In what the Ministry of Health and Human Services called a “historic step forward,” it announced the further development of a plan to re-launch dialysis services in Majuro.
Health Minister Ota Kisino joined officials with the India-based company Aprameya Medical Ltd. earlier this month to sign two agreements related to dialysis services.
The ministry said one of the agreements “sets a new precedent in our healthcare journey” with the “creation of a dedicated hemodialysis center within the Atama Zedkaia Memorial Hospital.” The second agreement details the financial and operational requirements.
The “ceremony was not only historic for its impact on our healthcare system but also its embrace of modern technology,” said the ministry, adding that establishment of a hemodialysis center “represents a transformative milestone in our healthcare journey, reflecting our commitment to ensuring the health and well-being of every individual in the Marshall Islands.”
Nearly 40 years ago, the Marshall Islands government halted its dialysis treatment program at Majuro hospital.
This followed Cabinet in the mid-1980s establishing a panel of locally based health experts to review the entire health system. That review recommended upending the model of healthcare that had been in place since US Trust Territory times and placed most emphasis on hospital-based patient care and off-island medical referrals.
Emphasizing this focus on curative rather than preventive health was demonstrated by the fact that ministry’s community health education budget was a paltry $600 for a year.
The Cabinet’s health task force recommend reinventing healthcare in the RMI by focusing on primary health care to put a priority on prevention.
This led to the creation of the first Bureau of Primary Healthcare Services and a massive infusion of funding to preventive services including health education, family planning and reproductive health, immunization and other public health programs.
As part of this reinvention of the health services program to focus on prevention, the Cabinet approved the task force’s recommendation to end dialysis service that used up a significant portion of the limited Ministry of Health budget at the time.
There were a few people still using the system and the decision that was approved was to accept no new dialysis patients and when the last of the small group using the program left the islands or died, the program would end. Since about 1987 the RMI has not offered dialysis services, partly due to the high cost and partly due to the complexity of operating and maintaining the service.
The cost of dialysis differs widely depending on location of service. In Fiji, the cost is estimated between $10,000 and $15,000 a year per patient. In the US, the cost per patient is about $100,000 annually.
The current FY2024 RMI national budget included an appropriation of $800,000 to initiate dialysis here. The FY2025 that is this week the subject of public hearings includes $1 million for the dialysis program.