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Tears and smiles as new dialysis unit opens in Nambucca Valley: PHOTOS - Nambucca Guardian News

TODAY was a day many local residents thought they would never see – and sadly, a few didn’t – with the official opening of a dialysis service unit in the Nambucca Valley.

Tears and smiles as new dialysis unit opens in Nambucca Valley: PHOTOS

TODAY was a day many local residents thought they would never see – and sadly, a few didn’t – with the official opening of a dialysis service unit in the Nambucca Valley.

More than 100 people, including mayor Rhonda Hoban, Oxley MP Melinda Pavey and health service representatives, were on hand for an at times emotional ceremony to celebrate the new building.

The centre, the dialysis chairs and medical staff have come about after a significant investment by the local health service and through a long-running grassroots community fundraising campaign.

Located at the Nambucca Healthcare Centre, the service is the culmination of a 20-year lobbying campaign that was driven by a frustration that local people requiring dialysis had to travel to Coffs Harbour and sometimes further afield, for treatment.

At the forefront of the campaign has been Rona Freeman, who gave a short and heartfelt speech at the opening as did a current patient, Eric Day.

“It’s been a long hard road with many hoops and hurdles and there were a lot of knockers over the years,” said Rona, who’s son Paul was forced to travel for dialysis before his passing.

Dr Mark Smith from Nambucca Healthcare Centre recalled that Paul had told his mum “I don’t want to do this anymore”, and that had sparked her drive to see a service established locally so that renal patients would one day not have to travel for treatment.

“Rona made a promise to her son and she kept it,” Dr Smith said.

While the campaign had been long and in danger of flagging, it ‘grew legs’ at a public meeting in Nambucca in September 2011.

Key stakeholders steadily came onboard, the fundraising ante was upped, and the political will to deliver a local dialysis service became irresistible.

“It’s not the size of the dog in the fight, it’s the size of the fight in the dog,” Rona said, only half-jokingly.

Today’s ceremony marked the official opening for Nambucca Healthcare Centre’s Stage II building, which was constructed in 2014 and began operation in January.

The Nambucca Valley Dialysis Unit was brought to fruition through funding via the Nambucca Valley Dialysis Fund, and a partnership hosting arrangement between Nambucca Healthcare Centre and the Mid North Coast Local Health District, which was represented by chief executive Stewart Dowrick.

The unit began as a three-chair pilot program in May last year in the existing Stage I NHC building while a purpose built facility was constructed (Stage II). The unit was moved across to the new completed facility in December and increased to six patients in January this year.

“We are now looking forward to increasing to operation six days a week in order to provide local treatment for six more patients who currently travel out of the local area to Coffs Harbour, said NHC’s Sheree Smith. 

Just last month, radiology practice Active Medical Imaging also began operation from the Stage II building to provide comprehensive quality medical imaging services in the Nambucca Valley.

The range of services available includes fully digital x-ray, high resolution ultrasound and low dose technology CT, utilising leading edge equipment to provide significant reductions in radiation dose. The partnership arrangement includes collaboration with some of the State’s top university teaching radiologists in partnership with local medical service providers.

“It’s been a credit to everyone here today that we have come so far,” Sheree said. 


No promotion mechanism for nephrologists - DAWN.com

LAHORE: As the country faces a threat of ‘chronic kidney disease epidemic’, the fact that Punjab has no rules and regulations for promotion of nephrologists highlights the apathy of the government.

According to the latest statistics, nearly 21 million people in Pakistan have either stage 3 or 4 Chronic Kidney Disease (CKD) and there are only 145 qualified nephrologists.

“Punjab being the largest province faces a gruesome situation as kidney failure incidents have assumed alarming proportions,” an official told Dawn.

He said a batch of nine qualified nephrologists, which was produced a few weeks ago for the first time by any public hospital of Punjab, was recruited (on a regular basis) as senior registrars. “They have become a rolling stone as the government has no rules for their promotion in higher grade. Besides, there are few designated nephrology sections all over the province,” he said.

He said it was quite disturbing for highly-educated persons (nephrologists) who were forced to work without promotions in the public hospitals.

He said the health department recently conveyed to them to “bring rules and get promotions otherwise wait for an indefinite period.” When they pleaded their case, he said, the officials got annoyed and ‘directed’ them to visit them next time with a copy of the rules.

Although they later tried to present Shaikh Zayed Hospital’s model of rules for promotion for the nephrologists, the health department was reluctant to adopt it in letter and spirit.

The official said the nephrology services were already facing a grim situation in Punjab as there were only six FCPS accredited public teaching institutions. They are Shaikh Zayed Hospital, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore, Allama Iqbal Medical College/Jinnah Hospital, King Edward Medical University Lahore, Punjab Medical College/Allied Hospital Faisalabad and Nishtar Medical College, Multan.

Similarly, he said, there were only six seats of consultant nephrologists at the district level hospitals of Punjab and four positions of assistant professors and one each of associate professor and professor at the teaching hospitals. “SZH is the only institution in Punjab which has been producing the nephrologists for the last 30 years,” he added.

Some nephrologists have managed to establish a new nephrology unit at Mayo Hospital with the help of a charity organisation. It is said to be the first designated nephrology unit of the health department which is training FCPS doctors. Recently, it produced a batch of nine nephrologists which injected hope that the patients would continue to get trained practitioners of the neglected specialty.

The Punjab Public Service Commission (PPSC) advertised the nine posts of senior registrars and these nephrologists got recruited first time on a regular basis in various tertiary-care hospitals. Dr Muzzamil Riaz Malik and Dr Irfan Elahi were posted at Mayo Hospital, Dr Salman Tahir Shafi at Jinnah Hospital, Dr Aurangzaib Afzal at Lahore General Hospital, Dr Poonam at Banazir Bhutto Hospital Rawalpindi, Dr Samee and Dr Yousaf at Nishtar Medical College Multan, Dr Irfan Rasool at DHQ Hospital Faisalabad and Dr Bilal Chaudhry at Allied Hospital, Faisalabad.

They were happy to join their new job but soon realised that there was no mechanism for promotion. Dr Shahid Anwar has been working as assistant professor at FJMC/SGH on an ad hoc basis for the last five years. Neither his service has been regularised nor has his post been sent to the PPSC for regular recruitment.

Similarly, Dr Zahid Rafique has been working as senior registrar for the last seven years as the post of assistant professor of nephrology does not exist due to absence of rules of promotion.

There is only one post of SR Nephrology in Jinnah Hospital Lahore which had been recently advertised via the PPSC. Dr Arslan Khalid is working there as an assistant professor on an ad hoc basis. At the Allama Iqbal Medical College, the post of an associate professor is vacant for the last many years and there is no post of professor of nephrology. Dr Hafiz Ijaz, who is the professor of medicine, is heading the nephrology department.

At Mayo Hospital, Dr Muhammad Anees has been working as assistant professor of nephrology without designated unit for the last 11 years. He has not been promoted as associate professor of nephrology on a regular basis.

Published in Dawn, May 22nd, 2015

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'Dialysis' for the lungs - AsiaOne
The way the Hemolung Respiratory Assist System works is similar to a kidney dialysis machine. It collects the patient's blood, removes carbon dioxide and then returns the blood back to the patient. Friday, May 22, 2015
Mind Your Body, The Straits Times
By Joan Chew

A new machine is being tried out at a hospital here, which could save the lives of patients on mechanical ventilators.

The ventilator that helps patients breathe, thus keeping them alive, is also the device that could make them worse.

The machine is needed for patients who have moderate to severe acute respiratory distress syndrome, a life-threatening condition which prevents enough oxygen from reaching the lungs.

But the ventilator changes the way air is delivered to the lungs.

It pushes air into a patient's airway, instead of relying on air being sucked in through breathing, said Dr Matthew Cove, an intensivist and consultant at the division of respiratory and critical care medicine at National University Hospital (NUH).

The airway then reacts to the increased pressure by releasing inflammatory substances that further injure the lungs and worsen acute respiratory distress syndrome.

Up to half of these patients can die when this happens.

Doctors now reduce the amount of air that is pushed into the lungs, called the tidal volume, but this has created other problems.

As less carbon dioxide is removed through the ventilator with a lower tidal volume, it accumulates in the patient's blood, turning it acidic.

High levels of carbon dioxide in the blood causes hypercapnia, which impairs the function of the heart and puts a patient at risk of a cardiac arrest. It also appears to slow down or impair bacterial killing, preventing patients from fighting infections properly.

Dr Cove and his team are now testing a new machine that collects blood from the body and removes the carbon dioxide before returning it back to the patient.

He said it is similar to a dialysis machine, which takes over the function of an impaired kidney by removing toxins from the blood.

The machine, called the Hemolung Respiratory Assist System, is easier to operate than other carbon dioxide-removal machines, he added.

In the next 11/2 years, up to 50 patients with acute respiratory distress syndrome who are on ventilators will be randomly assigned to either Hemolung or standard care. Consent for the study will be sought from their next-of-kin.

Their rate of recovery and number of days on the ventilator will be tracked, among other things.

Dr Cove said: "Our goal is to halt the progression of acute respiratory distress syndrome and facilitate lung recovery, while avoiding more invasive treatments."

Acute respiratory distress syndrome affects critically ill patients and is typically triggered by pneumonia, sepsis (blood poisoning) or trauma. Up to 60 in every 100,000 people will be affected, according to overseas studies.

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This article was first published on May 21, 2015.
Get a copy of Mind Your Body, The Straits Times or go to straitstimes.com for more stories.


Defunct nephrology unit finally put to use - Times of India
AURANGABAD: In a bid to silence mounting criticism over its lackadaisical approach to the kidney patients, the Government Medical College and Hospital (GMCH) authorities shifted the dialysis unit to the Rs 10-crore modern nephrology and transplant unit on its premises on Wednesday.

The government spent Rs 10 crore to build the state-of-the-art facility in Marathwada. The equipped building was completed last year but is lying unused due to absence of experts and required staff.

GMCH medical superintendent Suhas Jewlikar said the dialysis unit was functioning at the medicine department till now and was shifted to the new building on Wednesday. "Formally, the new building was inaugurated by acting dean Chhaya Diwan. The shifting of the dialysis unit from the medicine department was initiated," he said.

At present, the unit has one dialysis machine and other machines will be soon be set up at the building. The dialysis unit would be made fully functional in some days.

Activists, however, criticized the administration for the move and called it eyewash. "The building was constructed to serve poor patients with kidney ailments. Provision of infrastructure to perform kidney transplant was the objective behind setting up the facility," social activist Masihuddin Siddique said.

The building was inaugurated with much fanfare in February 2014; albeit without the posts of nephrologists and urologists being sanctioned to run the units. The inauguration was done days before the Lok Sabha elections code of conduct came into effect.

To build pressure on the government to fill up the posts of specialists at the unit, activists of Bharatiya Dalit Cobra had resorted to a hunger strike few months back.

Ashok Borde, president of the organization, said the government has failed to fill the posts of specialists at the only place available for affordable treatment for the poor patients from Marathwada and Khandesh.

Social activists said kidney patients had hoped to get treatment closer home after the new unit was inaugurated last year. The government's failure to make any appointments of experts to the unit has deprived the patients of affordable treatment.


Dialysis Patients Win Quality Care Fight at NYC Public Hospitals - PR Newswire (press release)
NEW YORK, May 21, 2015 /PRNewswire-USNewswire/ -- Today, the NYC Health and Hospitals Corporation (HHC) cancelled a contract with Big Apple Dialysis Management, LLC, a NYC-area for-profit dialysis chain seeking to acquire chronic dialysis facilities currently located inside four NYC public hospitals.  Currently, all four of the HHC clinics – at Harlem, Kings County, Lincoln and Metropolitan hospitals –are rated good to outstanding in terms of mortality outcomes. During public hearings regarding the issue, experts worried about the future of those ratings under Big Apple management. "We all pulled together in this important matter: patients, community advocates, public health experts, elected leaders, doctors and other public sector unions," said Anne Bové, RN and President of NYNSA's HHC/Mayorals Executive Council. "This effort demonstrates that when we marshal the evidence and our forces come together we can win. This is a real victory for patients, and for the public hospital system." NYSNA extended its thanks and gratitude to many, including the patients who spoke out in testimony and at rallies, as well as numerous politicians who remained committed over many months. "I have fought the privatization of dialysis services from day one, because it puts profits before people and harms public employees," said NYC Public Advocate Letitia James. "I am grateful that the de Blasio Administration is doing the right thing and recognizing the flaws in this contract. We must strengthen our healthcare services and support our patients and healthcare providers." "After relentless advocacy over the past year, patients and science won the day," said City Council Member and Health Committee Chair Corey Johnson. "I'm extremely gratified that the New York City Health and Hospitals Corporation is terminating its agreement with Big Apple Dialysis, a for-profit company that was contracted to replace dialysis services currently provided by HHC. This was the right decision. HHC is the greatest public hospital system in the world, and outsourcing its dialysis services would not have been in the best interest of patients. I'm grateful ?for New York State Nurses Association's tireless efforts and for HHC President Dr. Ram Raju's leadership." "I applaud the NYC Health and Hospitals Corporation (HHC) for finally ensuring that essential dialysis services at our public hospitals—including Harlem Hospital in my Senate District—will continue to be offered by nurses dedicated to public service and not heedlessly privatized into the hands of for-profit institutions," said State Senator Bill Perkins. "Patients must always come before profits in our health care system and this wise decision will ensure that our loved ones continue to receive the highest quality of care."    SOURCE New York State Nurses Association RELATED LINKS


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