The ranks of kidney patients are reported to be swelling, though it is difficult to find a reliable basis for estimating their number. However, those in the know are attributing six to seven digits to the size of the problem in Nepal. The problem with most kidney diseases is that the patients get to learn of it only when both their kidneys have suffered serious damage. Many kidney patients, therefore, will have to go through frequent medical tests and regular medication just to delay the progression of disease. To be or not to be is then the question.

The problem is one of another kidney. If everything else, including luck, goes well with you, you can lead a relatively normal life, as long as the foreign spare part works. Or you can submit to the lengthy and complication-prone process of blood purification just to stay alive. But the cost of each proposition can easily scare away a lower-middle-class family, as the treatment is not just a one-off affair, to boot. Most of kidney-failure patients in Nepal breathe their last before the first dialysis. So the cognoscenti chip in with suggestions for making the treatment possible for those with modest means, such as government subsidy or assistance from other quarters. Efforts towards this end will be worthwhile. But even then, the existential

problem will remain acute. For poor Nepalis, the best advice is: Prevention is better than cure.

This means heeding some do’s and don’ts.