to say the least.”.
The heavy demand for dialysis treatment was further bemoaned in the 2013/2014 budget of the BVI Health Services Authority (BVIHSA). The document detailed concerns for not only the heavy use of the dialysis machines, but the growing number of patients requiring such services.
While the increasing number of dialysis patients continues to be lamented by Minister Skelton the gravity of the situation was fully expressed by the document which announced that the situation is costing the Authority, causing machine overuse which opens the door possible malfunctioning which will be problematic if encountered and overall worry as the list of future dialysis patients lengthens.
The document stressed that nurses have been working overtime in the Hemodialysis Unit which in the last year ended up costing the BVIHSA $40,092.99 in staff overtime. As such it was suggested that nursing overtime hours be eliminated with the introduction of two haemodialysis technicians to handle the non-nursing functions currently undertaken by Registered Nurses.
It was further suggested that improvements be made to the quality of patient care by introducing nutritional guidance and social service interventions thereby reducing the need for inpatient hospitalization. The budget also mentioned the replacement of four dialysis machines to enhance functioning and delete downtime due to faulty equipment.
In outlining the present situation of the Hemodialysis Unit the document indicated that operations are carried out six days per week in order to meet the needs of 47 patients.
“There are eight Registered Nurses in the department and a Nurse Manager. The nurses currently work 8-hour shifts with a total of 160 hours at the end of four weeks. Patient appointments commence at 7:30a.m with the latest appointment time commencing at 2:30 and ending at 6:30p.m. The final 30 minutes to one hour of the shift is spent cleaning the machines and preparing the unit for the following day,” the document stated.
It was further mentioned that the patient population continues to grow, adding an average of 603 treatments per year with a total of 16 new patients admitted last year.
“The current machines and staff are operating at full capacity. Five of the 13 hemodialysis machines have in excess of 35,000 (working) hours and require frequent servicing due to breakdowns. Two of the 13 machines require immediate replacement. The nurses have duties apart from their nursing responsibilities including the set up and stripping of machines, cleaning of the machines and recliners, preparation of the dialysate baths and unit set up. The machines run an average of 14 hours per day and there is no back up machine, in case of intra-dialysis breakdowns. There is currently a list of 12 known patients who will require hemodialysis therapy over the next 12-18 months,” the document stressed.
In November, 2013 during Diabetes Awareness Month at least two legislators complained about the growing list of persons in the Territory who are in need of dialysis treatment.
Pundits say that Non Profit Organisations who hold regular fundraising activities (raffles, dinners, auctions etc) should focus consistently on the dialysis dilemma facing the BVI.