Does the Religion prohibit Organ Donation ?

‘ My religion is very simple , my religion is kindness ’- Dalai Lama

All the religions around the world have emphasized on importance of love , charity , sympathy and empathy . Donation of food , alms , cows and  land have been well documented in religious scriptures . The giving of an organ is an opportunity for generosity. The giving of part of one’s body to a person in need is an example of a very high level of generosity.

In Mahabharata , an incidence is mentioned wherein  Karna donated his life-saving Kavach to Indra as the later approached him as Brahmin  in disguise , knowing it  well that this would cause his death in the battle.

No religion is against organ donation. Centuries ago , when the religious scriptures were written , blood or organ donations were not invented but these have become a reality today. So we need to focus on stretching the spirit of donation to organ donation to save lives . The jest of the religious scriptures  is that the saving  of  life  overrides all objections . Organ donation is thus a greatest sacrifice one can do.

There are certain religious groups who believe that the God created them as whole and  they prefer to return to Him as whole. With this belief , many people  bury amputated limbs, foreskin from circumcision ,  amnion and placenta from delivery. This belief also prevent them from organ donation .

In Islam, religious leaders, ‘ustazs’ , ‘ulamas’ and mufti have different interpretations on organ donations , but all agree that holy book Koran does not forbid tissue donation.

‘MUFTI’  are experts in Islamic law qualified to give authoritative legal opinions know as fatwas. Mufti are appointed by government  to deal with Islamic matters. ‘FATWAS’ are religious rulings made by ‘Fatwa Committee’ as official stand by government  on various issues. ‘Fatwa Committee’ chaired by MUFTI includes prominent religious leaders, lawyers, doctors and other members of public. Fatwas are not legal binding. Often these religious leaders have come out with fatwas to donate organs . But  despite Fatwas,  people are often reluctant to donate organs.

A religious practice that often comes in the way of organ donations among different  communities is that a body must  be buried as soon as possible after death – the sooner the better usually less than 8 hours , often because of procedural delays it is not possible. If the officials co-operate then this delay is avoidable.

Christianity promotes organ donation. John Paul II  stated that ‘ We shall receive our supreme reward from God according to the genuine and effective love we have shown to our neighbor ’. Bible  states , “Give, and it will be given to you. A good measure, pressed down, shaken together and running over, will be poured into your lap. For with the measure you use, it will be measured to you.” (Luke 6 : 38).”

The attitude of Buddhism is in perfect agreement with organ and tissue donation; and in Buddhist Scriptures there are stories where donation of tissues have been referred to as an act of charity earning merits . In the Sutra of Golden Light, a Mahayana Sutra, where the Buddha in a previous lifetime (as a young prince) is said to have encountered a starving tigress and her cubs and killed himself in front of her to provide her with food .

What is important for a person at the time of death for a Buddhist is not the condition of their body but of their mind. A state of non-attachment to the body is desirable at this time, and this could be aided by the generosity involved in deciding that one’s body could be used to help others after death.

According to statistics provided by India’s Organ Retrieval Banking Organization, every year 1- 1.5 lakh kidneys are required in the country but only 3,500-4,000 are transplanted. At the same time 15,000-20,000 liver are required every year but only 500 are transplanted. If people donate the organs after death then these shortages will be overcome and many lives can be saved .

We must realize that concept of brain death is the reality today , once a persons’ brain is dead , he or she  ceases to survive .

As I leave this transient world

Let me kindle a ray of hope

In the eyes of those

Who can not see

A breeze of fresh air for those

Who can not breath

An  elixir of life for them

Whose kidneys have failed

Let my heart beat in those

Whose  heart is fluttering to stay alive .

( Author is eminent Kidney Transplant Physician and founder member of Central India Kidney Foundation )

Organ Transplantation

One step forward , two back

This Saturday , the nation shall observe Organ donation day with the aim to spread awareness about organ donation . But over the years it has become a reality that the rosy and flowery words of organ donation has become a thorny and painful path for the doctors who are actually carrying out organ transplantation .

The Government of India wants to promote organ donation and transplantation. They have made laws to see that organ donation and transplantation can be done smoothly without exploiting the poor but they have not safeguarded the doctors.

Every time a kidney racket is exposed doctors are the first to be victimized. 

While it is a well established fact that many patients suffering from organ failure like kidney , liver or heart failure die every day awaiting organs , the very doctors  who make it happen face arrest and humiliation by the hands of authorities. Recently five doctors of a Mumbai hospital have been arrested and put behind bar for alleged unrelated unlawful transplant. 

Story goes like this – a patient suffering from kidney failure comes to a nephrologist with his wife as donor. Nephrologist conducts certain tests and finds wife suitable for kidney donation . He forwards the case to authorization committee who find the relationship of husband and wife as genuine and give permission for transplant. Just prior to transplant , police moved in and arrested the patient , donor and the doctors stating that the lady was not a real wife!

Now the question arises whether a doctor is also responsible for scrutinizing the documents whether these are real or fake ? We doctors are not trained for this .We are not the watch dogs . After spending 18 precious years of our life studying medicine and then building a career by full devotion to the well being of patients over a decade or two , suddenly we face a humiliation and treated as criminals for an offence we have not committed . 

The result of this action by law enforcement authorities is disastrous . As a doctor , our primary responsibility is towards health of our patients , but lately a doctors’ priority has become his  own safety . 

Organ transplant is full of challenges and risk. Like any other major surgery donor nephrectomy has its own risks. The recipient is always at risk …risk during surgery due to suboptimal health, risk after surgery due to post operative problems and of course the effects of drugs  both short term and long term. It is the doctor who accepts  all the challenges and goes ahead just so that the patient gets a good quality of life, just so that the patients can go ahead and enjoy seeing their children grow up and fulfill some of their life’s dream. For a doctor the whole process is very stressful ….before , during and even after surgery.

General perception is that doctors mint money through organ transplantation but is that really true ? Will any doctor go through the stressful process of doing a transplant and caring for the patient and then face the humiliation of being jailed , loose respect , loose the license to practice and destroy his reputation so painstakingly built over years just for money ?

Its time for the lawmakers and implementing authorities to rethink about their approach of insolence of  a devoted professional who is in no way concerned with confirming identity of a donor – a  job to be done by  police  ……..

By harassing doctors , the authorities are in fact harming the organ transplantation program.

Why the hospitals in Dhantoli MUST close down

Everyone is made to believe that small hospitals of Dhantoli and Ramdaspeth are the cause of woes for the congested roads and miseries of residents.

So true !

Let all these hospitals of these areas be closed down . No need of such monstrous hospitals which turn the city in to hell . Let these  be relocated to a nearby isolated place  which is free of human inhabitation say fifty kilometers away from Nagpur.

So , you think that the woes of residents will end ! You are in a fools paradise , dear friend.

Till 40 years ago , plots admeasuring  ten thousand sq.feet were occupied by single families with less than 10 members .  These plots have been sold to property dealers , who have constructed multi story buildings with due permission from Nagpur Municipal Corporation ( NMC ) . Now each of these buildings have minimum sixteen  flats ( four flats each floor for a four story building ) , each family has minimum 4 members . Thus  the civic facilities meant for 10 people are utilized by minimum sixty four persons !  None of these buildings have parking facilities enough for  their own occupants , so they are forced to park their vehicles outside their premises on the road.

Eighty percent of these buildings have  commercial establishments in basement and ground floor , like shops , banks , scooter repair shops , marriage halls , car show rooms , restaurants , hotels , beauty parlors , saloons , STD centers , courier services etc . These also harbour coaching , dance  and Yoga classes.  All of them park their vehicles on the road . All of them throw their garbage not in front  of  their own plot but the plot on the  next door  .

With these come vendors sitting on the foot paths with vegetables , washer men , shops ironing clothes , tailors , hot samosa wallahs , shoe , cycle, scooter repair shops , temples , shops of daily needs , puncture repair shops , autos waiting for passengers and off course pan and  tobacco sellers . Where there is human inhabitation , can the  wine shops lag behind ?

Has the NMC given thought about the necessities needed for so many people  before giving permission for construction of  so many buildings ?

The foot paths in Dhantoli simply do not exist. If you wish to go to a park nearby with your toddler baby on a cart , you can not walk on the foot path but on the roads , where  already vehicles are parked. So naturally you have to walk on almost middle of the road with a baby with flowing traffic . Naturally , traffic slows down for your and baby’s safety.

This all is due to improper planning by the NMC .  This is also due to the greed of the property dealers who work hand in gloves with NMC babus.

Now let us go back to small hospitals . Let them all close down and shifted fifty kilometers away. Now if a person has say heart attack , there is maximum possibility of his death before reaching a hospital fifty kilometers away.  A child has acute asthma , or a injury , a pregnant lady with labor pain in the middle of the night ,  no problem sir , just rush fifty kilometers away ! A person with kidney failure needing dialysis thrice a week , simply rush that distance.

Can you imagine the physical and mental torture a person goes through while carrying a sick person . He only prays God that  “ somehow I must reach a hospital , I must see a doctor as early as possible , my wife has labor pain , my child has acute asthma , sister has appendicitis , mother has brain hemorrhage  or father has excruciating chest pain . All of them may die if not taken care of immediately.”

There are minimum five thousand employees working in these small hospitals and clinics , 90% of them are females. They are from nearby areas. All of them will loose jobs if these hospitals close down.

Small hospitals means less charges. Most of these hospitals do charity and also hold free public education and health camps.

Alternative to private small hospital are  Government hospitals which are doing yeomen services in a most difficult situation with resource crunch .

Other alternative is off course corporate hospitals , which a middle class family with limited earning can not afford without health cover insurance.

The fact is very simple ; the doctors of Dhantoli and Ramdaspeth areas have become easy scapegoats . Common residents are made to believe that doctors are responsible for all their woes.

Answer lies in stopping all new constructions with high rise more than two floors , immediate repair of roads and foot paths , keeping foot paths free of pot holes , proper traffic management , constructing  paid parking facilities , proper street lights and indicators , adhering strictly to no parking norms and towing away vehicles in no parking zone with heavy fine , heavy fine for throwing  garbage on the road  , strict actions on the developers who put building material on roads , close down unauthorized pan and tobacco shops . These are simple but effective ways if followed honestly.

Make it mandatory for each developer to maintain greenery in each plot for controlling pollution and also rain water harvesting besides solar power arrangements  should be a must before giving permission for any constructions.

Once these have been done , then ask doctors to close down their small hospitals and go away . After all no one needs them any way !

( Author is nephrologist practicing in Dhantoli since last two decades)

Story of two friends

Ramu and Raman* are two close friends who studied together in primary school in a village . Ramu , son of a farmer continued his studies to become agricultural graduate and settled  in village only . Raman , son of a businessman became an engineer , did MBA and settled in Mumbai .

Ramu has a small farm  earning just enough for his families’ livelihood .

Raman on the other hand is top executive in multinational firm , earns handsomely, has too many responsibilities. Due to work pressure he is constantly under tension .

After a decade , Raman developed diabetes and soon hypertension followed . He had to take eight different tablets to keep his blood pressure and diabetes under control .He soon got frustrated with the chain of events . He remembered his childhood friend Ramu and rushed to his village .

Ramu was very glad to see Raman, he gave a bear hug and both gossiped  under the banyan tree . At night both sat for dinner together .

Raman asked Ramu , “How much do you earn ?”

Ramu replied humbly , “ Just enough to keep my family going , few thousands , but its enough for us .”

Raman laughed at him , “ Only thousands ! I pay that much of tax every quarter . Well what do you drive ? ”

Ramu replied ,” I have a bullock cart and also a bicycle , but I prefer to walk ”

Raman gave him a sarcastic look , “ I always travel by Mercedes. You know it costs 40 lacs . And you know Ramu , I have a flat in 13th floor from where I can see Arabian sea all around . That flat costs two crores . ” Raman looked around with pride .

“ Bhai sahib , should I give you some more rice ? ” asked Ramu’s wife .

“ Oh no , my blood sugar will shoot up ”.

“ Then will you like to have jhunka bhakar , bhai sahib , and also have some baingan bharta with pickle.” , she asked again .

“ Oh no  bhabhi , my blood pressure will go up , already I am on 8 different drugs to control it . And pickle ! My doctor will go mad if he comes to know about nimbu achar . I am on antacids round the clock. ” said Raman .

After  dinner , Ramu offered him rus malai but Raman refused due to diabetes.

While departing , Raman invited Ramu and family to Mumbai . “ Why don’t you come and settle in Mumbai , Ramu ? I shall help you in starting a business there . There is lot of money in Mumbai. ”

“ Yah , there is , but you get diabetes , hypertension and acidity free with that money . What is the use of such money which prevents one from enjoying jhunka bhakar , nimbu achar , baigan bharta and rus malai ?” said bhabhi innocently .

Raman thought that how foolish these villagers are , while Ramu felt lucky that he did not settle in Mumbai !

( Names changed )