'Can’t Afford COVID-19 Tests Regularly,' Dialysis Patients Worried

'Can’t Afford COVID-19 Tests Regularly,' Dialysis Patients Worried

A patient undergoing dialysis at the Bhiwandi Dialysis Centre near Mumbai.

52-year-old Navnath Ghodekar needs to undergo dialysis bi-weekly to survive. Before the lockdown began on 25 March, Ghodekar underwent the procedure at a clinic close to his home in Mumbai’s Saki Naka at a cost of Rs 700 per session. But, in the last two months, the clinic he regularly visits has shut down just like many other affordable dialysis clinics in the city.

With no other options before him, Ghodekar now undergoes dialysis at a clinic about 25 minutes away from his home and ends up shelling out Rs 1,700 for each session, that is more than double of what he paid earlier. What’s worse, Navnath Ghodekar, who works as a labourer, is the sole breadwinner for his family. With no work, no money, Ghodekar and his family have no option but to cut down on his dialysis sessions.

Madhuri Ghodekar, Navnath’s daughter “Shantiniketan (the dialysis centre) charges Rs 1,500 and we have to buy all the additional equipment. Since we have no money, after requesting them, they agreed to reduce the charges to Rs 1,200. In addition to this, we need equipment worth Rs 600. That’s why we get it done only once a week. We haven’t gotten his dialysis done for 6 days now because we don’t have enough money.”

Screening Dialysis Patients for COVID-19

The BMC’s directive instructing dialysis centres to screen patients for COVID-19 symptoms before putting them on dialysis has caused further problems for patients like Ghodekar. The civic body’s directive issued on 10 April, states,

“It has been observed that few Centres are doing Dialysis of COVID-19 symptomatic patients, thereby spreading the disease. Therefore, it is directed that these Dialysis Centres should screen for COVID-19 like symptoms (cough, cold, fever, etc) before putting them on Dialysis. Similarly, such dialysis centres can create exclusive facilities for doing Dialysis of COVID-19 patients apart from doing Dialysis of other patients.”

The notice further adds that a second alternative for patients with COVID-19 requiring dialysis can be government hospitals like Kastuba Hospital, KEM Hospital, Saifee Hospital, Seven Hills Hospital and Nanavati Hospital.

The BMC’s directive comes after two dialysis patients from Millat Hospital in Jogeshwari tested positive for COVID-19 in the first week of April, forcing the hospital to be shut down for a few days.

While the BMC notice talks about screening and not testing of patients, several hospitals have taken to demanding that dialysis patients produce test results that indicate they are COVID free, before being allowed in for the life saving treatment.

This has left patients, already dealing with a debilitating disease, in a fix.

For most patients, spending Rs 4,500 multiple times a month for the COVID-19 test before undergoing dialysis, is not an option. 61-year-old Sadruddin Khan’s son wrote to CM Uddhav Thackeray on social media, seeking help urgently. Sadruddin, who undergoes dialysis at Masina Hospital is South Bombay, has allegedly been asked to produce COVID-19 test results every 10 days. With no source of income for two months now, his family is worried that they can’t afford this test thrice a month as Sadruddin undergoes dialysis thrice a week.

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A notice issued to dialysis patients at Masina Hospital

Owais Khan, Sadruddin’s son“We got COVID-19 test done once for Rs 4,500 at SRL. If we are forced to do this every 10 days, that means we would have to get tests done thrice a month. This would come up to Rs 13,500. The dialysis cost was already a burden, but this is another additional cost that we must bear now. We haven’t had a source of income for a month now. Everyone is sitting at home, not earning at all and upon that if there are more expenses, where do we get the money from?”

The COVID-19 test is an added expense for Khan’s family that has already had to spend an additional Rs 50,000 in the last two months at various dialysis centres that overcharged them before Masina Hospital reopened.

Owais Khan’s request for the authorities was echoed by all the patients who spoke to The Quint, “Dialysis patients will die if they don’t receive treatment and if you want to make COVID-19 tests compulsory for such people, then make these tests available at the hospitals and clinics. Make these either free of cost or keep the charges nominal at about Rs 500-1000. How do we pay if it is Rs 4500?”

The Quint has reached out to senior BMC officials for a comment. This story will be updated once they respond.

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Why Not Get Tested at Govt Hospitals?

24-year-old Pankaj Jadhav commutes 18 kilometres thrice a week all the way to Thane, to undergo dialysis. Even though money is tight, Jadhav would rather get his COVID-19 test done at the private clinic as he is scared of visiting government hospitals like KEM and Kasturba.

Pankaj Jadhav, Patient “They have told us that we can get it done from government hospitals as well but in these hospitals there’s a wait period of 3-4 days. Paying this amount is a problem but I’m scared of going to a govt hospital because of the coronavirus scare. My family tells me that it’s okay if I have to pay Rs 4,500 this one time, just get it done there at the clinic.”

Keeping the safety of their patients in mind, some private dialysis centres are paying for COVID-19 tests for registered patients from their own pockets. The Bhiwandi Dialysis Centre that administers dialysis on at least 105 patients, is one such example.

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Zaheda Fakih, Administrator, Bhiwandi Dalysis Centre “As a precautionary measure, we are asking all our patients to get a COVID-19 test from Kalyan and we are paying for it from our own pockets. We don’t want to risk our other patients in case one of them can’t afford to take this test.”

The centre that administers dialysis for free even during these trying times, started stocking up on essential injections and equipment required for the next four months since February 2020. Apart from this, the dialysis centre has also initiated several precautionary measures.

“We started making it compulsory for patients, their families and staff to wear masks since February. For those who are coming from Bhiwandi town, we have asked the attendants to drop their patients to the clinic and go back home. We have asked them not to wait in the waiting room to ensure that there’s no crowd. As for patients who come from far, instead of letting them wait at the centre, we are making them wait in the waiting room of the adjacent hospital to maintain social distancing,” she said.

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Shuttling From One Dialysis Centre to Another

With many dialysis centres having stopped operating since the lockdown, patients have been forced to deal with the uncertainly and anxiety of finding new centres that can accommodate them at the last minute. 56-year-old Peter Fernandes has had to seek appointments for dialysis with at least 4 different hospitals since the lockdown.

When he finally got an appointment at a hospital, that he did not wish to name, they charged him Rs 10,000 for a single dialysis session. Fernandes, who is a resident of Worli, needs to undergo dialysis bi-weekly.

Peter Fernandes, patient “I can’t afford to pay Rs 10,000 for a single dialysis session every time. I have financial problems. Before I could pay the hospital for a second sitting, the first hospital where I used to visit regularly called me back as they had reopened. After two weeks, they again shut down. Shuttling between hospitals, trying to find an option has been causing me mental and financial strain.” 

While Fernandes has finally managed to find a centre that he has been regularly visiting, Navnath and Sadruddin’s families are unsure for how long they can afford the treatment of their loved ones.

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