Why India doesn’t have enough organ donors

Every year, more than 2 lakh people with renal disorders await kidney transplants; however, only about 2000 of these receive them. Around 10 lakh people suffering from corneal blindness lead unfulfilled lives for lack of availability of cornea donors. The statistics for the transplant of heart, liver, and other organs and tissues are further alarming.

Lack of awareness and education regarding organ donation procedures in India is a major reason for the scarcity of organ donors. While for those people who are aware and could be possible donors, superstitions and misconceptions related to the process influence their decision. Some believe that harvesting one’s organs could lead to mutilation upon rebirth, whereas some say it would be against their faith to donate their organs.

India has an organ donation rate of a mere 0.01%, whereas western countries like Spain & Croatia have the highest organ donation rates (ODR) of about 35.3% and 36.5%, respectively, as per a report generated by the National Transplant Organization, 2011. The high ODR rates in these countries could be attributed to the “opt-out” model implemented in these nations according to which all individuals from these countries after death are considered organ donors unless they explicitly object to donate. India, on the other hand, follows the “opt-in” system. Accordingly, individuals have to pledge their organs through NGOs or other similar organizations, or the hospital authorities are required to seek prior consent from individuals if they wished to donate their organs upon death. Usually, this decision is made by the family members in the case of patients that are declared brain dead.

Harvesting organs from brain-dead individuals has often been challenging due to a common misconception that brain death is reversible. Family members refuse to accept that the patient cannot be revived. In such situations, even starting a conversation regarding organ donation is uncomfortable for the hospital authorities as it can intensify the grief of the family members.

Similarly, obtaining the consent of the family members of deceased individuals for donating their organs has been a difficult task as the family is sometimes untraceable. This is seen especially during deaths of migrant workers as their families reside in remote villages making it difficult for the hospital authorities to communicate with them.

The COVID-19 pandemic has further affected the already plummeting transplantation rates in India with most resources being diverted towards treating infected patients, thus, creating a backlog of people awaiting transplants. Besides, performing such surgeries in the first place was a challenge for doctors in early 202o when hospitals were considered major hotspots for contracting COVID infections. Usually, a person who undergoes an organ transplant is administered immunosuppressants, which can minimize the response of the immune system and thus, prevent organ rejection. However, it also leads to lowered immunity in such persons, a risk factor for possible infection by the virus.

With a high demand for organ transplantation and an abysmally low number of donors to meet this demand, India has garnered a negative reputation in organ trafficking. Impoverished citizens are targeted by luring them with fairly large sums of money as compensation for harvesting their organs and then transplanting them in rich, desperate people willing to pay a large price for the same. In response to the same, the Ministry of Health & Welfare has introduced the Transplantation of Human Organs and Tissues Act in 1994 that regulates the removal and transplantation of organs to curb their illegal sale in black markets. However, the wide network of medical institutions, organ brokers, and government officials has made it easier for people involved in the trade to get away with it and make a thriving business venture out of the same.

Moreover, the portrayal of organ trafficking victims by the media has scandalized the reputation of organ donation. Having been scarred by horrific images of patients waking up in abandoned hospitals with a missing kidney or cornea, potential donors become apprehensive about donating their organs fearing that they might get scammed by illegal trade markets should they choose to go ahead with the procedure.

Another major challenge in India is the inadequacy of transplantation centers. Currently, there exists only one hospital having ransplantation facilities for about every 43 lakh people. Moreover, doctors are unable to advise patients and their families regarding organ donation procedures as they have inadequate knowledge about the same. This makes it difficult for family members to come to a proper decision.

Though newsfeeds of fatalities keep coming in, the people by and large have not caught on to the seriousness of the need for organ donation in India leaving the lives of lakhs of people upended upon waitlists. Being on the waitlist to receive an organ transplant is agonizing for patients. Even more for the families who quietly suffer along with these patients hoping that their loved ones would be able to lead normal lives one day.

Someone once rightly said, “Don’t think of organ donations as giving up a part of you to keep a total stranger alive. It’s really a total stranger giving up almost all of themselves to keep a part of you alive.” Thus, passing on the greatest gift of life is the truest form of service one can do to give back everything one has received from the universe. To rekindle faith in each other as human beings, after all, humans are all we’ve got.

A budding writer. Interested in Public health, Medicine, Global affairs, and films.