The Andhra Pradesh state government is extending the Aarogyasri program for dialysis. Very soon, 111 new dialysis centers are going to be operational. People with Aarogyasri cards can avail of dialysis thrice a week at these centers free of cost.
This is truly revolutionary.
So far, dialysis under the Aarogyasri scheme was limited to existing centers with their limited facilities. Very few people could undergo treatments. Also, the coverage was only for twice-a-week dialysis, clearly inadequate by any standards. The new scheme increases the coverage to thrice a week dialysis - of course, still inadequate, but an excellent step ahead, at least by Indian standards.
Is this utopia? Far from it.
There are two basic problems when you talk about dialysis in India. One is the dialysis providers, the cost of treatment and the payment model and the second and more serious problem is that of knowledge among the patient population. Patients and their caregivers (family) do not understand that dialysis is solving a problem - that of kidney failure. They treat dialysis as the problem. This mindset causes a large number of problems.
For example, when I tell a fellow patient (and even some doctors) that I dialyze every night, for seven hours each night, they are shocked. Why?! Do you need that much dialysis? That is the common refrain. They do not understand that the more you dialyze, the better it is - both in the short term and the long term.
I have people tell me that their doctor has asked them to dialyze thrice a week but they feel all right with twice a week dialysis. Why should they go thrice a week? The cost of dialysis and the fact that most people have to pay out of pocket for their treatments has a huge role to play in this "Why more" mindset.
Hopefully with the state providing for thrice a week treatments, we will see better compliance with the increased frequency prescription.