By Zubeida Mustafa
NOT many may recall Naveed Anwar today because when he slipped into the valley of death 14 years ago he went silently without making a splash in the media.
At a time when the Transplant Society of Pakistan is launching its deceased organ donation campaign we should be paying homage to Naveed and the four others* who followed his pioneering trail. They conclusively established that our society is capable of unbelievable generosity and care, even in the bad times we live in.
It was in 1998 that Naveed (24), an accountancy student, met with a fatal road accident and was declared brain dead — an irreversible condition when the brainstem stops working. The vital functions (heartbeat and breathing) of a person in this state can be sustained on a respirator for a few days. Naveed’s family — educated and enlightened as they are — came forward to offer his organs for transplantation.
They knew about the procedure as the family had often talked about deceased organ donation. Naveed would, as though presciently, express his wish to gift his organs to save the lives of the seriously ill. Since there was no precedence of such donation in Pakistan, extreme caution was exercised. All the universally recognised protocols were carefully observed and an independent team of neurologists was called in to certify brain death before a separate team of transplantologists retrieved the organs. Most importantly, no financial transaction was involved.
Today Pakistan stands at the brink of the age of deceased organ donation. We have a law on the statute book, namely, the Transplantation of Human Organs and Tissues Act, 2010. The illegal organ trade that descended on us like a curse faces tough resistance from the advocates of the law. We also have the ‘living’ examples of Naveed and others to show the way.
It is time to break the silence on the issue of the dead donating their organs to the living. There is the closure that this act of magnanimity brings to the grieving family. Naveed’s father termed it as sukoon that he derived from the knowledge that his beloved son had given in his death a new lease of life to others.
The Sindh Institute of Urology and Transplantation (SIUT), regarded as the premier institution in the field in Asia, is at the forefront of the campaign that is being launched to create public awareness and dispel the myths and superstitions about life and death that persist in our society. Strangely, we still have doubting Thomases when many Muslim countries have accepted the concept of brain death and their deceased organ donation programmes have received the ulema’s blessings. Hasn’t the Holy Quran said so categorically, “If anyone saved a life, it would be as if he saved the life of all mankind”?
At the launch of the campaign, a team of SIUT doctors — Anwar Naqvi, Naqi Zafar and Nasir Hasan — presented a well-prepared briefing to the media. Nearly 50,000 people come down with organ failure in the country annually and of them 30,000 are in need of kidneys. Only a small fraction of these receive an organ from a live related donor. Organs of people with brain death and on respirators — there are 2,000 of them in Karachi every year — could also be a source of organs if donors can be attracted.
There is need to create public awareness. Towards this aim, a three-day conference will be held in April to be attended by the speaker of the National Assembly. This will be the first step in the journey of a thousand miles towards a fully fledged organ donation and transplantation programme. But many more steps have to be taken. Not only should the donors be registered with an authority — the procedure is still being worked out — it is also important to impress upon prospective donors the importance of sharing their ideas with their families in normal times and not wait for a crisis when sensitive decisions become difficult..There is also the need to organise an organ registry on a national level so that the clinical details of those in need of an organ are stored in its databank for easy access. Of course, surgeons have to be trained in different transplantation fields so that all organs that can be transplanted are used — one deceased donor can benefit 17 people.
Dr Adib Rizvi, director of the SIUT, believes, “Once the need is created the training of manpower will follow automatically.” This is not an empty boast. Dr Rizvi knows best because he is the visionary to whom the SIUT owes its creation.
A great humanist and a friend of the poor, he dreamt of a model health facility in the public sector providing free services to all who, he believes, have the right to healthcare. This dream found expression in the shape of SIUT where even the most expensive state-of-the-art treatment is provided free, with dignity. No one is ever asked to go through a process of proving his poverty to earn an exemption.
The institute is staffed by a team of health professionals that Dr Rizvi has mentored over the years with great devotion. They have been trained in various sub-specialties of urology, transplantation and nephrology. SIUT has expanded over time with the financial cooperation of the community which adores him for his people-friendly style of practising medicine.
*Shamim Bano (2005), Prof Razzak Memon (2007), Imran Ahmed Shah (2010), Arsalan (2011)