In 2015, Siddhivinayak temple trust paid state for dialysis machines for hospitals across Maharashtra; not a single machine procured till date
Chronic end-stage kidney patients have to use dialysis machines for an average three to four hours at a time
The Shree Siddhivinayak Ganpati Temple Trust, in 2015, had deposited Rs 7.5 crore with the state for 102 dialysis machines across hospitals in Maharashtra. That year, the government had mooted the idea of roping in religious bodies to provide financial assistance, and the trust had promptly responded. Three years later, not a single one of those machines has been procured.
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The state public health department's lackadaisical attitude has irked activists and health experts, who have been raising concerns about chronic red-tapism.
Aadesh Bandekar, Chairman, Shree Siddhivinayak Ganpati Temple Trust
Why the delay
Senior health department officials told mid-day that the entire process of approvals had got delayed right from the start. An initial tender floated was recalled as there were a few discrepancies, which the government later corrected. Also, instead of the department directly procuring the machines, the job was to be handed over to the state-approved committee at Haffkine Bio-Pharmaceutical Corporation Limited.
Dr Praveen Shingare, head of Directorate of Medical Education and Research (DMER), said, "This matter never came up for approval before the committee. Once the health department finalises the tender procedure and the rate bid is completed, it informs the procurement committee at Haffkine, which procures the equipment from the shortlisted bidder. But, nothing has come so far." When asked about the delay, the official said, "The process is underway."
Dr Praveen Shingare, Head, DMER
Dr Nitin Ambadekar, joint director, health department, who also looks after procurement, said, "We have already floated the tender and are in the process of finalising the bid, which may take another few days; sending details to Haffkine will take another few weeks." Dr Ambadekar, however, refused to commit to a date or time period in which the equipment would be delivered. On why it took three years for the process to even begin, Dr Ambadekar said due procedures were followed.
On average usage of dialysis machines in rural Maharashtra, he said, "A single machine is used by three to four patients for at least three to four hours each. We have shortlisted 31 hospitals, where these machines will be provided, and 15 new centres across the state will be started." A senior Haffkine official said, "I am aware that a tender was floated in November 2017... I have no intimation about the status of its finalisation."
Lack of planning
Milind Mhaske, director, Praja Foundation, said, "This shows lack of political will and planning, which has led to the failure of a noble cause, where funds were taken from charitable trusts but lay unused for three years. This is nothing but a criminal breach of trust of the common man."
Nishit Kumar, MD of Centre for Social and Behavioural Change Communication, an NGO working for the upliftment of child issues, said, "It is unfortunate that the present government, both at the state and Centre, has ignored the health-care sector. Other than boasting of bringing down the stent cost and capping it under price control, no other basic health-care need has been addressed. I'm not surprised that they've done nothing for three years about procuring the dialysis machines."
Trust says
Aadesh Bandekar, chairman, Shree Siddhivinayak Ganpati Temple Trust, said, "We were prompt to deposit Rs 7.5 crore in August 2015, soon after we got approval from the state's law and judiciary department, which controls and supervises the trust's functioning. Our devotees visit the temple and drop their offerings, which the temple believes should be given back to the public by way of providing medical equipment.
"We have provided dialysis to nearly 6,500 kidney patients at our centre located close to the temple. It has 22 beds, where we charge a nominal fee of Rs 250 and the temple trust pays the balance Rs 900 per patient per dialysis. We have already tied up with Prabodhan Dialysis Centre at Goregaon East where 12 machines will be set up and will become operational in the next few weeks."
Dr Bharat Shah
Prevention is definitely better than cure
Dr Bharat Shah, senior nephrologist and founder of Narmada Kidney Foundation, said preventive care of diabetes and hypertension is more important than providing curative treatment. "Unfortunately, in our country, awareness about kidney disease is very low. There are rising instances of chronic kidney disease (CKD) in our country. About 3 to 4 lakh people develop end stage kidney disease every year. Diabetes and hypertension account for more than 60% cases of chronic kidney disease. We believe in 'Prevention is better than cure," he said.
He added, "Each dialysis patient needs to shell out between Rs 1,000 to Rs 2,000 per sitting and moreover the cost of a dialysis machine is around R6 to R7 lakh, with a life span of 10 years. Preventive steps should be taken at all district and sub-district hospitals, where patients who come for diabetes/hypertension treatment, should be given tips on how to prevent damage to the kidney, heart and brain. Such methods are much cheaper than procuring dialysis machines."
Dr Shah said, "Unfortunately, we do not have any registry in India which collects data on the number of patients undergoing dialysis," in response to whether statistics of dialysis patients in both Mumbai and India were available.
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