We are a big country. Thousands are born every day and many die.

We die because of natural causes, we die because of health ailments, we die because of long-term exposure to bad air, water, pollution or other pathogens.

What saves us, though, is good medical treatment at the right time, drugs, and doctors. There are ailments, however, which cause irreparable damage to our bodies and certain organs. For some people, organ replacement is rendered the only option.

In the case of India, because of sheer numbers, this figure is multiplied many times and there is a need for roughly 1,75,000 kidneys, 50,000 hearts and 50,000 livers for transplantation each year.

Our current donor figures though are at an abysmal low of 0.05/million (about 50 cadaver donors/million a year).

I run a research startup called Outline India in Gurgaon and we focus on field data collection and research assistance within the socio-economic/development space. One of our recent projects embarked upon this mammoth plan to understand the current process of organ donation in India and gather doctors’ opinion on how to streamline it, teeing off from the capital city of Delhi.

Missing a system While the term ‘developing country’ in the context of India is fairly archaic, India has absolutely no centralised system in place for willing donors to connect with needy recipients or needy recipients to reach out to potential donors.

Health is a state subject, and while a few states have tried to grapple with it, most are indifferent to its concerns.

Unlike countries in the West, such as Spain, where every cadaver is automatically a donor, or the US that boasts of a very sophisticated system called the United Network for Organ Sharing (UNOS), the concept of organ donation and brain death are rarely discussed in the cities and bigger towns of India, forget the interiors.

Our research revealed that the concept of ‘brain death’ is not necessarily taught in medical school. To clarify, a person is said to be brain dead when there is an irreversible loss of consciousness, absence of brain stem reflexes, and apnea. Brain death is normally considered the initial stage for organ retrieval and transplantation.

The total number of brain deaths resulting from accidents in India is roughly 1,50,000 annually. If 5-10 per cent of all such cases result in organ harvest, there would be no need for live donation!

In India, religious sensitivities govern not only politics but in some sense our everyday lives as well. Belief in an afterlife or the idea of keeping the body intact is a big reason why most people do not donate. Lack of counselling in hospitals and disinterest in the process of organ extraction is the other side of the coin.

All the cons Then again, laws in India prohibit organ donation for monetary purposes.

The process of organ extraction, however, mandates the presence of two practitioners appointed by the Government, one being a neurology expert, together with two certifications six hours apart. It’s a cumbersome process and most medical centres in India (the good ones at least, the bad ones couldn’t care less) are too swamped and pressured to be able to fulfil such requirements.

All these factors coupled with lack of awareness and a government body directly overseeing organ transplant, and the long patient waiting list make the organ donation process a tough cause.

India needs its own centralised organ donation system. It needs its celebrities to step up and speak about the cause. It needs medical centres to make that extra effort to save lives. And above all, it needs people, at least a fraction of the teeming 1.2 billion, to pay heed to this very crucial aspect of saving lives.

However, not all is lost and unlike Rhett Butler in the novel Gone With The Wind , some of us do give a damn!

Our fieldwork results and report are currently being shared with medical centres and the data is being used to devise an awareness campaign.

The writer is the founder of Outline India

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