Dialysis crisis in Ghana: A call for government’s intervention and philanthropic support

The sudden increment in the price of dialysis in Ghana has left many dialysis patients in a state of shock, making them cry their hearts out to the government to subsidize the cost of their life saving treatment. Dialysis, which performs the essential functions of the kidneys when they are no longer able to work effectively on their own is a medical procedure which removes waste products, excess fluids, and toxins from the blood, maintaining a balance of electrolytes and other substances in the body. This process is crucial for individuals with severe kidney dysfunction or kidney failure.

Dialysis has two main types, which are Hemodialysis and Peritoneal dialysis. Hemodialysis treatments are performed three times a week, with each session lasting about 3-5 hours while Peritoneal dialysis, on the other hand, has two main types: Continuous Ambulatory Peritoneal Dialysis (CAPD), which is usually done 4-6 times a day, and Automated Peritoneal Dialysis (APD), which is typically done nightly.
Looking at the number of times these patients visit the hospitals to get their dialysis treatments, the latest increment in the price of dialysis will pose a great harm to their lives.

THE SUDDEN PRICE HIKES IN DIALYSIS TREATMENT

In September, 2023, news broke out in Ghana that the GH¢ 380.00 dialysis treatment fee that dialysis patients had become accustomed to has been increased to a whopping amount of GH¢765.00. The news frightened dialysis patients as they expressed their worries over the issue and called on the government to come to their aid. Some called the price hike a death sentence that was being imposed on them since they were even struggling with the old price. The Ghanaian populace also weighed in on the issue, with the likes of Parliamentary Candidate for Ayawaso West Wuogon, John Dumelo, calling on the government to include dialysis treatment in the list of services covered by the National Health Insurance Scheme (NHIS). However, management of the Korle-Bu Teaching Hospital, in a statement issued on 27th September, 2023 made it clear that the new price was a proposed fee from the Renal Dialysis Unit and it was yet to receive consideration and approval from management and also Parliament, therefore maintaining the old price. This came after criticisms and backlash from the public.
On 13th May, 2024, dialysis patients were left stranded at the Renal Unit of the Korle-Bu Teaching Hospital after they were told that the price of the treatment has been increased from their accustomed GH¢ 380.00 to GH¢ 491.00. Reacting to the latest increment, the Renal Patients Association of Ghana voiced their concerns over the issue, lamenting that this latest increment will exacerbate the financial strain on patients already struggling to manage previous bills. President of the association Baffour Kojo Ahenkorah, appealed to philanthropic organizations to step in to help patients.

REASONS FOR INCREASED DIALYSIS PRICES

With the sudden surge in the price of dialysis treatment, threatening the lives of dialysis patients, many people are asking questions, trying to know the factors leading to the instant price hike in dialysis treatment.
The presidential adviser on health, Dr. Anthony Nsiah-Asare, in 2023, said the increase in the cost of renal dialysis at the Korle Bu Teaching Hospital was due to foreign exchange fluctuations. In a radio interview on an Accra based radio station, Dr Nsiah Asare said dialysis is generally expensive irrespective of the location the treatment is being given. He explained that most of the dialysis consumables are disposal materials which also explains the increase and admonished hospitals to make use of the tax exemption regime to avoid paying import duties. He said this after the purported increase in 2023, which was later confirmed to be false.
Speaking in an interview with Joy News after the first purported increment, Public Relations Officer for the Korle-Bu Teaching Hospital, Mustapha Salifu said the increase in dialysis costs was due to the government no longer subsidizing the service, including tax exemptions for equipment clearing, which were previously absorbed by the state. He added that the unit may have faced a shutdown if the price is not adjusted upwards.

Heart surgeon and founder of the National Cardiothoracic Center, Professor Frimpong-Boateng defended the Korle-Bu Teaching Hospital’s decision to increase the price of dialysis which backfired after public criticism, stating that the inputs needed for dialysis are very expensive and without any increase or subsidy, it cannot be sustained. Even though he admitted that most of the patients cannot pay for it, he insisted that without the increment, the service cannot be rendered at all.
Even though the new price of dialysis treatment is very hard to bear, it might not come as a surprise because the CEO of the Korle-Bu Teaching Hospital, Dr Opoku Ware Ampomah, on 28th September, 2023 hinted that the current cost was likely to be adjusted upward once government completes the review of proposed prices. According to him, the hospital will need GH¢961,000 in subsidies per month to be able to maintain the current price as at the time which was GH¢ 380.00 and added that they were already owing a deficit of GHs4 million.

GOVERNMENT’S RESPONSE TO RISING DIALYSIS COSTS

The situation is very disturbing due the fact that it has resurfaced at a point where the country is facing serious financial hardships, with citizens finding it hard to make ends meet. Many patients have died as a result of their inability to raise funds for their dialysis treatment even at the point when the price was not increased. What is then going to happen to these patients at the back of these increments? What are the government and other authorities doing to salvage the situation?
Speaker of Parliament, Alban Bagbin, who believes that stakeholder engagements with relevant agencies can provide an amicable solution to address the dialysis price hikes, referred the price hike to the Subsidiary Legislation Committee to consider a stakeholder engagement on how best to address the challenge. This happened after the latest increment in the price of dialysis.
Speaking on the floor of parliament after concerns were raised, the chairman of the Subsidiary Legislation Committee, Dr. Dominic Ayeni, confirmed that the price increment was indeed a mistake and assurances were given that corrective measures would be taken.
Also, The National Health Insurance Authority (NHIA) has introduced free dialysis sessions for patients for six months, starting June 1, 2024.
According to a press release from the Authority, patients under 18 and those over 60 will receive all eight free monthly dialysis sessions at all teaching hospitals nationwide. The scheme also provides coverage for two monthly dialysis sessions for individuals within the 18-59 age range at the following hospitals: Komfo Anokye Teaching Hospital (KATH), Cape Coast Teaching Hospital (CCTH), Efia Nkwanta Regional Hospital (ENRH), Ho Teaching Hospital (HTH) and Tamale Teaching Hospital (TTH).

The NHIS Free Dialysis Program is financed by a combination of GHC2 million from Parliament and GHC2.4 million from the Authority’s administrative budget.
The President of the Renal Patients Association, Kojo Baffour Ahenkorah, welcomed the initiative but stressed the need for a plan to ensure its continuity and sustainability.
The initiative, which is laudable is also questionable because of its short term nature. Are the patients going to be left on their own when it ends? The government should start looking at long term solutions to this problem. With the sudden rise in the prices being caused by foreign exchange fluctuations and the government no more subsidizing the service among others, the government should be looking at making provisions to subsidize the service to provide relief to the health centers in order to minimize the price hikes.
Some Ghanaians have also questioned the authenticity of the initiative, particularly with regards to why it is ending in December, this year. They are arguing that the initiative was rolled out by the ruling government as a strategy to gain popularity from the masses as the country is gearing towards elections. If this happens to be true, are we heading towards the right direction as a nation?

CALL FOR HELP

As the cost of dialysis treatment continues to soar in Ghana, the plight of patients struggling to access this life-saving treatment has reached a critical point. The recent price hike has left many families devastated, forced to choose between their loved ones’ health and their own financial survival.
In this darkest of hours, we turn to the benevolent individuals and organizations, both locally and internationally, to lend a helping hand. We appeal to philanthropists, NGOs, and humanitarian groups to come to the aid of these vulnerable patients.
Your support can be the ray of hope that saves lives. Every contribution, no matter how small, can help cushion the burden of these patients and their families. Together, we can make a difference and ensure that no one succumbs to kidney disease due to financial constraints.
Let us join forces to alleviate the suffering of our fellow human beings. Let us show that compassion and kindness know no borders. I, through this write-up urge you to:
– Donate to reputable organizations providing financial assistance to dialysis patients in Ghana
– Partner with local healthcare providers to subsidize treatment costs
– Support advocacy efforts to push for affordable healthcare policies
– Share the stories of these brave individuals to raise awareness and inspire action
Together, we can be the change that brings hope and healing to those in need. Let us act with generosity to ensure that our brothers, sisters, parents and loved ones in this situation are not left to their fate.

FACTS ABOUT KIDNEY DISEASE IN GHANA AS OF OCTOBER 2023

According to a pharmacist and Research Fellow at the Center for Democratic Development, CDD-Ghana, Dr. Kwame Asiedu Sarpong, based on research, it is estimated that between 13% and 17% of Ghana’s population have some form of renal function impairment. This equates to between 4 million and 5.2 million citizens. Researchers suggest that, from this segment of the population, between 15,000 and 19,500 should be on dialysis.
The data available suggests that approximately 2,000 people are currently on dialysis. This means between 13,000 and 17,500 people are without treatment. These people will often seek alternative forms of treatment and access renal care only when the situation is acute. This has an impact on their quality of life and life expectancy.
All research suggests that the prevalence of chronic renal disease in Ghana has approximately doubled in the last 10 years with cases across the entire span of Ghana’s population age profile.
According to the Ministry of Health, Ghana’s outpatient per capita is 1.06, suggesting that on average Ghanaians see a primary care clinician once a year. In proactive health systems, this figure is around 4 (citizens see a clinician once every three months). The fallout is that for the majority of our population, there is only one chance a year for any diagnosis of renal failure to be made except in an emergency. Whilst in proactive health systems there are at least four chances to identify these patients.
Dialysis has two main types. These types of dialysis are Hemodialysis and Peritoneal dialysis. In hemodialysis, blood is drawn from the patient’s body and passed through a machine called a dialyzer or artificial kidney. The dialyzer filters out waste products, excess fluids, and toxins from the blood. The cleaned blood is then returned to the patient’s body.

In peritoneal dialysis, the lining of the patient’s abdomen (the peritoneum) acts as a natural filter. A cleansing fluid (dialysate) is introduced into the abdominal cavity through a catheter. Waste products and excess fluids pass from the blood vessels in the peritoneum into the dialysate, which is then drained from the body and replaced with fresh fluid. There are two main types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD), which involves manual exchanges of dialysate several times a day, and Automated Peritoneal Dialysis (APD), which uses a machine to perform exchanges overnight while the patient sleeps.

HOW TO CURB THE GROWING RATE OF RENAL DISEASES IN GHANA

To curb the growing rate of renal diseases, these are some things that need to be done;
Increase awareness: Educate the public about renal diseases, their causes, symptoms, and prevention methods.
Screening and early detection: Encourage regular check-ups and screenings, especially for high-risk individuals.
Healthy lifestyle promotion: Encourage healthy habits like regular exercise, balanced diets, and adequate hydration.
Diabetes and hypertension management: Improve access to healthcare for effective management of these renal disease risk factors.
Access to clean water: Ensure availability of clean drinking water to reduce the risk of water-borne diseases affecting the kidneys.
Reduce salt intake: Promote low-sodium diets to reduce blood pressure and kidney strain.
Improve healthcare infrastructure: Enhance healthcare facilities and equipment for effective diagnosis and treatment.
Dialysis and transplantation services: Increase access to affordable dialysis and transplantation services.
Research and data collection: Conduct studies and gather data to better understand renal diseases in Ghana and develop targeted interventions.
Collaborate with international organizations: Partner with global health organizations to leverage resources, expertise, and best practices.
By implementing these strategies, Ghana can reduce the growing rate of renal diseases and improve healthcare outcomes for its citizens.

Source: Galley Bernard, UniMAC-IJ