First satellite self-dialysis centre

Background

Officially opened on 24 December 1987 by then Second Deputy Prime Minister Ong Teng Cheong, Singapore’s first satellite self-dialysis centre is located in the Toa Payoh housing estate.¹ Called the Singapore Airlines-NKF Dialysis Centre,² it was a major initiative by the National Kidney Foundation (NKF) to bring affordable dialysis centres to kidney patients, either near their home or workplace.³ Singapore Airlines (SIA) was the first corporate organisation to sponsor such a centre.

Background
In 1987, NKF embarked on an ambitious programme to provide low-cost dialysis treatment islandwide through a network of satellite (suburban) dialysis centres.⁴ There was a need to provide such centres, as statistics then showed that about 200 kidney patients died each year because they could not afford dialysis treatment which were deemed expensive, or they were not eligible for subsidised treatment programmes. The poor public response to pledge their kidneys also compounded the difficulties. A solution was thus identified: to set up satellite dialysis centres in major public housing estates developed by the Housing and Development Board (HDB). This would locate affordable dialysis treatment at the void decks of HDB flats⁵ – the first of such initiative in the world.⁶

Establishment
NKF sought sponsorship for the first self-dialysis centre in early 1987. SIA responded and became the first sponsor for the initiative. The HDB also offered to rent its void decks at a minimal rate of 30 cents per square foot.⁷

Besides the corporate sponsorship, NKF also held its own fundraising activities. For instance, proceeds from the sale of 1.25 million Christmas and Lunar New Year greeting cards were donated to the cause. The cards featured works of local artists such as Ong Kim Seng, Ang Ah Tee and Tan Swie Han.⁸

The total cost of the first satellite self-dialysis centre at Toa Payoh was S$400,000, S$233,000 of which was donated by SIA. The donation paid for the centre’s 12 dialysis machines. SIA also sponsored other equipment such as its water-treatment system, defibrillator and resuscitation pump system.⁹

The centre could only accommodate about 40 patients per month initially. Thus applicants had to be selected by a 10-member panel, which comprised both NKF officials and members of the public such as religious leaders and professionals.¹⁰ The applicants were selected based on their medical condition, employment status, willingness to undergo self-dialysis training and ability to pay the subsidised charges.¹¹

The centre provided two main services when it opened. As a self-dialysis treatment centre, patients who were trained in self-treatment procedures using the dialysis machine would conduct their own four-hour treatment, supervised by the centre’s nurse. Patients had to undergo 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, the monthly treatment cost ranged from S$400 to S$800, which was a fraction of the fees charged by private centres.¹²

The other service provided at the centre was patient welfare, comprising both psychological and social aspects. The service was run by social workers and volunteers who helped to fix suitable schedules for patients’ dialysis treatment, organise activities to encourage interactions among patients, and provide counselling for patients and their families. The services aimed to increase the self-reliance of kidney patients and their ability to pay for their own subsidised treatment.¹³

Impact
Today, there are more than 30 satellite dialysis centres located throughout Singapore.¹⁴ These centres are part of NKF’s holistic programme, which combines dialysis treatment using sophisticated machines with a rehabilitation programme for patients and their families.¹⁵ The approach seeks to help patients and their family members cope financially and emotionally with the illness. It is aligned to NKF’s principle of providing subsidised but not free service, and that the public dollar going into supporting kidney patients must be matched with a tough spirit among patients and their families to first help themselves.¹⁶

NKF’s satellite dialysis centre programme has been successful due to generous contributions from the public, societies and private companies. By 1995, the programme had enabled 97 percent of its patients to return to work, compared with 30 percent when it began in the 1980s.¹⁷



Authors
Nureza Ahmad & Nor-Afidah Abd Rahman



References
1. “Encouraging Response to Organ Transplant Law,” Business Times, 25 December 1987, 2. (From NewspaperSG)
2. “Dialysis Centre Locations,” NKF, accessed 12 September 2020.
3. Cheong Choong Kong, “Centre Is SIA’s Gift to the Community,” Straits Times, 24 December 1987, 16; Hedwig Alfred, “Cheap Dialysis at Void Decks Plan,” Straits Times, 25 April 1987, 18. (From NewspaperSG)
4. “NKF to Set Up Satellite Dialysis Centres Throughout Singapore,” Business Times, 25 April 1987 2; “First Satellite Kidney Dialysis Centre Ready in 4 Months,” Straits Times, 17 July 1987, 18. (From NewspaperSG)
5. Alfred, “Cheap Dialysis at Void Decks Plan.” 
6. “NKF to Set Up Satellite Dialysis Centres.”
7. “NKF to Set Up Satellite Dialysis Centres.”
8. “First Satellite Kidney Dialysis Centre Ready.”
9. “Encouraging Response to Organ Transplant Law”; “First Satellite Dialysis Centre to Open on Xmas Eve,” Straits Times, 17 December 1987, 17. (From NewspaperSG)
10. “Dialysis Made Available and Affordable,” Straits Times, 24 December 1987, 16. (From NewspaperSG)
11. “How the Toa Payoh Centre’s Scheme Works,” Straits Times, 24 December 1987, 16. (From NewspaperSG)
12. “Dialysis Made Available and Affordable”; “How the Toa Payoh Centre’s Scheme Works”; “Richard Paves the Way for Self Dialysis,” Straits Times, 24 December 1987, 17 (From NewspaperSG); “Encouraging Response to Organ Transplant Law.”
13. “Dialysis Made Available and Affordable”; “How the Toa Payoh Centre’s Scheme Works”; “Richard Paves the Way for Self Dialysis”; “Encouraging Response to Organ Transplant Law.”
14. NKF, “Dialysis Centre Locations.”
15. “Treatment Options,” NKF, accessed 12 September 2020.
16. Claudette Peralta, “NKF Helps Patients Help Themselves,” Straits Times, 1 April 1995, 1; Claudette Peralta, “Kidney Foundation Injects New Optimism into Patients,” Straits Times, 1 April 1995, 2. (From NewspaperSG)
17. Peralta, “NKF Helps Patients Help Themselves”; Peralta, “Kidney Foundation Injects New Optimism into Patients.”



The information in this article is valid as of October 2020 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.