ABOUT KHDC NEPAL

ABOUT KHDC NEPAL

KHDC is a community outreach program led by Prof. Dr. Sanjib Kumar Sharma since 2003. Currently, Dr. Sharma works as a Professor in Department of Internal Medicine, B.P Koirala Institute of Health Sciences (BPKIHS), Dharan. 

The story behind the establishment of KHDC goes back to 2003 when Prof. Sharma, who was leading the dialysis facility at BPKIHS, met a young patient from rural Nepal who had kidney failure. The patient needed urgent dialysis, but he had no money even for his daily living and was helpless at the moment. He fell in front of Sharma and begged for his life. This incident touched him. He recalls, “I felt that day that I had become a doctor in vain. The incident made me feel very helpless. There was nothing that I could do.” After the incident, Sharma vowed to help thousands of other patients like him. He wants people to realize that dialysis is not the solution to the problem; it is only a temporary treatment. But the solution to the problem is when these people are free from kidney disease either by spreading awareness at the outset or by treating the early stage of kidney disease, then neither dialysis nor kidney transplantation will be required. Understanding this essence, he decided to go to the root of the disease and treat it and that was the turning point that gave birth to KHDC.

Since then, Prof Sharma and team have been actively running this awareness and treatment KHDC campaign over the various parts of eastern Nepal. Prof. Sharma and his team came with program with a captivating slogan “ABCDE जाचौं, मृगौला मुटु बचाऔं (Check Your ABCDE; Save Kidneys, Save Heart)” and visited door to door in and around Dharan every Saturday and on holidays. There they mainly tested ABCDE. Namely, A-Albuminuria, B-Blood pressure, C-Cholesterol and Creatinine, D- Diabetes, E- eGFR. Tests of these things would reveal the condition of the heart and kidneys of the people and could also assess the possibility of getting the disease. In this way, they made good use of every holidays and other free time to reach many homes. There, he advised people at high risk of heart and kidney disease to seek immediate treatment, while also educating others about the prevention of such diseases. At the same time being himself kidney and heart disease specialist he also manages patients, but emphasizes more on educating other health care providers on these aspects.  He also suggests paying special attention to healthy diet and healthy way of life.

Prof. Sharma says, “Infectious diseases can be cured by medications, but chronic non communicable diseases like kidney, heart diseases, diabetes are very difficult to cure without early intervention. So, the only solution to cut down developing NCDs is to prevent getting sick which can only be achieved by focusing on healthy way of life; either by healthy diet and physical activity. ” 
 

ABOUT KHDC NEPAL

KHDC is a community outreach programme led by Prof. Dr. Sanjib Kumar Sharma (Professor, Dept. of Internal Medicine, BPKIHS) since 2003. This program works for prevention, early detection and management of Chronic Kidney Disease, Hypertension, Diabetes and Cardiovascular disease (KHDC) in community of Nepal.

Till date, it has reached over 130,000 individuals in Dharan city and its surrounding Sunsari, Morang and Jhapa districts in Eastern Nepal, providing counseling, treatment, and follow-up for those who tested positive on screening. Currently this program is being conducted over different wards of Mechinagar municipality, Jhapa in collaboration with Mechinagar municipality and in Damak, Jhapa in collaboration with Damak municipality and Damak Red Cross Society and over 13,000 populations have been screened and followed up in total of these areas.

We have been trying to reach more people through this programme aiming at scrutinizing the chronic disease conditions (NCDs) that remain hidden in the general population in our community. With this programme we are able to control the disease before it develops into its grave form. By this means, all the burdens that are brought by the diseases are controlled beforehand. This program remains a gateway for the general population to benefit with the consultation with Prof. Sharma, who has been actively involved since its foundation. 

Earlier, this program conducted in Dharan highlighted the very high prevalence of hypertension (33.9%), diabetes (6.3%), metabolic syndrome (22.5%), projected 10 years cardiovascular risk (28%) and chronic kidney disease (10%) in population of >20 years of age. (Sharma, 2011) In subsequent years, it was possible to achieve significant control of these chronic diseases,with a predicted 10 years cardiovascular risk of 10% or more decreased from 28% to 17% after 3 years in this cohort. (Sharma et al., 2014)

The program has demonstrated that community based screening is an effective means of identifying subjects at risk of diabetes, kidney and cardiovascular diseases (more precisely NCDs) early in the course of their diseases to allow for proven effective interventions and management of their condition. In a country like Nepal, due to various reasons such as loss of daily wages, lack of disease awareness, belief of ‘being healthy’ in the absence of symptoms, people don’t seek regular medical attention, leading to late presentation of NCDs, including their acute and chronic complications, to the medical units. This was apparent in this community screening as people with very high blood pressure, very high blood sugar, advanced CKD, silent myocardial infarctions were detected during screening.

ABOUT KHDC NEPAL