LIFE AFTER LIFE: ORGAN DONATION IN INDIA
And Lord Shiva was enraged and beheaded Ganesha; And Parvati was pained beyond grief.
“Ganesha! Oh My Son! Be it that it was me.” She wailed, and Lord Shiva was moved and transplanted an elephant’s head onto Ganesha and Ganesha became the Deity of Learning and Wisdom
'Shiva Purana' : Hindu Mythology
Organ transplantation is a process in which an organ is removed from the donor’s body and placed in the body of a recipient, to compensate for a damaged or missing organ. Organ transplantation has succeeded to associate life and death for the benefits of the society. Common transplantations include kidneys, heart, liver, pancreas, intestines, lungs, bones, bone marrow, skin, and corneas. Kidney, part of the liver, part of the pancreas, part of the lungs or part of the intestines can be donated by living donors, but most of the donations occur after the donor has died.
The procedure of organ transplantation is a crucial health guarantee for society. However, the paradoxical shortage of organ donations in India limits this possibility.
The World Health Organisation (WHO) reveals that the organ donation rate in India is the lowest in the world. The rate varies between 0.05 to 0.08 per million of population while in the Western countries, 70-80 percent of people sign up to be organ donors. Infact, countries like Spain and Germany are contemplating making every citizen an organ donor. Following its footsteps, countries like Austria, France, Norway, Italy, Singapore, Columbia to name a few, have introduced presumed-consent policies. Presumed consent (or opt-out system) means that the consent of organ donation is assumed unless the deceased has expressed in life not to be an organ donor. From presumed consent to incentives for donors, these countries have tried different ways to promote organ donation among their people.
However, India has been following an informed consent (or opt in) system of organ donation and lacks serious organized campaigns to steer organ donation drives, which explains its low organ donation rates.
Consequently, every single day, more than 15 patients die waiting for an organ and every 10 minutes a new name is added to the list in India. India is struggling with an acute shortage of organs for transplantation and the picture looks dismal looking at the disparity between the demand and supply of organs. The yawning gap between the two is very unfortunate as organs from an individual can save upto 8 lives.
Lack of opt-in consent process makes organ donation rates low since obtaining consent from family and relatives involves emotional, ethical and religious constraints. Lack of knowledge about the concept of ‘brain death’ among many Indian doctors and distrust against the medical staff also contribute to the low donation rates.
So what can be done to alter this scenario?
It has been seen that the willingness to donate organs is directly proportional to the level of education. NGOs need to take up the lead in spreading awareness about the organ donation process as the Government should work towards strengthening the laws. Many NGOs are already working towards educating every Indian of the merits of organ transplant and breaking existing myths related to organ donation. To name a few, Gift Your Organ, Shatayu, MOTHER, ZCKK and MOHAN Foundation are some NGOs that promote and educate people on deceased organ donation. As a result of organ donation drives steered by NGOs, Government and other agencies, the organ donation increased three-fold in nine years, as of a Report of 2019.
Political leaders and celebrities should come to the frontline in large numbers to support this important cause. Adding the concept of organ donation to school curriculum will help educate the newer generations, who can further educate their family members. The journalists need to bring out the positive aspects of organ donation to encourage people.
Considering how lucrative the business is, child trafficking for illegal organ transplant is an organized business and operates covertly in widespread manner. It is a double benefit for the trafficking mafias where they can push the trafficked children into forced labour and begging as well as prostitution after organ stealing. To attempt to overcome the uncontrollable trade in organs, Indian Parliament has provided for the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for prevention of commercial dealings in human organs. State Medical Councils have suo motu powers of investigation, however these have never been invoked. The Councils have turned a blind eye to complaints lodged with them. With a largely illiterate and gullible population, such attitudes by disciplinary agencies have nurtured a fertile ground for organ smuggle. This scenario demands a change in legislation of the country. The organ donation rates will increase if there is an improved transparency and public trust in the procedure.
Thus, the concept of clinical organ and tissue transplantation can prove to be more beneficial and life saving if everyone involved in the process, including doctors and medical institutions consider the best interests of the donors and recipients and are not tempted to seek personal fame or financial gains in the procedure.
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