Re: Khaw being naive again
- From: "....lobert...." <lobert@xxxxxxx>
- Date: Tue, 17 Jan 2006 09:30:02 +0800
Rodney wrote:
Khaw is showing up himself as another incompetent by advocating kidney transplant instead of dialysis. Is he aware how difficult it is to find a donor? Is he aware of the recent spate of sudden deaths of healthy donors who died suddenly after giving away one kidney? Is he aware of post-operative complications like rejection of the organ? All the million$ salaries are clogging the brains of the MIW; they think they can throw money at every problem, especially when the recession free money is milked from the hapless peasantry through GST, PARF, COE, LTA, etc including water-borne tax which is further subject to GST.
Minister Khaw should also compare the medical cost of kidney transplant instead of just comparing the dialysis and kidney transplant in these countries. NKF should also consider subsidizing kidney transplants.
========================================================== Hot News // Wednesday, January 18, 2006 The move towards life without the dialysis crutch Derrick A Paulo derrick@xxxxxxxxxxxxxxxx
EVER since the National Kidney Foundation (NKF) scandal broke, efforts to improve governance standards in the charity sector have never been greater.
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Now, another area will be getting some overdue attention in the wake of the episode.
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The way Singapore manages patients with kidney failure is being given a serious rethink, and the renal treatment landscape of the future could be rather different than what it is now.
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For one, transplants, and not dialysis, may be way to go, bringing Singapore closer to the practice in most developed countries.
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Health Minister Khaw Boon Wan gave these insights yesterday in Parliament when he fielded questions from MPs on renal treatment.
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Ironically, NKF's many years of success may have led to the assumption that the problem of kidney failure in Singapore was "well taken care of", said Mr Khaw in explaining why change was now afoot.
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"But when I looked at other countries, I realised we stood out like an outlier," he said.
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The most glaring anomaly is Singapore's low transplantation rates. Two years ago, there were only 17 kidney transplants per million population.
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The corresponding figure for both the United States and Spain was 50, while Norway led the way with 58 transplants per million population.
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Overall, only 28 per cent of renal patients in Norway are on dialysis. In Singapore, it is the reverse, with 73 per cent of patients on dialysis.
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However, if the Republic is to improve the outcome for renal failure patients, one approach it should "actively encourage" is live transplants, as the other countries have done, said Mr Khaw.
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"Norway is outstanding. The doctors, when faced with a patient with renal failure, automatically asks: 'So, which of your relatives do you think can donate a kidney?'," he said.
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The reasons are simple: Lives of better quality and more years of survival.
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"After a kidney transplant, it gets much better for patients. They are more active, there's no machine they have to be hooked up to, they don't feel drowsy," Dr Li Man Kay, a urologist, told Today.
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On average, a recipient who undergoes a successful operation can survive with a functioning kidney for 21 years for a cadaveric transplant, and 32 years with a kidney from a living donor.
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According to Mr Khaw, Singapore's Asian culture and the lack of awareness would be among the most probable causes for the low rates here.
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Kidney transplant patient Sheralyn Tay, 24, agrees. "My doctor said she had never seen anyone more eager to donate a kidney than my brother. Normally, she has to counsel the relatives," she said.
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"I think there's a lot of fear. People are scared they can't function normally with one kidney. They ask questions like: Will I be able to give birth? Will I be able to father a child?
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"There really isn't enough information out there. The fact is you normally use only 35 per cent of your kidney functions — of both kidneys."
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There are signs that things are changing. After the Human Organ Transplant Act was amended in 2004 to facilitate transplantation, there were "a couple dozen more" live transplants last year, said Mr Khaw.
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Yesterday, Mr Khaw also released the complete cost figures and subsidies for kidney treatment in Singapore, in response to questions filed by Nominated MP Eunice Olsen, who wanted to know how many Singaporeans died each year because they could not afford dialysis.
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According to Mr Khaw, the ability or inability to pay for dialysis is "not a significant factor" and he reiterated the Government's stand that no Singaporean will be denied treatment because of this.
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Mr Khaw said yesterday he would address all these issues in detail during the Committee of Supply debate in Parliament in March.
Derrick A Paulo
derrick@xxxxxxxxxxxxxxxx
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