JUL 30 - In March, the Chan-digarh-based Ivy hospital reportedly closed its doors to Nepali patients seeking kidney transplants. The hospital, a popular destination for Nepali kidney patients, was asked to act harsh by the local administration after complaints of ‘illegal’ transplants, especially among Nepalis.
The Nepali policy on organ transplant is limited to transplants of the kidney and the eye (cornea). Among the two, only eyes, upon consent, are harvested from donors after death. Kidneys had to be donated by the living people. However, the Ministry of Health and Population has recently consented to post-death harvest of donor kidneys. Although there is little statistics on Nepali kidney seekers migrating to India, many doctors in the field claim that 150 people on an average get transplants in various Indian cities annually. This number is almost the same as that of transplants performed by the Bir Hospital and the Tribhuvan University Teaching Hospital (TUTH), the two authorised transplant centres in the country, combined.
Following a series of kidney transplants performed in the Capital, notably at then Everest Nursing Home with help of Indian doctors, the government came up with the Human Body Organ Transplantation (Regulation and Prohibition) Act 1998 to prevent India’s illegal organ trade from seeping into Nepal.
The Act attempted to address shortcomings in India’s law on organ transplant and adapt it to the national context. Four years later, the Kidney Transplantation (Regulation and Prohibition) Rules 2002 was passed, curbing much of the illicit kidney trade and transplant by specifying strict conditions under which a transplant should take place.
“The Organ Transplan-tation Act specified who is eligible to donate a kidney. It is probably due to this provision that people resort to illegal means,” said Dr Praveen Mishra, secretary at the Ministry of Health and Population.
The 1998 Act allows only ‘close relatives’ to donate kidneys given that they are medically fit. A ‘close relative’ is defined as a son, daughter, mother, father, brother, sister, uncle, nephew, niece, grandfather, grandmother and legally adopted family members. Although India provides for an ‘authorisation committee’ that will approve kidney donations from unrelated donors on grounds of ‘attachment or affection’, Nepal has no such provision and it’s up to the doctor involved to decide. Legally, if a patient is unable to find a donor who fits into the ‘close relative’ criteria, there is no way to obtain a kidney transplant. These are the people who go abroad for transplants despite having international-standard transplant centres in the country, according to Dr Rishi Kafle, director of the National Kidney Centre.
Director General of the Department of Health Services Dr Mingmar Sherpa said that a recent meeting of the Organ Transplantation Coordination Committee had floated the idea of voluntary donations and organ harvest from cadavers.
According to Dr Pukar Chandra Shrestha, around 100 brain deaths occur annually at Bir Hospital alone, and a brain-dead person is eligible to donate eight organs—a pair of eyes, a pair of kidneys, a pair of lungs, a heart and a pancreas. The Human Organ Transplant Centre in Bhaktapur could be vital infrastructure for the purpose. For 3,000 kidney
failures every year in the country, the supply of the delicate organ is a meagre 100. An estimated 1,000 livers are in need annually. For some 3 million diabetic patients, 100,000 pancreases are in need.
0 comments:
Post a Comment