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First satellite self-dialysis centre

Officially opened on 24 December 1987 by the late President Ong Teng Cheong, then the Second Deputy Prime Minister, Singapore's first satellite self-dialysis centre is located in the Toa Payoh housing estate. Called the Singapore Airlines - NKF Dialysis Centre, it was the first centre to open under the National Kidney Foundation's (NKF) major initiative to bring affordable dialysis centres to the doorstep of kidney patients, either near their homes or workplace. Singapore Airlines (SIA) was the first corporate organisation to sponsor such a centre.

Background
In 1987, the National Kidney Foundation (NKF) embarked on an ambitious programme to provide low-cost dialysis treatment islandwide through a network of satellite (suburban) dialysis centres. There was a need to provide such centres as statistics then showed about 200 kidney patients died each year because they could not afford dialysis treatment which were deemed as expensive, or they were not eligible for subsidised treatment programmes. The cold response from the public in pledging their kidney also added to the difficulty. An effective solution was pinned on satellite dialysis centres in major HDB estates, places of "cheap dialysis at void decks" and the first of its kind in the world.

Description
NKF sought sponsorship for the first self-dialysis centre in early 1987. Singapore Airlines (SIA) took up the call and became the first sponsor to support this initiative. The Housing Development Board (HDB) also offered to rent out its void deck premises at a minimal rate of thirty cents per square foot. Apart from the corporate sponsorship, NKF held its own fund-raising activities. For instance, proceeds of the sale of one and a quarter million Christmas and Lunar New Year greeting cards were donated to the NKF's cause. Local artists such as Ong Kim Seng, Ang Ah Tee and Tan Swie Han had their works printed on the cards.

The total cost of the first centre at Toa Payoh was S$400,000 of which S$233,000 was sponsored by SIA. SIA's donation paid for the centre's 12 dialysis machines, costing S$25,000 to S$30,000 each. SIA also sponsored other necessary equipment such as its water treatment system and defibrillator and resuscitation pump system.

When it opened, the centre could only accommodate 40 patients at any one of its two shifts. Thus applicants had to be selected by a ten-member panel consisting of a mix of NKF and public sector members. They were selected based on their medical condition, their employment status, their willingness to undergo self-dialysis training, and ability to pay the subsidised charges. The centre has since expanded, able to take in 84 patients and is equipped with 15 machines.

The centre provides two main services. As a self-dialysis treatment centre, patients who have been trained in self-treatment procedures using the dialysis machine conduct their own four-hour treatment with the supervision of the centre's nurse. Patients have to go for a two and a half months of training before beginning their self-dialysis treatment. The cost of monthly treatment varied depending on the subsidies received by patients. When the centre started, it was between S$400 - S$800 monthly, a fraction of what was charged at private centres.

The other service provided at the centre is patient welfare (psychological and social), run by social workers and volunteers. They help to fix suitable schedules for patients' dialysis treatment, organise activities to encourage patients to interact with each other, and provide counselling for patients and their families. The services are aimed at making kidney patients self-reliant and financially able to pay for their own subsidised treatment.

Impact
Today, there are 20 satellite dialysis centres conveniently located around the island. The dialysis centres are part of NKF's holistic programme which combines dialysis treatment using sophisticated machines with a rehabilitation programme for patients and their families. This approach is aimed at making both patient and their family members cope financially and emotionally with the illness. It stays true to NKF's firm principle of providing subsidised but not free service, and that the public dollar that goes into supporting kidney patients must be matched with a tough spirit among patients and their families to first help themselves.

The NKF's satellite dialysis centre programme has been successful due to not in small measure generous contributions from the public, societies as well as private companies. By 1995, the programme has enabled 97 percent of its patients to return to work, compared to 30 per cent when it began in 1988. The programme's belief in treating the mind and not just the disease has also gone a long way in instilling hope and confidence in patients and their families.



Author
Nureza Ahmad & Nor-Afidah A Rahman



References 
A lending hand for patients. (1987, December 24). The Straits Times, p. 16.

Cheong, C.K. (1987, December 24). Centre is SIAs gift to the community. The Straits Times, p. 16.

Dialysis made available and affordable. (1987, December 24). The Straits Times, p. 16.

Encouraging response to organ transplant law. (1987, December 25). The Business Times, p. 2.

First satellite dialysis centre to open on Xmas Eve. (1987, December 17). The Straits Times.

First satellite kidney dialysis centre ready in 4 months. (1987, July 14). The Straits Times.

Hedwig, A. (1987, April 25). Cheap dialysis at void decks plan. The Straits Times.

How the Toa Payoh centres scheme works. (1987, December 24). The Straits Times, p. 16.

NKF to set up satellite dialysis centres throughout Singapore. (1987, April 25). The Business Times.

Richard paves the way for self dialysis. (1987, December 24). The Straits Times. 


Further Readings
Peralta, C. (1995, April 1). NKF helps patients help themselves - Kidney Foundation injects new optimism into patients. The Straits Times.

National Kidney Foundation. (n.d). Dialysis centre locator. Retrieved August 31, 2004, from www.nkfs.org/patientsinfo/patients_dialysis-centers_locator.htm

National Kidney Foundation. (n.d). National Kidney Foundation timeline. Retrieved August 31, 2004, from http://www.nkfs.org/aboutus/aboutus_timeline.htm

The information in this article is valid as at 2004 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.

Subject
Politics and Government>>Health
Architecture and Landscape>>Building Types>>Public Buildings
Hemodialysis facilities--Singapore
Health and medicine>>Medication and therapies
Health and medicine>>Health services



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