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Times of paradoxes

What a world of contrasts we live in. We have heartwarming tidings entwined with horrible news. We have compassionate souls struggling to save lives alongside brutes who blow the life out of people.

Then we have a government that is an intriguing compound of Dr Jekyll and Mr Hyde. Its conscience is not moved when it fails to provide security to the citizens while the police force guards the privileged of the land leaving ordinary folks vulnerable to acts of terror. But this very same government becomes the first to steer the Transplantation of Human Organs and Tissues Act 2013 (Thota) through the Sindh Assembly unanimously an act of great humanity.

These contradictions are difficult to fathom. Let`s talk about this law which reminds us that humanity is still alive in parts of Pakistan. The transplantation law was initially adopted by the National Assembly in 2010 after a long campaign spearheaded by the Sindh Institute of Urology and Transplantation (SIUT). The 18th Amendment created the need for a new law for every province.

In the backdrop of this law had been the scourge of organ trafficking that plagued Punjab. Mercifully Sindh was spared and that is what has helped the adoption of the new act in this province. The focus is logically now on the need to develop a well-structured deceased organ donation programme. Since 2006 the SIUT has organised a number of campaigns to create public awareness about the need for deceased organ donation. The idea has been to persuade people to sign the organ donor card and over 500 people have signed, including a number of eminent personalities.

Signing a donor card however does not necessarily ensurethat the signatory will become an organ donor. That will be determined by the mode of his death. Only a person who suffers brain stem death and is on a respirator qualifies for donation.

According to Dr Adibul Hasan Rizvi, director of SIUT, who has fought an uphill battle for ethics in medicine, organ transplantation is rooted in the concept of deceased organ donation. As the science of transplantation caught on organs were expected to be available in large numbers and free of charge from cadavers.

This expectation has unfortu-nately been belied. The situation, as it obtains today, places the onus of procuring organs for transplantation on a few living related donors. This created a shortage of organs to meet the growing needs that opened new avenues for profiteering and exploitation.

Why is a deceased organ donation programme so essential, especially in the times we live in? It offers hope to many who are critically ill. More than that, it could help restore ethics in the practice of medicine that has fallen victim to the onslaught of the forces of commercialisation in the health sector.

The organ trade that has flourished in Punjab owes its success partially to the absence of a strong law and the presence of unscrupulous surgeons who have succumbed to the forces of greed and exploitation.

With poverty in abundance, organs were available from desperate people willing to sell a kidney for a pittance to glibtongued middlemen.

There were hospitals in Lahore and Rawalpindi that actually advertised their business on the web and struck deals on the internet with affluent foreigners with end-stage kidney failure looking for an organ donor.

The SIUT has refused to submit to unethical practices. A strong believer in healthcare being the birthright of a person, Dr Rizvi has provided the most expensive treatment to his patients free of charge. This includes transplantation as well.

The SIUT`s strong moral high ground has kept the organ trade away from Sindh. As the deceased organ donation programme gains currency more organs should become available. That should deter the racketeers. Dr Rizvi says that one organ donor can benefit 70 people.

`We do not have the means to use all the organs, but shouldn`t we be using those that we can?` That is what the SIUT has tried to do. It has been organising campaigns to enlist donors, but more public awareness needs to be created. With Thota in place in Sindh, it should be easier to start a public discourse on the issue and motivate people to become donors.

Thus alone will it be possible to get people to appreciate the `feel-good` impact of diseased organ donation. Those who have defied traditions to talk about organ donation and have actually become donors after death have been a very small minority. But they were truly men and women of courage. I have spoken to two families of deceased donors.

Each of them has expressed satisfaction at the thought of their loved ones having given a new lease of life to a seriously ill person.

`Once he was dead he would have carried his organs to his grave. By donating them to those who needed it he has saved two lives. I call this sadga-i-jariya (ongoing charity) and it heartens me,` says Naseem Razzak, whose husband, Dr Razzak Memon, died in 2007 and donated his kidneys and corneas to this cause.

The family of Naveed, the 24-year-old man who became Pakistan`s first cadaveric organ donor in 1998, express similar sentiments. It brought closure to his grieving father when he saw others restored to health with his son`s organs.

There is need to proliferate this spirit in the hope that the fight between good and evil in every walk of life will end in victory for the first. m www.zubeidamustafa.com

Zubeida Mustafa, "Times of paradoxes," Dawn. 2013-03-06.