I don't know if this would be available there, but maybe the kidney patients could change to Peritoneal Dialysis? It allows the patient to do dialysis at home
without a machine. It works with the body to do the toxin extraction using a water solution that is flushed. No machines, no blood exchange, no traveling to a dialysis center 3 times a week. It seems to be very popular in rural areas where getting to a dialysis center is very far away. Our nephrologists are from Texas and it is very common there. See this link to help describe it better.
Treatment Methods for Kidney Failure: Peritoneal Dialysis - National Kidney and Urologic Diseases Information Clearinghouse
My dad has been on hemodialysis for the past 4 months and just now had the operation for Peritoneal Dialysis. My family needs to go to a few training sessions, and Dad will need to be seen by the doc at the center once a month. Everything else--paperwork, fluids, bags, nozzles, gloves, masks, bp cuff, digital scale--is sent to the home and replenished as needed.
Hemo is usually started through a catheter in the neck, then changed to a more permanent method. There are 2 arm methods--a graft and fistula--
Vascular Access for Hemodialysis - National Kidney and Urologic Diseases Information Clearinghouse. Dad wasn't a great candidate for those since he's 85 and his veins aren't great (common in the elderly). The stomach PD catheter seems to be the best answer. Four half-hour sessions every day while he's relaxing at home. I'm praying this works for him since it is so much gentler on the system and won't require his traveling back and forth to the clinic (30 min away).
If anyone thinks this might work down in PP, let me know and I can ask his Peritoneal Dialysis nurse.