Editorial: Don’t take renal health for granted

The kidneys, bean-shaped organs located on each side of our spine, constitute a very important part of our body.

How so?

Healthy kidneys filter a half cup (roughly) of blood per minute, removing wastes and extra water to make urine, which flows from the kidneys to the bladder via pair of thin tubes of muscle called ureters, one on each side of the bladder. The kidneys, ureters and the bladder form part of the urinary tract.

Apart from removing wastes and extra fluid from the human body, the kidneys also remove acids that the cells produce and maintain a healthy balance of water, salts and minerals like sodium, calcium, phosphorus and potassium in blood.

What happens to the human body without this delicate balance? Nerves, muscles and other tissues may not work normally.

Aside from these functions, the bean-shaped organs also help control blood pressure, make red blood cells and keep the bones strong and healthy.

The points mentioned above make it clear that keeping the kidneys healthy is of paramount importance.

But data show that the individuals, the society and all three tiers are not giving kidney health the utmost attention it deserves.

Out of the total population of around 30m, three lakh people (approx) in Nepal have renal problems. About 30,000 people experience moderate kidney problems every year, 3,000 have severe kidney failure. About 8,000 people are on dialysis in Nepal whereas the number of people on dialysis in Malaysia (total population: 28m), a popular job destination for Nepali workers, is 45,000.

Though not well off, Nepal provides free dialysis through government hospitals, the first of its kind in Asia, providing Rs 2,500 for each session. This, of course, is not enough for kidney patients with hypertension and diabetes as they have to foot extra cost for non-kidney ailments.

The federal government provides a lump sum of Rs 1 lakh to each kidney patient apart from conducting kidney transplant for free. Local governments provide a monthly allowance of Rs 5,000 to each patient. Yearly, the government spends around Rs 1bn on dialysis. 

Despite these efforts, kidney patients and/or their family members gone broke and appealing for monetary assistance here, there, everywhere for continuation of treatment has ceased to be a new thing.

This, in spite of a Constitution that has recognized the right to health as a fundamental right. This, in a ‘country geared toward socialism’ where the political elites get to fly abroad and avail themselves of the state-of-the-art services in one of the finest medical institutions of the world, all at the taxpayer’s expense?

A question arises: Where are the governments of all three tiers failing?

Instead of focusing on prevention of kidney ailments, the state is focusing on treatment. The state alone is not to blame, though.

Increasing kidney problems should prompt us to look into our food and drinking habits. Are we drinking enough water? Are we taking food that boosts our overall health, including kidney health?

Water requirements also vary depending on the nature of work and climatic conditions. Lakhs of Nepali youths sweat it out in hot climes abroad where drinking water is scarce. This takes a huge toll on their overall health, including renal health. Many of us are taking all sorts of synthetic/alcoholic drinks to quench our thirst.  

This daily, through its extensive reporting, has brought how our public health delivery system is failing the very public. Our conversation with experts has made it crystal clear that the government should focus more on preventing ailments, including kidney ailments, rather than on treatment. The government should provide immunosuppressive drugs to kidney patients for free. Also, the state, together with private and public health service providers, should launch door-to-door campaigns to raise awareness and keep kidney diseases at bay. Here’s hoping that the government on a splurging spree has enough funds—and political will—in its coffers to do that.