BY: Ng Wan Ching
IN early April, he flew to southern China for kidney transplant surgery. He paid $52,000 to a hospital there for the donor kidney and the procedure.
The money was scraped together from his savings, and from friends and family. Mr R Lim didn't want to reveal his real name because what he did is illegal in China, and most other countries, including Singapore.
But like other Singaporeans before him, he took a desperate gamble on the overseas surgery because the alternative, he said, was too painful.
Every year, the National Organ Transplant Unit receives requests for the removal of 20 to 30 patients from the waiting list for kidneys.
Reason: These patients have received transplants overseas.
Three or four liver transplant patients also go off the list every year for the same reason, the Ministry of Health said.
These people do it despite the very real risks involved in getting a transplant overseas.
But Mr Lim, 33, said he was desperate. "I couldn't work or live a normal life," he said.
He was diagnosed with a kidney condition at the age of 13. Then, about two years ago, his kidneys failed. Since then, three times a week, he had to be hooked up to a dialysis machine.
He was also in and out of hospital every two months.
Mr Lim felt he could not make it through nine years of dialysis before a donor kidney would become available. That's the average waiting time here for a donor kidney.
Said the polytechnic graduate who has his own business: "During the two years of dialysis, my veins would collapse after a few months and doctors would have to find new ones in order for me to continue having dialysis.
"It was very tiring and very scary for my family members."
In one emergency operation to find a vein, nothing in his hand or chest could work, so one in his neck had to be
opened up, he said.
Dialysis also made him very tired. He needed to sleep for three to four hours after each session.
The cost of dialysis and hospital stays were heavy burdens for him and his family, despite a subsidy from the
National Kidney Foundation.
He was paying about $500 a month for the dialysis. Together with medications and hospital stays, he was paying about $10,000 a year to treat his condition.
Then, last year, a friend told him about a relative who had gone for a successful transplant in China. "I spoke to my friend's uncle who said there is this doctor in China who had so far operated on more than 30 Singaporean patients.
"All of them are doing very well, with no complications," he claimed. Still, his family was reluctant.
"There had been negative reports of people who had gone to China for transplants and come back with Hepatitis C infections or the Aids virus."
But none of his family members were suitable to give him one of their kidneys. So, in the end, they reluctantly agreed to the overseas transplant.
"My friend's uncle recommended me to the surgeon. I did my tests and sent the results to the surgeon so that he could match me up with a donor," he said.
Late last year, he flew to China to see the surgeon. "I had to have a check-up there so that the surgeon would have a clear picture of what it would be like to operate on me," he said. The hospital was very "advanced", he claimed.
And because Singaporean patients pay more, everything used was new, he said. "They brought it to me all wrapped up, so that I would know it was all brand new," he said.
Mr Lim also saw the operation theatre and was satisfied with it. After his check-up, he returned to Singapore to wait. "The surgeon said he would operate only when there was a very good match for me," said Mr Lim.
Days, weeks, then a month, and another slipped by. Mr Lim became increasingly anxious.
Then the call came - the surgeon said he had found a match. "I flew back there with my mother and sister. I had to undergo intensive dialysis three times to get rid of as much toxins as possible before the operation," he said.
He was told that the kidney would come either from someone willing to trade it for money or from an executed convict.
On the day of the operation, he was wheeled into the operating theatre and given local anaesthesia. Mr Lim said the surgeon operating on him was the most senior one in the hospital. "He was very, very fast. He cut me open in the front and I could feel him pushing aside my intestines.
"In 11/2 hours, it was over. I had my donor kidney inside me," he said.
"It wasn't very painful, but I grunted a bit as I felt the surgeon pushing and tugging inside me. The anaesthetist told me to keep quiet," he added.
Half an hour after his operation was completed, he started to pass urine normally, a sensation he had not felt for many months as his kidneys deteriorated.
"Usually, with cadaveric donor kidneys, it's not that fast, as it takes a while for the donor kidney to "wake up".
"But with my donor kidney, my ability to pass urine again came very fast," he said.
But around midnight, he developed a mild shock syndrome and started shivering.
"The surgeon came back to the hospital. He said the shock could be due to contaminated equipment or an allergy to medications.
"He said it was the first time he had seen something like that. But he managed to stabilise me within three hours," he said.
Mr Lim stayed in the hospital for two weeks, and as soon as he arrived back here, he went to the A&E department at Singapore General Hospital, as instructed by the surgeon there.
An SGH spokesman confirmed that the hospital does see such patients. Mr Lim was screened, and said he was
given the all clear.
"Since then, I have been very well. I can live my life normally again, without needles and dialysis," he said.
|China transplant hospital accepts only cash
Mr R Lim is careful not to reveal his name or that of his surgeon because what he has done is illegal. He does not want to get his surgeon into trouble or have the Chinese authorities close down the hospital.
"So even how we get referred to this doctor has to be through friends and it's very, very discreet," he said.
According to him, the doctor has flown here to meet all his patients. He is said to be a very caring doctor.
Mr Lim said the operation and hospital stay in China cost him $60,000 in all.
"That includes air fares for my mother, my sister and me as well as my mother's and sister's accommodation in China," he said.
The cost of the donor kidney and the transplant operation was $52,000.
"I heard the price has gone up. The price I paid was last year's price as I contacted the China surgeon last
year. Now it is $60,000 for a donor kidney and the operation," he said.
According to him, the hospital accepted only cash. "We transferred the money to a China account. Once there, we had to take everything out in cash to pay the hospital.
"It was quite odd, handing over this huge pile of notes to them," said Mr Lim.
For a living donor transplant at the Singapore General Hospital, the recipient would pay $5,000 to $8,300 as a subsidised patient, and $24,000 to $27,000 as a private patient, for an estimated nine-day stay.
The estimated bill size for the donor is $1,200 to $2,600 for a subsidised patient, and $7,650 to $8,900 for a private patient.
This is for an estimated four-day stay. The recipient usually bears the cost.
At Gleneagles Hospital or Mount Elizabeth Hospital, the cost of a living donor transplant for both donor and recipient, including hospital stay, is about $74,000.
This article was first published in The New Paper on July 7, 2008.
Overseas transplants run risk of death & disease