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As the year draws to a close, it often is a time for giving and reflection. And both these shine through, when a person or family signs up for organ donation, a medical intervention that helps give someone else a better life.
Much has changed in the world of organ donations to ensure transparency and increased governance, in the interest of donor and recipient. And yet, incidents of fraud get reported, where vulnerable people are preyed on, lured by money, to donate an organ to someone who is in need of a transplant.
But that should not deter this life-changing journey, say doctors, as India has a huge gap to bridge. About three lakh people wait for an organ and only about 15,000 got them last year, says Dr Varun Mittal, Head of kidney transplant and Associate Chief of Uro-Oncology and Robotics, at Gurugram’s Artemis Hospital. Of those who got organs, about 10,000 were kidneys and an estimated 5,000 were livers, he said.
Nearly 1.5 lakh fatalities occur annually from road accidents, and “a large number of victims become brain dead and they could provide life to many,” he says, if the families donated their organs. The newer drivers’ licences mention organ donations, allowing people to opt into the programme; it is part of some school curriculums; and in Gujarat, for example, even small centres are organ retrievalcentres, he says.
Organs donations can be live (from a family member) or cadaver organ transplants, and Mittal calls for awareness and sensitisation programmes, even among health workers.
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Abhishek Gupta, Chief Marketing Officer with Edelweiss Tokio Life Insurance says, people are reluctant to talk about organ donations, for reasons including social and religious misconceptions, a mistrust of the medical system and the association with death, rather than seeing it as a life-changing act. It needs to become part of “dinner-table conversations,” says Gupta.
The life insurer is associated with non-government organisation, Chennai’s Mohan Foundation, since November 2019. In January, their awareness initiative “Zindagi Express” covered 50 cities, starting from Hyderabad and tracing a heart shape, to end in Bhopal — to tell people to make the right choice for their organs and “Pass It On”.
The idea was to show that India has a heart and can show its heart by participating in organ donations, says Gupta, besides conveying, the heart too can be donated. A study by them revealed that people feared donating an organ would affect their after life, or that their religion disallowed it, he says, when, in fact, several leaders have called the medical intervention a “service to humanity”.
Sometimes families are reluctant to allow organ donation, even when an individual has pledged his/her organs, says Gupta, urging people to communicate their pledge with their families.
Fixing frauds
People also don’t pledge organs, fearing they would not get good medical care when required; or their organs may be harvested and misused in some way, the study revealed. This mistrust is despite the regulatory framework being tightened, he says. But, with every industry, there will always be elements circumventing the process, he observes.
Despite scrutiny of documents, it sometimes becomes impossible to call out a fake being propped up as a family member, say doctors. Recently, Apollo Hospital (Delhi) was mentioned in a “cash for kidney” organ donation racket involving vulnerable people from Myanmar — an incident that is under investigation; and denied by the hospital.
Dr Mittal agrees, complaints need to investigated and accountability fixed. He recommends DNA-tests to establish family ties and insists that it is not a major additional cost to the entire procedure (estimated ₹7-10 lakh).
Transplant centres have a “donor advocate” whose letter is mandatory on every transplant file, he says. The advocate understands the donor’s situation, if they’ve been coerced, for example, he explains.
On a note of hope, Health Minister, Mansukh Mandaviya said (in September), nearly 70,000 people had pledged to donate organs on the National Organ and Tissue Transplant (NOTTO) portal. He too has taken the pledge.
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