SamareshK at 30 years of age was on cloud seven with an annual package of 20 lakhs, a loving wife and a 3 yr old daughter living in an upmarket Delhi suburb. He had recently being diagnosed with high blood pressure. As there were no symptoms he was not taking it seriously. For some weeks he felt breathless on climbing stairs and noticed swelling over his feet. His wife turned him in the hospital where he was told that he was suffering from advanced kidney damage (CKD) Life came suddenly to a halt. The doctors advised kidney transplantation which means one of his close relatives undertake an operation where one of his kidneys is surgically removed and is then transplanted into Samaresh.
The impossibility about getting a kidney transplant emanates fromthe unlikely availability of a blood relative who is healthy and has a compatible blood group. Above all he or she must be motivated enough to donate one kidney to his ailing relative. It is a Hobson’s choice. Samaresh had no such altruistic acquaintance forthcoming and succumbed to his illness.
Aneesat 35 summersis suffering from total liver failure as a consequence of a life led full of spirits. He is admitted in ICU in a critical condition. He needs a liver transplant to survive.
In the ICU of the same hospital Maanav Singh is oblivious of all joys and sorrows of life. A day before he was returning late from his BPO, zipping rapidly home when suddenly a bright flood light blinded him into a head on collision with a truck veering straight into his path. Maanav was on ventilator and life support. He was pronounced brain dead. No medical miracle could bring him out of coma. The family was distraught and being meaning fully educated wanted to donate his eyes kidneys and liver.
The story did not have a happy ending. The hospital could not retrieve Maanav’s organs as it did not have the statutory permission from thestate government to remove organs from a brain dead person although the hospital was already conducting organ transplants from living related donors and had all the infra structure in place. Without this statutory permission even a willing person or family cannot donate their organs. The necessary paper work to get this permission had been applied more than a year back but without avail.
Some bare facts-
- Every hour 14 people are dying of road accidents in India. The total annual deaths due to road accidents has crossed 1.18 lakh in the year 2009, according to the National Crime Records Bureau (NCRB).
- Every year nearly one 1.5 lakh new patients requiring kidney transplants are added to the inexhaustible patient numbers, in need of kidney transplant.
- Majority of us do not have compatible and willing family donors. It means if one gets kidney failure it boils down to lifelongdialysis or transplant or an imminent death.
- The live, lung and cardiac failure numbers are no less daunting.
- The economics of demand and supply is totally skewed. This encourages unethical practices in which the poor is coerced to sell one of his kidneys or a part of his liver. Besides exploitation of the poor there is sexual exploitation too. 85% recipients are males and 90% organ donors are females.
- In many developed nations the concept of implied consent is in place. Simplistically it means that the hospital will retrieve transplantable organs before declaring a brain stem dead person, dead, unless the relatives explicitly forbid the organ retrieval.
What is the way out?
At societal level
- Multi pronged strategy to increase awareness among people about the facts of brain death.If a patient is braindead then it is irreversible and final.
- Organ retrieval does not disfigure the body.
- No religion in the world forbids organ donation.
- By this noble and virtuous act by one family, at least half a dozen families get newlease of life. What goes around comes back.
The society is as good or bad asits individual members. We reap tomorrow what we sow today.
At government’s level-
- Simplifying and expediting the necessary permission to secondary and tertiary care hospitals to retrieve organs from brain dead person.
- Both the government and private hospitals should be incentivised /motivated to retrieve organs and transplant them by cutting the bureaucratic red tape.
- Government and private sector to commit financial support for economically challenged/ BPL persons to for organ transplant.
- Help organ transplant to come out of the illegal cobwebs of brokers by making organ transplant laws more practical.
- Promote research in organ regenerative therapies and animal organ transplant into humans.
- Reduce cost of post transplant medicines
At the level of hospitals/doctors-
- There should be a better interaction amongst different specialists in identifying a potential brain dead donor. Professional ego should not come in way of active cadaver transplant service.
- Dedicated social workers and transplant coordinators should be appointed in major hospitals to promote organ donation. They will have the necessary training to approach the distraught families with empathy.
Above all the print andelectronic media need to use their reach in educating people about the necessity of allowing organ donation in the unfortunate situation involving brain death of their near and dear ones.
Tomorrow this epidemic may engulf us. Lets pledge-
Don't take your organs to heaven; God knows we badly need them here.