One of the main reasons for the thriving illegal organ trade in India is an acute mismatch in the demand and supply of organs. While nearly two lakh patients in India require kidney transplants and over a lakh need liver transplants every year, the actual supply is less than 3 per cent. This calls for measures to make voluntary donation of organs in India easier. The draft of the Transplantation of Human Organs and Tissues Rules, 2013, put up on the website of the health ministry, however, indicates that instead of simplifying the process for organ donation, the government is putting more bureaucratic hurdles and adding to the trauma of donor’s family members.
The latest draft rules, for instance, say that forensic doctors of government hospitals need to be present during organ retrieval operations to check whether organs are suitable for retrieval. Next, the body will be taken to a government-designated centre for post-mortem. This means grieving relatives may have to wait longer first for busy, overworked forensic experts from understaffed departments to turn up for the donor operation at the transplant centre and, second, for the donor’s post-mortem to be completed at a different centre.
The Centre’s plan is to introduce an all-India transplant programme, along the lines of the American one. Unlike the US, however, India has an acute shortage of forensic doctors who can be present during organ retrieval. As more peripheral centres get recognised as non-transplant organ retrieval centres, it may become difficult for limited number of forensic doctors to attend organ retrieval operation. Further, more time will be lost coordinating to get forensic doctor to the organ retrieval centre. The result will be that the Deceased Donor Transplant (DDT) programme, which has not picked up after so many years, will further suffer. If the Centre wants to follow the American system, it should follow in all respects. The US has several non-transplant organ retrieval centres and several forensic doctors who can be present.
The Transplantation of Human Organs Act is supposed to help in meeting the demand for kidneys, liver and other organs and curb commercial organ trade by accepting the concept of brain death. It has, however, done precious little to decrease the illegal organ sale and at the same time created unnecessary delays and hurdles in cases of genuine donation.
The majority of the deceased donors the world over are victims of road accidents. Given that over 1. 5 lakh persons die in road accidents every year India, there is tremendous potential for cadaver transplantation. A brain-dead person’s body can yield nearly 37 organs and various tissues that can help a number of patients. Yet, people are not aware of the DDT programme. And even if they were, many states do not have organ retrieval facilities.
The government must realise that for organ donation and transplantation to be a success, a number of motivated government agencies, voluntary health organisations and aware families must work in tandem. In addition, the infrastructure to facilitate organ donation must be put in place. Only then can the thriving racket in the sale of organs be curbed.
The Centre should take a leaf from Tamil Nadu’s successful donor organ retrieval programme, which is based on a strong partnership between NGOs and backed by consistent efforts to popularise the significance of such donation. It also includes training of transplant counsellors and allied medical staff so that they can effectively convince grieving family members to agree to the donation within a limited time period after brain death. The state government too has been proactive in ironing out unnecessary bureaucratic obstacles.
gaursaroj@ymail.com
Gaur is a former Allahabad University professor and rights activist