MIRI (Oct 29): A recent post by a representative of kidney dialysis community exposing the shortage of peritoneal dialysis (PD) solution at government hospital caught the attention of netizens and media.

It is understood that the PD solution is used in continuous ambulatory peritoneal dialysis (CAPD) treatment, which is a manual, machine-free method.

In connection with this matter, The Borneo Post reached out to dialysis patient Yong Kiam Kong, who explained that unlike the regular dialysis machine, CAPD did not require machinery to drain solution out of the body.

"It uses gravity to move the solution in the body. It involves filling the abdomen with fresh PD solution four times a day and the used solution (which contains toxin) will later be drained into a separate bag."

This process, however, could take between four and six hours, said Yong.

"Failure to replace the used PD solution with a fresh batch will cause the toxin to accumulate in the abdomen; if not removed from the body fast enough, it can result in fluids building up inside the body."

Yong said for the past four years, since being under CAPD treatment, he had observed that PD solution shortage would occur in Sarawak between mid-September to early November.

He said even when he was unaffected as he was subsidised under the Social Security Organisation (Socso), he was a part of the community where patients could be seeking help for PD solution from those unaffected ones.

"This is a tight-knit community where we know what is happening whenever something goes wrong. I'm puzzled too as this situation occurs every year without being highlighted by the media, or being brought to the attention of the relevant agency.

"I hope that this issue could bring to light the plight of dialysis patient and their challenges," he said, adding that he had just lodged a complaint about the issue via the Public Complaints Management System (SISPAA).

It was informed that the PD solution shortage means that patients in need are forced to reduce the frequency of replacing of the fresh solution from four times, to once or twice a day.

It was also revealed that subsidised patients under CAPD obtain their PD solutions from contractors either via Socso, the Welfare Department, or government hospital.

"The issue here is that subsidised patients under government hospital are the affected ones. The shortage of PD solution arises from expired contracts between the government hospital and the contractor during these months (September to November) of the year.

"Without payment, the supplier cannot deliver the products, and this would heavily affect the patients who could not delay the treatment," said Yong.

"The delay in payment may also be due to the government reviewing the annual national budget."

Meanwhile, an agent of a supplier company, upon request of anonymity, said there were three government hospitals in Sarawak providing subsidised CAPD treatment: Sarawak General Hospital (SGH) in Kuching, Miri Hospital and Sibu Hospital.

The situation in Kuching, according to the agent, has just been resolved, but patients in Miri and Sibu are still struggling.

"Subsidised CAPD patients in Bintulu would need to get their fresh batches of PD solution as well as follow-up appointment from Miri Hospital, which is the nearest location.

"From our point of view, the shortage occurs due to delay in payment from the government. On the supplier's side, we always have the products ready," said the agent.

When contacted by The Borneo Post, Miri Hospital director Dr Jack Wong acknowledged that the hospital management had been made aware of the issue, and already carried out procurement.

He also urged all affected patients to contact Miri Hospital via its general line 085-460600, or 085-329200, and refer to the CAPD Unit during regular office hours.

Meanwhile, Miri MP Chiew Choon Man, currently attending Parliament sitting in Kuala Lumpur, expressed deep concern over the disruption in the supply of PD solution faced by several hospitals in Sarawak.

"I will raise the matter with the Ministry of Health at the earliest opportunity, and I urge the authorities to promptly identify the root cause of the supply shortage and implement urgent remedial measures as well as long-term solution.

"I am fully aware that this is not an ordinary administrative delay but a serious medical issue involving human lives.

"Any delay could pose severe health risks to patients who must undergo CAPD multiple times a day," Chiew said in a statement.