By Zubeida Mustafa
A REPORT in Dawn last week brought to light the unearthing of an illegal organ transplant centre in Lahore and the arrest of a doctor and six paramedics. A Pakistani donor and an Indonesian who was to receive the kidney were also present at the improvised clinic in a private house when the police raid took place.
This is not shocking because reports of the resurgence of the organ trade have resurfaced lately. Recently a doctor from the Dubai Medical College had reported that a UAE citizen had obtained a kidney transplant for $60,000 from a Lahore-based hospital on May 27. This prompted the decision by 12 civil society members to go to court.
In the petition all the provincial governments and the federal governments are named as the respondents, but the main body that will be held answerable is the Human Organs Transplantation Authority (Hota). Set up under the Transplantation of Human Organs and Tissue Ordinance, 2007 and the Act of the same name adopted in 2010, this body was entrusted with the responsibility of ensuring the implementation of the law and overseeing the transplantation process in Pakistan to ensure that it observed the stipulated guidelines.
It was required to set up the necessary machinery in the form of evaluation committees in every medical institution carrying out more than 25 transplantation surgeries a year to ensure that the donor was related to the recipient. If the donor was not related then an emotions-based relationship between the two had to be established to disprove any commercial motives. In any case no foreigner was to be involved in organ transplantation surgery. Hota was also supposed to look into complaints when any were sent to it and take remedial action.
True, scattered reports of illegal transplants in Pakistan had continued to trickle into the open since organ sale was banned in the country after the 2007 ordinance was promulgated. It was widely believed, especially after two doctors were actually hauled up in court where they admitted their wrongdoing, apologised before the judge and promised to reform themselves, that the law would reign supreme in this sector.
There was much rejoicing and WHO representatives and transplantologists from abroad came to Karachi to celebrate with Dr Adibul Hasan Rizvi, director, Sindh Institute of Urology and Transplantation (SIUT), and his colleagues their victory in getting a ban imposed on this obnoxious evil that the development of medical technology has spawned.
But it was soon clear that this was no more than an illusion as the number of reported cases started to rise. It is now feared that if no notice is taken of this trend the country will very soon return to the ignominy of yesterday when it had acquired the dubious reputation of being a leading kidney tourist spot in the region. It is now believed, as the petition categorically states, at the heart of the problem is the “lack of will on the part of the regulatory and law-enforcing authorities of the state and the weak implementation of the laws by the authorities mandated to enforce them”, that is, Hota. It never bothered to undertake a credible investigation or inquiry when a complaint was lodged.
The petition lists 14 specific cases of foreigners having purchased organs in Pakistan for transplantation. A number of these patients later died. This blatant display of contempt for the law and the unabashed demonstration of avarice — the rates have gone up from $40,000 to $60,000 — is shocking. The claim by surgeons that they are doing a noble deed by saving the lives of those suffering from end-stage renal failure is an eyewash. So is their assertion that those who sell their organs are impoverished souls whose difficulties are alleviated.
This is a myth. The sale of human organ robs a person of his dignity and good health. The small share of the vendor in the transacted amount — usually running into several lakhs — brings no financial relief while burdening him with new health problems caused by clandestine surgery done in haste. The recipient also suffers as organs may not be well matched.
Dr Rizvi is a staunch critic of the surgeons who are bringing a foul name to his profession in Pakistan. He terms the practice as downright exploitation and demeaning to human dignity. As someone who has fought for the right to health of all people, he is repulsed by a system that makes distinctions between people on the grounds of economic status. The SIUT’s motto is “We do not let them die just because they cannot afford to live”.
By providing free services to anyone who enters its portals not as charity but as a birthright, SIUT has vindicated the importance of ethics in medicine. It has proved to be a bulwark against the illegal organ trafficking racket. Because of SIUT’s presence in Karachi, the whole of Sindh has been protected.
Although patients come from as far as Afghanistan and Azad Kashmir, its support base lies in the community in Sindh. A major source of its funds comes from public donations. But as the state of Pakistan’s economy slides, the community’s capacity to pay is shrinking. It is time the international community chipped in with financial support. A strong SIUT with a wide reach will wipe out the organ trade from Punjab which will be appreciated by the world at large. Let it step forward to help.