Sir: The number of patients seeking renal dialysis is increasing day by day but the proper dialysis centres where the patients could be treated are very few. Besides this fact, in Pakistan there is not even a single institute for technicians of dialysis machines where they could learn about the new techniques properly. Many technicians do not know how to prick the needle without damaging the fistula (surgically modified blood vessel created by connecting an artery to a vein). One must be aware that without the fistula, dialysis is nearly impossible and it is very expensive to have an operation for the fistula again. It is requested to the government to introduce a proper diploma for the technicians of dialysis machines and establish proper centres for patients. HIRA AHMED Karachi