Organ donation - One of the Noblest Gift a Human can Give

Pradip Bhandari
Founder CEO - Jan Ki Baat

Organ donation across the globe is one of the noblest gifts a human could give to a fellow human – and the act could be equated to that of god himself.

India is considered to be land of values, compassion and sacrifice; and organ donation in this respect should play a very central role in the Indian society.

According to a report by Times of India, India has witnessed a 4-fold increase in organ donation; however there is still a very long way to go. The need and significance of this is extremely urgent. If we compare India with some of the global standards, one realizes how far we are lagging behind. India's organ donation rate in 2016 stood at 0.8 persons per million population compared to Spain's 36 per million, Croatia's 32 per million or US's 26 per million, but still India has taken positive strides with a year on year increase in organ donation rate.

What is the scenario within India?

Ten states and two UTs have an active donation and transplant programme. States such as UP, Chhattisgarh, Himachal Pradesh, Goa and the North-East are yet to make a debut. Stakeholders blame lack of awareness, infrastructure and political will as well as myths and misconceptions for the sluggish pace of organ donation.

India is one of the most populated countries in the world. It should ideally be one of the countries with the highest number of donors. It is sadly among the lowest because of a lack of awareness about the process and circumstances of organ donation. (https://www.mapsofindia.com/my-india/society/what-makes-organ-donation-difficult-in-india).

Tamil Nadu, Maharashtra, Kerala, Karnataka, Telengana and Gujarat currently lead the way in organ donation. Delhi and Chandigarh too managed 30 donations in 2016.

State –Specific Data:

- Tamil Nadu runs India's most successful programme by taking a slew of decisions to ease donations about a decade back; families donating organs don't have to move for NOCs or post-mortems. Also, the state offers free kidney, liver and heart transplants in government hospitals like developed nations.

- Maharashtra - crossed 100 cadaver donations in 2016 despite one of Mumbai 's top hospitals being involved in a kidney racket, and has carried out 1,064 transplants in the last five years. Pune suddenly emerged as a high-donation centre, surpassing Mumbai. "Till April 2017, 69 donations took place in Maharashtra.

- Telangana - Hyderabad and other districts of Telangana have crossed over 1,000 organ donations since 2013. From less than 1 per million population, the donation rate has now reached 4.4. From just 41 being recorded in 2013 to 106 organ donations in 2016. In 2017, over 80 organ donations have already been reported.

- Karnataka - donations taking a leap from 18 in 2013 to 70 in 2016. According to officials, this could be attributed to linked Aadhaar cards appealing to pledge organs. Anyone who enrolls for Aadhaar will be directed to the website of Jeevasarthakathe where they can pledge organs.

- Kerala - recorded only 11 donations after 73 in 2016. Kerala, however, has to its credit some of the unique organ transplants that include larynx, pancreas, small intestine and hand transplants.

How grave is the challenge? https://twitter.com/republic/status/1013408850752495616?s=19

Each year about 5 lakh patients die in the country due to non availability of organs. Some 2,20,000 Indians await kidney transplant on any given day while only 15,000 manage to get a donor’s kidney. Of the 1,00,000 patients suffering from liver diseases in the country only 1000 manage to find a donor. Each year the average number of people seeking corneal transplant adds up to about 10,00,000; there are some 50,000 patients seeking heart transplant; and about 20,000 people seek lung transplants. The number of donors, on the other hand, is miniscule.

Of the 85,000 liver failure patients who join the country's waitlist annually, less than 3% get an organ. Also, of the two lakh fresh annual registrations for kidneys, 8,000 manage a transplant. Thousands waiting for heart or lungs face bigger odds as barely 1% get an organ before time runs out.

What could be the solutions?

  • Urgent need of education and awareness among patients, doctors, donors their families alike. The activities of organizations like Dadichi in Delhi need to be replicated in other state also. Government should also actively promote organ donation.
  • Improving the screening of brain death, removing the discomfort around declaring patients brain dead (more common in government hospitals) or at the same time, fake reportage of brain deaths to mint money (as done by some stakeholders in organ trade rackets)
  • India needs more retrieval centres. India's largest centre of neuroscience, NIMHANS, is still not recognized as a retrieval centre.
  • In India brain death must be certified by a panel of 4 different doctors after running a battery of tests and donors’ families, will be required to permit the transplant.
  • These processes should be simplified, with minimal paper work along with hassle-free bureaucratic interventions.
  • The role of non-profit and social sector working in this area have been performing quite selflessly, and will continue to push this noble cause phenomenally.

What are some of the positive steps taken in this direction?

- Signing of MoU by National Organ and Tissue Transplant Organization with Spain which has the world's highest donation rate. About 100 countries are learning their model. Their experts training five of our regional coordination centres.

- India's infrastructure too is growing. The national network facilitated 136 instances of organ sharing between cities and states.

 In short, one very important angle about organ donation is that its awareness and significance needs to reach at a very local and household level; that - donation is safe and noble act – not something ritually impure; and could be better than burning the cadaver or burying it as last rites for the deceased, and rather to let his/her organs live on.

This has the capacity to increase love, compassion and even happiness in the society. Sincere attempts at organ donation gives a more fulfilled experience to the donor that she/he is going to help another one even after death, the donors’ family too is expected to feel the same. Similarly, for the recipient, the organ is a life-saver, a blessing in disguise – and s/he and his/her family would be the happiest to receive it.

Collectively, organ donation becomes an act of sharing and caring, capable of increasing India’s gross happiness Index. So, pledge to donate your organs and be a happier person in a happier and healthier society!