People: Focus on the less fortunate

DIFFERENT doctors practice differently. Some are able to separate emotions well, some get too emotional and some use that emotion as a catalyst for what they want to do for society and such is the case for kidney specialist Dr Amrish Krishnan.

Dr Amrish is a name synonymous to many Fijians battling kidney failures because he has seen them through their ordeal and continue to fight tooth and nail to ensure they continue to live a normal life on earth. His interest in medicine began at the age of 11 when he was once admitted at the Lautoka Hospital and the voices of children screaming irked him.

“When I was 11, I was admitted at the Lautoka Hospital. I had a problem with my leg and while I was there I saw children screaming and it was then that I decided to be a doctor and I wanted to be someone who could take people’s pain away,” Dr Amrish shared.

“Initially, I wanted to become a heart specialist, but in the year 2010 when I was doing ward rounds with Professor Joji Malani, he used to take me to the dialysis room and he used to show me the machines and introduced me to the patients and overtime I got more interested in the patients.

“When you have kidney failure you are here two to three times a week and it changed from a doctor-patient relationship to friendship and I know my patients so well that sometimes I refer to them by their nicknames. We laugh and joke and I like that type of medicine where I am more connected to the patients.”

Dr Amrish was born in Lautoka and attended Natabua High School before his father died and his family moved to Suva where he then completed his studies at Jai Narayan College. His journey in the medical fraternity began immediately after and by 2006 he graduated with his Bachelor of Medicine, Bachelor of Surgery (MBBS) from the then Fiji School of Medicine.

“I did my internship at CWM Hospital which is a very challenging place to do you internship and there was one in particular where I did my shift 32 hours straight.

“I’m so glad that as years passed the Ministry of Health and those in leadership recognised that doctors need their rest. A tired doctor can be dangerous to the patients.

“It was a very tiring year and after this I got posted to Nanukuloa Health Centre in Ra which was a good and very pleasant experience for me.”

Towards the end of his Masters in Medicine training at the CWMH, Dr Amrish was given an opportunity to go to New Zealand and studied specifically about kidney diseases. He returned home after two years and headed the renal services at CWMH.

“At that time the intensive care balances was not very well formed and a lot of people with acute kidney failures or injury and we were losing a lot of lives prior to that. “So that was one of the things I tried to do really early again with the help of donors try to set up our intensive care dialysis and that service still runs very effectively today.

“Now so many nurses in the public health care system know how to provide dialysis in the ICU. So many doctors know how to put dialysis catheters in, when I started I used to go at 3am to show them how to do this and now it just flows so easily.

“This shows that sometimes starting a service can be daunting, but once you start it things start falling into place and when you look back some years later and we say why were we so scared to start it.”

Once that was well established, Dr Amrish shifted his focus to the less fortunate and those who could not afford dialysis. He said during those years, the only people who could afford dialysis were people who were doing quite well or business owners or those who had children supporting them from overseas.

“When you look at kidney dialysis, around 60 to 70 people were on dialysis nationally and when we did ward rounds and we informed them about dialysis, they told us ‘sorry doc we can’t do it its beyond our means’.

“Sometimes, there are 30 to 40-yearold and I had to refer them to palliative care and I just could not deal with it.

“I said we need to find a more sustainable and economical way of doing dialysis and that’s where I started talking to leaders and the government and unfortunately it took a while, but in the end we persevered to open it and that was the inception of the National Kidney Centre project.”

Dr Amrish said he felt happy that the people he used to fundraise for could now go and do their dialysis for free and just having that there allows him to sleep much better at night and not worry about patients.

He also recently opened The Kidney Hub on Nadi’s Fantasy Road which will now allow kidney patients in the west to have access to dialysis and other kidney treatments. Being married to Dr Alisha Sahu Khan, the national advisor for communicable diseases, is a big advantage for him as a medical specialist because of their understanding of the job.

“We have three sons, one big advantage is we both understand each other’s passion. She is a very passionate doctor when it comes to looking after communicable disease, outbreaks and health protection issues for the country and she puts in a lot of hours to her work even during the height of COVID-19.

“We have to put in a lot of hours in my work, we understand that for each other, the work that we do requires commitment, hard work and we support each other.

“We also have a very supportive environment in terms of Alisha’s parents and we have had extra nannies to support us and its team work.”