• The culture of fear of death keeps us from writing wills, let alone donating organs
“Organ donation is an area that has seen amazing medical achievements but has not yet reached its full life-saving and life-transforming potential.” — Dr Sue Robertson
Over the course of the last century, organ donation and transplantation has overcome major limitations to become the success it is today. The year 1954 saw the first successful living donor transplant performed between identical twins aged 23 years in Boston, USA. A healthy kidney was donated by one twin and transplanted to the other, who had chronic kidney disease.
Since then, doctors have invested a lot of time and resources to advance this field, and with the aid of modern technology, more successful transplants are being performed.
Organ donation is the act of bestowing, as a gift, an organ to help someone else in need of a transplant. The person giving the organ is a donor, while the person receiving is a recipient. Organs for donation can be removed from either a living or a dead person.
Organ transplantation, on the other hand, is an operation that places a healthy organ from one person into another persons’ body. Organs that can be donated include the heart, lungs, kidneys, liver, pancreas and small bowel. Tissues such as bone and corneas can also be donated.
Through organ transplants, many terminally ailing people around the world have had their health restored and life prolonged. However, scarcity of organs, which is a global challenge, pauses as a hindrance to more success.
Actually, according to the World Health Organisation's Global Observatory on Donation and Transplantation (GODT), the number of organ transplants conducted globally, which is over 130,000, represents just 10 per cent of the global need.
Here in Kenya, kidney transplants have only risen from 20-100 transplants annually in the last decade. Yet there are about 4 million Kenyans who have some form of kidney conditions that could be assisted by kidney transplant.
Scarcity of organs has left many people on long waiting lists, waiting for organs that will never be available, until most of them die while still waiting. Others, like those with acute kidney failure, are left to rely on dialysis at least twice a week for survival, a process that is exhausting and expensive, to say the least.
To solve the shortage of organs, particularly in Kenya, a lot of work needs to be put in. For instance, the creation of public awareness around organ donation and transplantation is vital. This will impart knowledge on the pros and cons involved, and it will also alter attitudes and perceptions that citizens have towards organ donation. This, in turn, will increase the number of donors, both living and deceased donors.
Through deceased donations, shortage of organs can be effectively addressed. This is because a living donor is only capable of donating a portion of their liver, lung, pancreas and a single kidney, while a deceased donor can donate different organs to at least eight people when the organs are harvested within the required time. Deceased donors are also able to donate vital organs, such as the heart and lungs, which living donors cannot donate without resulting in their own deaths.
Through the Health Act 2017, competent Kenyans can now donate their organs by expressing their wishes to be deceased donors in their wills. And this is where the question comes in: Are we there yet? Have we even moved from the culture of fear of death that keeps us from writing wills as a way of expressing our wishes upon our demise? The answer is no, we are not yet there.
There is a need for Kenyans to place aside any cultural and religious beliefs that hinder them from embracing discussions around organ donation this way. More objectivity and ease will be experienced when faced with a decision to become organ donors, whether living or deceased.
Elizabeth is an Advocate of the High Court. Associate at Ibrahim Yakub & Associates Advocates. She is passionate about Medical Law and Ethics, most especially the ethics of both living and deceased organ donation and transplantation.