JOIN USThis year’s Organ Donation Day is distinctly different from the previous years. Many cases of donations are trickling in from across the country and it is heartening to see that the people have finally begun to understand the value and virtues of organ donation.
According to the World Health Organisation (WHO), only about 0.01 per cent in India donate their organs after death, while in Western countries around 70-80 per cent of people pledge their organs. India has one of the worst rates of organ donation in the world. With a population of 1.2 billion people, our organ donors per million population (PMP) is a paltry 0.08 persons.
Countries like the USA, UK, Germany, Netherlands have a ‘family consent’ system for donations where people sign up as donors. These countries have seen the donations double per million population (PMP) averaging between 10-30 PMP.
Other countries like Singapore, Belgium, Spain etc have a more aggressive approach of ‘presumed consent’, which permits organ donation by default unless the donor has explicitly opposed it during his lifetime. These countries have seen the rate of donations double, averaging between 20-40 PMP.
Lack of awareness, complex laws and inadequate facilities are key barriers in addition to the cultural and religious factors in India. Little surprise then, many people die for want of organs in the country.
Every year, nearly 5,00,000 people die due to non-availability of organs – 2,00,000 people die of liver disease; 50,000 people die from heart disease; about 1,50,000 people await a kidney transplant but only 5,000 get one; almost 10,00,000 people suffer from corneal blindness and await transplant.
We strongly believe that all stakeholders must come together to drive a concerted programme designed with experiences of all. We have conceptualised a programme called METHOD or Management of Transplantation and Harvesting of Organ Donation which needs be driven by government agencies, civil society organisations, medical colleges and hospitals.
Institutionalised mechanism for green corridors, wider recognition to donors' families, training and skill upgradation of support staff, counselling modules, and regularisation of registries are some of the key features of the proposed programme.
Worst donation rate
India has one of the worst rates of organ donations and this is strange given the otherwise charitable nature of this country. Over the years, lack of awareness and enabling policies have made the matter worse. News media has taken up the cause vigorously and we consider it a ripe time for all stakeholders to come together to give a big push to organ donation.
Between 2012 and 2014, the Delhi NCR registered a mere 59 cadaver donors as against 350 in Tamil Nadu, 116 in Maharashtra, and 105 each in Kerala and Andhra Pradesh. The total organs retrieved were 144 as against 1,057, 276, 168 and 298 respectively, in these states. While India’s organ donation rate at 0.34 per million is among the lowest in the world, Delhi, despite having a high literacy rate, fares poorly among states.
Rather than spend time on gigantic plans, we must start with incremental steps. On an average, about 380 persons die in th ecountry every day according to the National Crimes Records Bureau. If we have institutionalised mechanisms to access organs of even 30 per cent of such victims, we would end up getting 570 organs every day or over two lakh organs per year.
This would change the organ donation landscape in the country and we would become world leaders in resolving the pandemic crisis of organ shortage. However, to come closer to this is a herculean task and equally big steps and similar efforts will be required to realise this.
Several patients with end-stage problems are battling for life as there are not enough donor organs available. Families of patients who are brain dead should come forward to donate the organs so that their loved ones can live forever through this noble gesture.
(The writer is Senior Consultant and Director, Nephrology, BLK Super Speciality Hospital, New Delhi)