Hoodbhoy on organ donations in Pakistan

by Salman Hameed

Organ transplantations are saving and enhancing lives everywhere in the world. Pakistan is no exception. However, there is reluctance to be a donor. So corneas, for example, come to Pakistan primarily from Sri Lanka. Here is an article by Pervez Hoodbhoy from two weeks ago talking about some progress (and some challenges) in this regard on the ground: 

The news on organ transplantation is even better. The very thought of implanting another human’s organs inside one’s own body was once utterly abhorrent. But today, it is (almost) uncontroversial. Is your kidney about to conk out? Well, take a hike to the SIUT (Sindh Institute of Urology and Transplantation) in Karachi and get another one. The hospital motto reads: “No patient is turned away from our hospital or asked to pay for our services. The SIUT does it free — with dignity”. Indeed, the SIUT does hundreds of free kidney transplants a year. 

Fitted with a spanking new kidney, you can then hop across to one of LRBT’s (Layton Rehmatullah Benevolent Trust) 17 branches and get a corneal transplant. As at the SIUT, all treatment at the LRBT is “totally free so that no man, woman or child becomes blind just because he/she cannot afford the treatment. There should be no discrimination due to gender, caste, ethnicity, language, religion or sect”. 

The SIUT and the LRBT are superb charitable institutions; they do Pakistan proud. But, for those who believe in societal progress based upon science and reason, it is an additional delight to behold the triumph of pragmatism. The Enlightenment-era philosopher Rene Descartes should be especially pleased. About 300 years ago, this Frenchman had hypothesised that every human organ operates strictly on physical and chemical principles. With the Christian Church thinking very differently, what Descartes claimed had placed his life at great risk. And now for the bad news: we Pakistanis don’t seem to mind being fitted with somebody else’s kidneys and eyes, but almost none are willing to volunteer our organs after death. 

A young American-trained ophthalmologist, Dr Azhar Salahuddin, who spends his vacations in Pakistan doing free corneal transplants for the LRBT, told me that hardly any corneas (perhaps five to ten annually) are gifted by local donors. Although it is impossible to know true numbers, his guess is that most corneas come from Sri Lanka (80 per cent) and some from Canada.

The reluctance of organ donation is related to particular religious beliefs: 

Why won’t Pakistanis donate their eyes, kidneys, hearts, and livers after death? Are we less altruistic than Sri Lankans? I am not aware of any survey done in Pakistan, but one in Iran shows that most transplants are live donations; just 13 per cent of renal transplants performed in 2006 were deceased donations. Eyes are a particularly sensitive matter: some Iranians are told by their clerics that, having given away their eyes, they will not be able to see heaven. 

Dispelling such popular prejudice against organ donations was the focus of the 2010 International Congress of the International Society for the History of Islamic Medicine in Istanbul. Attended by some 200 experts on medicine and theology from 15 Muslim countries, the conference said that the majority of Islamic legal scholars do permit organ donations. But it noted that the general public remains distrustful.

I think this will change with time with a sensitive education campaign. The process may have a drag, but people are usually pragmatic when it comes down to dire needs. Hopefully there is a broader shift in this area as we have seen in the use of cadavers in medical universities. 

Read the full article here.