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THE struggle to have in place an effective and ethical organ transplantation programme has been a long and uphill one for health professionals in Pakistan.
Many milestones have been reached. The most noteworthy has been the success in creating awareness among potential live, related donors. While the task of creating a legal framework by adopting a comprehensive law providing for organ donation – both live and deceased – was arduous, this was accomplished in 2007 in the face of stiff opposition from vested interests. The latter had commercialised transplantation, bringing a bad name to the country as a centre for kidney tourism. The Tissues and Organ Transplantation Ordinance allowed the government to crack down on unethical practices to a large extent. Much of the credit for this and other achievements regulating organ transplantation goes to the Sindh Institute of Urology and Transplantation.
The time has now come to step up the campaign for deceased organ donation which is the most common means of procuring organs for transplantation all over the world. The SIUT launched this programme in 2008 once the law was in place, and 800 people have signed its donor card. But this figure is far from satisfactory: it is highly unlikely that most of the 800 will actually become donors since brain death is the first requirement for organs to be harvested after a stringent procedure of certification by an independent team of neurologists.
So far only three deceased donors have provided organs for transplantation in Karachi. Obviously, the reluctance is due to socio-cultural reservations. With deceased organ donation programmes working successfully in many Muslim countries religious taboos are not involved. It is therefore essential for the media and health authorities to join hands in a campaign to familiarise people with the practice of deceased organ donation and motivate them to sign donor will cards. With greater understanding of the issue – especially in the context of how many lives can be saved – people will come forward to help. This will reduce the pressure for organs – 15,000 patients die of end-stage kidney failure every year in Pakistan. Link...