“When I tell my colleagues I have not urinated for more than three years, they think I am making excuses to shirk work. They do not understand how painful dialysis is. It leaves me terribly weak. But then I cannot afford to miss work. My monthly expense on medication and dialysis exceeds Rs 30,000,” says Nozer H Canteenwalla, who suffers from end-stage renal disease (esrd). Three times a week, the 42-year-old development officer at a Mumbai-based insurance firm leaves office early for a dialysis session at the city’s Lilavati Hospital. A kidney transplant could have brought an end to his travails but Canteenwala hasn’t found a donor in five years.

“Getting an unrelated donor is extremely difficult in India. Cadaver organ donations are extremely rare in the country.Dialysis just delays the inevitable,” says Meeta Shah of the Narmada Kidney Foundation in Mumbai, an institution Canteenwala visits often to get information on esrd. Vatsala Trivedi, secretary of Zonal Transplant Coordination Committee (ztcc)