New hope for kidney patients in rural areas
Mobile teams provide dialysis help at home
Kidney dialysis — a treatment method for cleansing waste from the bodies of patients with a kidney problem — is often a physically and emotionally draining process.
Patients who need to take haemodialysis (HD) must go to hospital 2-3 times per week, and each session takes up to five hours. Dialysis draws blood out of the body into an artificial kidney to clean it.
The time and energy needed for treatment are onerous enough for patients in convenient urban cities. But for patients in rural areas, just travelling back and forth to a remote hospital for treatment can impose a difficult burden.
One of those patients is Suda Sangkhachaweng, a 37-year-old teacher at a school in the district, a remote rural area in Kanchanaburi.
Since last year, Suda has needed to travel to Sangkhla Buri Hospital three times a week.
HD dialysis makes her body feel better. But it’s the 40 minute trip on a motorcycle from her home to the hospital and another 40 minutes back, three times a week, which exacts a heavy toll.
“By the time you recover from each treatment, it is time for the next. I feel so tired and drained. I feel useless,” she said.
But Suda feels things are improving now she has joined the CAPD project provided by a team of doctors at Sangkhla Buri Hospital.
Under the project, doctors and nurses at hospitals and clinics under the jurisdiction of Sangkhla Buri district form teams to visit patients with kidney disease at home. The campaign is designed to reduce patients’ travel time and improve treatment.
Suda is one of 31 kidney disease patients in the district who have joined.
Doctors and nurses have taught her to perform continuous ambulatory peritoneal dialysis (CAPD).
CAPD is machine-free form of kidney dialysis that patients can perform at home by placing cleansing fluid in their bellies for draining waste.
The campaign also provides a financial subsidy by covering the cost of CAPD kits, which cost around 15,000 baht per month.
“The CAPD method has given me a sense of self-reliance so I can function like a normal person. I am currently a volunteer teacher at a local school, and all I have to do is go back home in the afternoon to perform CAPD before returning to school again,” Ms Suda said.
The National Health Security Office (NHSO) subsidises 100% of CAPD treatment across the nation through public hospitals.
CAPD has been widely hailed by patients and doctors in Sangkhla Buri district for helping keep people out of hospitals, and increasing their independence.
Despite that, some critics say the state should not spend taxpayer money supporting a group of people who in their view are no longer productive, says Athaporn Linpanyalers, a doctor at Sangkhla Buri Hospital.
“People wonder why we should care for patients suffering last-stage kidney failure. It is a misconception that they can no longer work and be part of society, as CAPD allows them to function just like healthy people,” Dr Athaporn said.
“Sangkhla Buri is sparsely populated with around 40,000 people, of whom 60% are Thais. Initially, CAPD simply gave them independence and took away the burden of travelling.
Over time, it became clear that they are also leading better, happier, and healthier lives,” Dr Athaporn added.