By Zubeida Mustafa
HAS the illicit organ trade that gave Pakistan such a bad name in the world of medicine made a comeback? We do know that for about a year after the Transplantation of Human Organs and Tissues Act was adopted in 2010 there was a lull and we were celebrating the end of this crime against humanity in our country. But one cannot be sure about that now.
Today reports trickle in that the clandestine sale of human organs is thriving. The scale of the operation is not known but the exploitation of the poor remains unabated.
With such a reputation, it was not really surprising when five days after the bombing of the All Saints Church in Peshawar last month, a website, Agenzia Fides, that has been described as the news agency of the Vatican, carried a shocking report linking the incident with the problem of organ trafficking.
Quoting NGOs, the website wrote that “some ‘jackals’, presumably local paramedics, seem to have taken advantage of the high number of deaths and injuries to steal the bodies of victims and exploit them for the illegal organ trade.”
There was a call for an investigation which was not seriously pursued. Yet the story was picked up and circulated. This report was not easy to believe because stolen organs removed by ‘paramedics’ from the dead victims cannot just be transplanted in anyone suffering from end-stage kidney failure.
Even the illicit trade, which has a high rate of failure, does not simply chase corpses to remove their organs. Such trade calls for elaborate networking and organisation. Small wonder, the police is not inclined to check this criminal activity. Today there are no grey areas and the law is very categorical in banning the sale of organs.
The whole incident proved beyond doubt that so low has Pakistan’s reputation sunk that even incredible charges levelled against the country stick and are easily believed.
One way of countering this social evil is to popularise deceased organ donation in a big way so that human organs are available legally. Thus the clandestine trade that involves big money will be automatically undermined.
That has not happened so far, notwithstanding repeated campaigns by the Sindh Institute of Urology and Transplantation and the Transplantation Society of Pakistan (TSP). Given the impeccable ethical record of Dr Adibul Hasan Rizvi, SIUT’s director, people should respond to his appeal to the public to become donors.
Dr Mirza Naqi Zafar, the secretary of the TSP, conservatively estimates the annual death toll from organ failure in Pakistan to be 150,000 with 100,000 suffering from liver failure and 25,000 being renal failure patients. What prevents people from becoming deceased organ donors? Is compassion dead? Or is public awareness missing?
Myths abound turning people away from this noble duty. Dr Zafar says it needs to be made clear that an organ can be taken only from a person who is brain dead and is on the respirator. But if he has not registered as a donor, there is no way of obtaining his consent at that critical hour.
Hence every one who signs the donor card may not become a donor. But everyone who becomes a donor must have signed the card and also talked to one’s family about it.
Brain death needs to be understood if the public is to cooperate. There are sceptics who believe that it is possible to revive the brain dead, so they wouldn’t take chances. But medical science has proved conclusively that when the brain stem stops functioning breathing stops and this condition is irreversible.
If the patient appears to be breathing it is the respirator that is forcing air into the lungs. One should not fear that the diagnosis will not be carefully done. A team of neurologists, anaesthetists and intensivists perform the examination at repeated intervals. Only when they have given their final verdict is the transplant team called in to harvest the organs.
Another impediment is the general belief that harvesting the organs mutilates the body. It does not. The surgery is neatly done with the scar being the same as is left behind by a surgeon who operates on a living person.
There is also the general belief that Islam opposes the removal of the organs from the human body after death. This is strange because no less than 15 fatwas have been issued in support of deceased organ donation from different Islamic centres of scholarship and many Muslim countries have formal deceased organ donor programmes.
Then why this reluctance? Is it apathy? Is it the innate fear of death? Or is it because we have been so brutalised that we have stopped caring? Dr Naqi Zafar, who has been campaigning hard, told me that only 1,431 have registered at the SIUT or through the TSPs website. This is a small number in a population of 180 million.
These are the compassionate souls who believe that it is sacrilegious to carry their organs to their graves when they are needed by the desperately ill. It is the supreme act of giving that a person can perform to save nine lives.
As for the spiritual satisfaction one gets, you only have to talk to the family of Naveed Anwar, Pakistan’s first deceased organ donor. “For us Naveed is alive even 15 years after his death. He lives in the person of those who received his organs.”