Tokenism in Organ Transplantation

Tokenism in Organ Transplantation

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Man Changes, the Program of the Government vanishes

Er. T.N. Panda

Inspired by the newspaper reports of the awareness programs conducted by MOTHER (Multi Organ Transplantation and Human and Educational Research), Sourendra Behera, a small tea stall owner of Patamundai, a small town of Odisha, offered to donate the organs of his fourteen year old son, who had just died in the hospital of S.C.B. Medical College, Cuttack, the premier hospital of the state, on 12th March 2011. Alas, there was no facility for cadaveric transplantation of organs in what to speak of Odisha, entire Eastern India, barring Kolkata. He had to remain content with only the eye donation. The facilities do not exist even now.

The first cadaveric kidney transplantation at Kolkata (the then Calcutta) was performed by Dr. Mohan Seal in June 1988 in the Belle View clinic but the next one could take place in January 2012 in SSKM hospital, a big gap of nearly 24 years. Similarly the first kidney transplantation of Odisha, though a living donation, took place in VSS Medical College, Burla in June 1985, the next one again a living donation was performed in November 2002 in Kalinga Hospital, Bhubaneswar after a gap of more than 17 years. Thus it can be seen that even the existing facilities for organ transplantation was not utilized owing to lack of awareness.

It can be safely inferred that promotion of the concept and its successful implementation depends on (1) generating awareness and appreciation among the people, and (2) suitable hospital/ infrastructural facilities which should develop simultaneously. While the NGO's working in this field are putting their best for spreading awareness, it is imperative on the part of the Government to extend its helping hand for the success of the same, by way of simplifying the procedures, helping the spread of awareness and putting the necessary hospital facilities in place.

The Transplantation of Human Organs Act-1994 provides for three types of organ donation, i.e. (1) Living Related (2) Living unrelated and (3) Cadaveric. It is our experience that sufficient number of organs are not available from the living ones to meet the huge gap between demand and supply and hence cadaveric donation is required in abundance. Every year nearly 1.5 lakh people die of road accident, and given the proper mindset among the relatives of the deceased towards organ donation, it should be our aim to retrieve as many organs possible. This is the only potential source, if harnessed properly, which can bridge the demand supply gap.

After a lot of persuasion by National Deceased Donor Transplantation Network(NDTN), having its Head Office at Mumbai,Government of India (GoI) agreed in 2007 to come up with a specific program for the above purpose and accordingly National Organ Transplantation Program (NOTP) was chalked out envisaging an expenditure of around 1500 crores of rupees during the last 5-year plan. The draft of the program was circulated to all the states in January 2009 seeking their comments. The Government of India reminded the defaulting states, who did not respond earlier, in March 2009. The aim of the program was to spread awareness and also create hospital facilities exclusively for transplantation on national basis.

In October 2007, Mr. Ambumani Ramadoss, the then Minister of Health and Family Welfare announced in New Delhi that the GoI has decided to set up 10 more Organ Retrieval and Banking Organizations (ORBO) in the country, apart from the only one that is functioning in AIIMS, New Delhi. These ORBO's would have helped, in preserving the organ after retrieval from the deceased, for a longer period than is possible now else where.

In order to facilitate simplification of procedure to help the declaration of brain death by the doctors, it was suggested to the Director General of Central Government Health Services (DG, CGHS) to please take up suitably with the Home Ministry to incorporate brain death in the IPC also. The suggestion was made in course of the deliberations on the occasion of the observance of The World Organ Donation Day on the 27th and 28th of November 2010 in Vigyan Bhawan at New Delhi.  Hopefully, some people are working on it.

It appears, with the exit of Mr. Ambumani Ramadoss from the Union Cabinet, the schemes announced by him, the execution of which would have gone a long way in promoting deceased donor transplantation in the country, have been shelved. It is high time the Government should revive the schemes. Better late than never!

The writer, after completing Degree in Electrical Engineering, worked with Bokaro Steel Plant for 30 years. After retirement he engaged himself in promoting Organ Donation and Transplantation, apart from promoting Human Dead Body Donation to Medical Colleges in Odisha since 2006. He is the founder of MOTHER (Multi Organ Transplantation and Human and Educational Research). He is also the General Secretary of NDTN (National Deceased Donor Transplantation Network) a Mumbai based organization to promote cadaveric donation and transplantation of organs in the country.

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