Every five hours, a person here is diagnosed with kidney failure
Seow Yun Rong speaks to kidney patients about their struggles
Nine years ago, Mr Ibrahim Khan, 63, was diagnosed with diabetes, hypertension and kidney failure.
"The doctor told me I would have to deal with this (kidney failure) for the rest of my life unless I get a kidney transplant. At that point, I felt like death was better than living," he told The New Paper.
The first three years were the hardest. He was easily tired and would feel demoralised after dialysis sessions.
But with the support of his wife, he slowly improved his lifestyle choices and became more positive.
Three times a week, he spends about six hours at the Thong Teck Sian Tong Lian Sin Sia National Kidney Foundation (NKF) dialysis centre in Woodlands. Two hours are for preparation and more than four hours for dialysis.
He showed us the angry keloids on his left arm that have formed as a result of the repeated use of syringes for the dialysis procedures.
He said this is the only way to sustain his life other than a kidney transplant.
He decided to take himself off the waiting list for a kidney transplant because he knew of patients who had the transplant, but still had to endure dialysis sessions.
Furthermore, he said he can't afford the surgery for a transplant.
Mr Ibrahim is part of a worrying trend.
Every five hours, a person here is diagnosed with kidney failure.
The plight of those with kidney failure made the news recently when 22 renal patients were infected with hepatitis C after being hospitalised at the Singapore General Hospital (SGH).
The majority of the patients had undergone renal transplants.
Eight of the 22 have died.
Mr Ibrahim said he first noticed that something was wrong when his body became bloated. It was so bad that he could not even put on his motorcycle helmet.
When he consulted a doctor, he was told he not only had diabetes, his kidneys had also failed.
He believes his lifestyle played a part.
At 1.73m, he weighed 80kg and even though he had quit smoking in 1998, he had been smoking before that for 31 years.
He said: "When I was working then, I always ate curry, nasi padang and lots of oily food.
"As a technician, I often worked late and would bring work home, which added to my stress."
Because his family has no history of diabetes or kidney failure, he never thought he would have to struggle with these diseases.
During the first three years after his diagnosis, he was negative and moody.
BACK ON HIS FEET
"My wife scolded me every day and told me that if I stayed negative, she would not take care of me," he said.
His wife, Madam Rosnani Mahrom, 55, a housewife, eventually got him back on his feet.
The couple live with their 25-year-old son. They also have a daughter who is 32.
The support of Madam Rosnani and that of the NKF nurses helped him develop a positive outlook.
Ms Sun Ting, a nurse at the dialysis centre in Woodlands, said he is the most optimistic patient there.
The 30-year-old said: "He's the most positive and compliant patient here. He treats us like we are his good friends."
Mr Ibrahim's weight has now dropped to 65kg, thanks to light exercises like walking.
No more oily food or sugary drinks.
He also sticks to home-cooked meals prepared by his wife every day.
"My wife scolded me every day and told me that if I stayed negative, she would not take care of me."
- Mr Ibrahim Khan
Waiting four years for a donor
She has been on the kidney transplant waiting list for four years and is still waiting for some good news.
About 10 years ago, Ms Angela Foo, 60, found out she had kidney failure.
According to the National Kidney Foundation's (NKF) latest annual report, there were 424 people on the waiting list in 2013, but only 68 received a transplant.
NKF encourages more friends and families to donate their kidneys as out of the 68, 34 were from cadaveric donors and the other 34 were from living donors.
Ms Foo said she was in denial after doctors at the National University Hospital told her the bad news. Weighing about 50kg, she had no weight problems or diabetes.
Ms Foo, who is single and lives with her older sister, said her family does not have a history of kidney failure or diabetes. There is family history of high blood pressure, which she also suffers from.
Ms Foo, who used to work as a supermarket department manager, said in Mandarin: "I took my health for granted then. I didn't exercise, ate whatever I wanted and I was also very stressed at work.
"But now I hope to get a kidney transplant and get better."
She goes for dialysis sessions three times a week. Each session lasts about four hours.
"After every dialysis session, I will feel very tired and just go home and rest. But on days when I don't have to go, I will exercise and participate in NKF activities," Ms Foo said.
The NKF activities include meeting new dialysis patients and interacting with them, as well as exercise events like walking.
Ms Foo also walks and cycles at Pasir Ris Park on the weekends.
Like Mr Ibrahim Khan, Ms Foo believes her lifestyle choices got her in trouble.
Ms Foo said: "I used to eat lots of durians, jackfruits and fast food without thinking of the consequences."
The rise in the number of obese Singaporeans has resulted in more cases of diabetes and a corresponding increase in kidney patient numbers.
And that has put a greater demand on dialysis treatment.
The NKF is building five more dialysis centres to add to the existing 25 and they will be operational by next year.
The cost to treat a patient is about $2,000 per month and the total running cost of NKF in 2014 was over $70 million. Most of their patients are poor and cannot afford the high cost of treatment.
Thus, 40 per cent of them pay nothing, 20 per cent pay $50 or less a month, and the rest pay whatever they can afford, according to the NKF's 2014 annual report.
Ms Foo does not pay for her sessions, while Mr Ibrahim pays $50 a month.
Kidney failure on the rise
According to figures from the Renal Registry, 1,730 people suffered renal failure last year, an increase from 1,657 the year before, reported The Straits Times in May.
At least one new dialysis centre had to be set up every year for the past few years to cope with the rising numbers.
At 67 per cent, Chinese patients formed the bulk of dialysis patients.
Last year, the proportion of Malay patients increased from 16.6 per cent in 1999 to 24.5 per cent.
The proportion of Indian patients also increased, from 6.2 per cent in 1999 to 8.8 per cent last year.
The main cause of kidney failure is poorly managed diabetes. And more Singaporeans are suffering from diabetes as more people are becoming obese.
According to Professor A. Vathsala, head of nephrology at the National University Hospital, diabetics need to control the progression of the disease in order to stem the rising tide of renal failure, reported The Straits Times.
Only 40 per cent of diabetics here are able to keep their blood sugar levels in check.
A study of more than 57,000 diabetic patients at the nine National Healthcare Group polyclinics from 2006 to 2009 found that half had diabetic kidney disease, which is the precursor of kidney failure.
Hep C outbreak at SGH
This month, there was an outbreak of the hepatitis C virus in the renal ward of the Singapore General Hospital (SGH) that led to 22 patients being infected.
Of these 22, eight have died. In four of those cases, hep C is suspected to have contributed to the deaths.
Three did not die of the disease, while one other fatality is being checked for the hep C virus, the hospital revealed at a press conference on Oct 6.
All the 22 affected patients had some form of kidney disease and most had past history of end-stage renal failure and/or had undergone a renal transplant.
They were admitted at the newly renovated Ward 67 between April and June.
The hospital said that four of those who died had multiple co-morbidities (presence of one or more additional disorders or diseases co-occurring with a primary disease or disorder) and severe sepsis, and the hospital was "not able to rule out the possibility that hep C virus infection could have been a contributing factor".