CHALLENGES AND MEASURES

What is hampering the movement of Organ Donation in India ?
What additional incentives and measures can be adopted ?


The Term Blood Donation is now-a-days known to anyone. Anyone who wishes to donate Blood, can attend the Blood Donation Camps organized by NGOs, Political Parties, Government Bodies or Blood Banks. One can donate blood in exchange of the blood used for known patients. In some hospitals or Blood Banks, it is even made compulsory to donate blood in exchange of blood for In-Patient/s. In simple words, the One who wishes to donate blood, can donate it (provided it is medically allowed by the attending doctors), and the one derives satisfaction that s/he has done the donation

But the same is not the case when it comes to the Organ Donation. There is not enough awareness of it. Everyone who is aware of this, do not wish to donate organ after death. If One wishes to donate organs after death, s/he doesn’t fill the form or spread his/her wish to close family members.

And the main thing is, Even if One is fully aware, wishes to donate organs after death, fills the required form and submits, inform about his/her wish to the family members and friends……, s/he cannot fulfill his/her own wish after death. There is no value to the wish of a deceased if the family members object for any so called reason. It is Purely a Wish of the Close Relatives and Family Members of the deceased. There is no legal binding upon the family members to fulfill the wish of the deceased, and the deceased is unable to awake and ask to fulfill it. So, according to me, the whole idea of Organ Donation Awareness Campaign is to be reshaped. Instead of collecting the ‘Wish Forms’ or ‘Self Declarations’ of Organ Donation after death of self, people should be inspired to declare that they will donate the Organs of their deceased close family member / relative / friend, so as to be useful to save someone else’s life. There should be clear message of donating organs of your beloved ones, which you are otherwise going to waste in funeral process. This concept will make clear awareness.

The Zonal Co-Ordination Centers set up by Government are busy mainly in arranging the Waiting List and maintaining the transparent distribution of Organs. They have end number of forms filled by the wishful donors but there is no system available to let them know about the death of anyone out of it, and that too within required time. The irony is, even if they come to know about the death in stipulated time, they cannot legally compel the family members or relatives to donate the organs of the deceased, whether it is a cardiac natural death or brain death.

The focus of Awareness Campaign is to be changed 360 degree. All our Awareness Campaigns are revolving around the wish of the person who loses control over his/her own wishes as soon as s/he dies. And contrary to this, the rights of the permission to retrieve organs of the deceased are solely and exclusively lie with the family members. The focus of campaign should be more upon the close relatives, who are decision makers.
If a person writes his/her WILL regarding property handover, it has legal status after his/her death. Same is not happening with a Will to donate Organs after death

  • The Organ Transplant by retrieving Organs of deceased has a legal status. There should be legal status ALSO to the Wish of Donating Organs after Death, expressed in any form of writing when alive and in a good state of mind and health
  • Awareness Campaigns should make appeal to the noble cause of donating organs of the deceased family members even if the deceased has not expressed such wish
  • The organs should not be retrieved if the deceased (when alive) had specificallexpressed wish not todonate his/her organs after death. Otherwise the wish of close relative should be treated as a permission to retrieve organ/s.
  • The question of Disfigurement doesn’t arise when there is a Post Mortem due to unnatural death. This happens because there is a law for that. Whether we want or not, we have to ‘Nod’ Yes for it and accept it. The cut on the body in case of retrieving organs is much less or unnoticeable comparing to the cut done for Post Mortem. People do not know this truth. We need to educate them, and a support of a law should be there.
  • Awareness Campaigns should use the term ‘Gift Organs’instead of ‘Donate Organs’, because the relatives of the deceased are not donating anything out of their own belongings. This is a Gift of Life to someone, without spending anything out of your pocket. You need not to be rich to gift life to the end stage patient. Everyone of us has got our life as a Gift. We should keep it passing on when time occurs. We give Gifts / Presents to each other on pleasurable ceremonies like Birthdays, Weddings, Anniversaries, Naming Ceremonies, Achievements, and what not ! Just imagine, is there any gift better than a life to someone ? That too, without spending anything from your pocket ? More than that, this gift becomes holy because you do not know the receiver.
  • All the Ambulance / Hearse Drivers and Owners should be made aware of, and trained to initiate the talks of Organ Donation to the close relatives of the deceased. It is because only close relatives and friends are around when the patient is declared dead, or at the time of calling Ambulance or Hearse service.
  • Every process of Funeral and informing the relatives, friends, social circle, colleagues etc. starts when the family physician or hospital doctor confirms the death of patient. That’s why Awareness Campaign specially for the Family Physicians and Hospital Doctors / Staff should be carried out, since they are the first ones to declare death and responsible for giving primary death certificate. Posters depicting awareness should be displayed at dispensaries and hospitals, so that the close relatives will remember of it when the death occurs in the family.
  • The family members are in a grief or intense sorrow due to the loss of their beloved and supposed to be not in the senses to think of gifting life to someone else with the organs of their deceased beloved. This subject can be raised by such a person who is not from within the deceased’s family but very close to them. Generally, the persons who go to Cemetery for arrangement of funeral are such type of persons. The Cemetery staff should be trained to make these persons aware of Organ Donation if they are not.
  • The law can be prepared to link the ‘The Wish of Organ Donation’ to the Aadhar Number after the ‘Wish / Consent Form’ if submitted. It will be useful in many ways. Like, it may happen that someone has submitted Wish Form with NGOs / at Awareness Campaigns, but not informed family members; or the family members and friends are informed but the death occurred at distant place; or the family members and friends were well aware but forgot at the time of death… This Linking with Aadhar will be helpful at such time, since the Wish of the deceased will be brought to notice at the very first stage of declaring death or at cemetery, making the enough time available for harvesting the organs.
  • A system can be developed to mention that the ‘Organs are Donated’ on the Final Death Certificate- which is given by Local Municipal Corporation after verification. Government may think to sponsor some nominal incentive or benefit at the time of Settlement/s of LIC Claim, Provident Fund and other Financial Transactions upon producing the ‘Death Certificate with a Remark of Organs Donated’. Such incentives or legal points will definitely boost the Awareness much faster.
  • Eye banks, Skin Banks give a Certificate after retrieving organs. On the same line, Government may give some Certificate to the Donor Family, the proud display of Government Certificate at home or office will itself automatically work as an powerful Awareness Campaign
  • There is a famous Quote of Samarth Ramdas Swamy ji, which says “cejs SkeÀ l³ee®ee ogpee MeeskeÀ Jeens, DekeÀmceele lees ner Heg{s peele Deens..”. Cemetery is such a place where a person may develop‘Ascetic Feelings’ (which is called mceMeeve Jewjei³ein Marathi) at least till the time the one is in Cemetery. We usually find the Sanskrut Shloks, Religious Poetries, Quotes etc. about ‘Soul (Deelcee) and Journey After Death’ written at the walls of many Cemetery. If the Appeal for Noble Cause is displayed at every cemetery, it will certainly have a powerful hammering impact on the minds of people. The atmosphere at Cemetery can be put to use to inspire the noble instincts about Virtuous Rewards (HegC³e keÀceeJeC³eeefJe
  • Institutional Heads of the Orphanages should be given legal status to give ‘Consent for Organ Retrieval’ after Death of their member, in case the close relatives are not there. Same way, the guardians should be given legal status to give ‘Consent for Organ Retrieval’ when the relatives are not available or traced for any reason.
  • When One fills in ‘Consent Form for Self’, there is a condition of signature of at least Two Witnesses; but there is no system by Co-ordinators or NGOs (with whom the Forms are submitted) to get informed about death of the concerned. So, Transplant Co-coordinator Agencies (ROTTO, SOTTO, ZTCC) and NGOs with whom the Form are submitted, should periodically remain in touch with all these Three Persons via Social Media Campaign. This will have Two Fold effect. Firstly, it will be a Reminder (Hammering Effect); and secondly, it will act as a Campaign (Mass Spreading Effect).
  • Submitting the Consent Forms in lakhs of numbers with Nodal Agencies, Eye Banks, Skin Banks, NGOs has not yielded that much result so far. It is because having the number of Donor and their relatives has NO USE until you have a foolproof system to reach to them as soon as the death occurs. What is important is- the relatives should have the Information of ‘whom to contact’ when the death occurs in family.
  • A special targeted campaign should be carried over for the ‘Groups of Senior Citizens’. Nowadays many Senior Citizens Groups are formed, and they actively organize and take part in competitions and programs. They are happily playing their Second Innings and they would be easily convinced because moral values are high in the later part of our lives. Considering their medications and other health issues at this age also, if not vital organs, at least Skin will be available in enough quantity in near future.
  • Government Intervention is also necessary in the Medical Syllabus. I assume the Importance of Organ Donation Awareness is there in the Medical Syllabus. My suggestion is to include in syllabus ‘How to initiate the talks’ about Whole Body / Organ Donation with the relatives of the deceased. It is because in every case, Medical Practitioner is the first one to identify and declare death (whether the death occurred at home or hospital)
  • ROTTO, SOTTO, and local Municipal Corporations should have some interconnected framework to identify the Brain Death. Brain Death Donors can be available more in Major Hospitals and Trauma Hospitals. Since One Brain Dead person can give life to more number of persons, and there is enough time available to retrieve organs comparing with Cardiac Dead Person, this would be the vital step.
  • Efforts should be taken to clear misconceptions regarding the disfigurements. People should be asked ‘What they do when post mortem is to be done ?” They do nothing but nod, because law is there. “What do they do when Gangrene is there ?” They do nothing but nod, because Medical need is there. Then Why so fuss about disfigurement at the time of Organ Donation only ? We all do some or the other kind of Sanskar on the dead body as per our religious beliefs. We either burn or bury the whole body and waste the organs. If the people are made aware, they will be ready to donate the Vital Organs to Re-Use for the needy ones waiting for it.
  • I noticed one more hurdle in the way of organ donation- that is about the time consumed by Police Procedure in some cases of Deaths. For example, my wife died while on the way between my home and hospital, and she declared dead on the arrival at hospital. As per the rule, it became police case. She had left from Goregaon at 3.50 am and was declared dead at Parel at 4.30 am. I decided on the spot to donate her organs but doctors said Post mortem would be required since she died on the way. Post mortem would have taken so much time (in no way before 11.00 am) that Organ Donation would have not been possible.
    The hospital doctors and police were convinced that any foul thing was not there in her death, so the police and family physician Dr. Amol Kadam of Parel helped me. I rushed to Goregaon to obtain Certificate (Form No,?)from Goregaon Police Station which was mandatory as per Law for removing organs. It was 8.00 am by the time, and it would have taken another 1.5 hours for me to reach KEM. It would have been difficult to retrieve organs in time. So I sent the Photo of the Certificate (Form…) on WhatsApp to my brother, who had reached hospital by that time. I had asked him to call Bacchubhai Hospital’s Eye Bank Team to reach before me and complete formalities on showing WhatsApp Photo of the said Certificate. All these efforts came to be fruitful because I took proper guidance, and acted fast upon it. Anyone who is firm about organ donation will do the same thing, provided one should know about Organ Donation and Transplant.My suggestion is the NEARES TPOLICE STATION should be allowed by Law to give N.O.C. (Form ) if they do not suspect any foul play.
  • The basic Infrastructure for Organ Retrieval / Storage / Transplantation in not available in the villages in India.All the awareness we have been doing so far is concentrated and limited to the urban areas and Mega cities only. The necessary facilities of Transplant Surgeries are not available in many so called cities. Even if a person from village wishes to donate, it is difficult to retrieve organs in required time. Where a patient needs 7 to 14 Hours’ journey to reach to cities, the awareness of organ donation is useless until the necessary set up is made available. The patients in remote villages havethe same right to get the Deceased Donors Organs. Why to leave them deprived of it ?
  • There must be enough networks available for military persons. It will be very noble and inspiring example for natives of India if Organs of the Martyrs are harvested for transplant. The feelings of the people are very intensive at such times and it will spread a good message. Even the family of the martyrs would get that proud feeling that their sibling died for nation and is still alive serving the society. I think everyone from Navy, Army and Air force who is prepared to surrender life to the nation, would welcome this idea to give life to his/her Indian brother or sister.
  • Some system should be developed like Aadhar Number. Each and every form received by any Organization will be collected at a central place like ZTCC, and the records will be maintained like Blood Group, Nearby Hospitals etc. There should be a system like PAN Numbers or Bank Cheque Number or RTO Vehicle Registration Number to immediately locate the respective Municipal Ward etc. Number will be given to each form and it will be printed on the Donor Card being given to the prospective donor. This will help every way for early retrieval and transplant.

© 2018 Arti Salunke Foundation | All Rights Reserved | Site Managed & Designed By | Webtactic