Organ Donation: The need for greater awareness

Published Aug 11, 2024

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AS an estimated 3 000 names are on the list of people waiting for organ donations in the country, and as many face the reality of death without getting assistance, calls to increase awareness on the pros over the cons are being made.

Explaining that donating organs and tissue did not threaten or lessen the lifespan of a donor, the World Health Organization (WHO) stressed countries and organisations, as well as the governments of countries worldwide, to encourage the practice of giving organs. They remained an ultimate gift of life.

“One organ donor can save up to seven lives and transform over 50 lives. As an organ donor, you can save the life of someone who is suffering from a life-threatening disease or someone who was in a serious accident,” they said.

The Department of Health called organ donation a valuable gift of life and they too urged members of the public to embrace the practice by seeking information and awareness.

“This is important to improve someone's quality of life, or even save someone`s life, especially those who are very sick or dying from a life-threatening disease, or who have organ failure,” the department said.

Organ donation is when organs such as the heart, lungs, liver, and kidneys are removed from one person and transplanted into another person. Tissue donation is when tissues in the body, such as skin, corneas, or bone are removed from one person and transplanted into another person.

Saying the over 2 500 people are on the active waiting list for organ and tissue donation was too long and as others lost their lives while waiting to receive this life-saving gift, the department said currently, organ donors in South Africa were in very short supply because of limited knowledge among its citizens.

They said the department would collaborate with various non-governmental organisations to use the month of August as part of Organ and Tissue Donation Awareness Month. This is to intensify awareness and increase knowledge about the significance of donating organs and tissues.

Transplant Education for Living Legacies (TELL) said they remained committed to helping educate South Africans about organ and tissue donation. “Anyone aged 18 years or older can become an organ or tissue donor without expecting a financial reward, and subject themselves to certain medical conditions that require one to wait or be physically well.

“One can donate organs such as kidney and liver lobe and continue to live a normal and healthy life because organs like the liver regenerate over time.”

The organisation said giving organs was none other than giving life, and it remained the best gift one could give. “TELL was created with a heart for hearts (and other organs).

“Two of the three founders received lifesaving lung transplants which not only gave them a second chance at life but also put them in the unique position to make a difference in the transplant community,” it said.

Through years of working in the field, TELL had identified various barriers to organ transplantation and this fuelled its efforts to solve as many of these as possible.

Studies conducted by different organisations and individuals found that having no knowledge, limited knowledge, or an understanding framed by misinformation or myths, impacted an individual response to the concept of organ donation and transplantation.

There were also cultural and traditional beliefs which served as impediments, the Organ Donor Foundation added.

Saying it was in the process of rolling out the ULUNTU Awareness Campaign in vulnerable communities, the foundation said: "This is the first step towards breaking through cultural barriers in order to increase organ and tissue donor consent.

“The lack of or limited knowledge, or an understanding framed by misinformation or myths, impacts an individual’s response to the concept of organ donation. And, at present, there are no formal programmes in vulnerable communities to educate and inform people about the concept of organ transplantation.”

The foundation said tied to this was the many individuals who are not aware of the high incidences of organ failure, or the likelihood that they, a family member, close friend or acquaintance, could find themselves on dialysis and needing a lifesaving transplant.

“Thus a holistic approach will be used involving research in the form of information gathering with transplant coordinators from feeder hospitals to conduct baseline surveys, which will be carried out with the communities.

“The awareness drive will be done using community participative methods and grassroots outreach that has been developed to directly address cultural and traditional barriers to organ and tissue donation and includes preventative education,” it added.

It was also working towards implementing the organ donor database/registry as an interactive tool to be used by the transplant coordinators during the referral and consent stage as an aid to speed up and facilitate the process.

This will make it easier for the coordinators to contact next of kin and facilitate conversation during the decision-making stage.

“The database also serves as a powerful instrument at that time when consent is needed to reassure family members of one’s intention to donate, which makes the family’s decision an easier one to make."

Organisations said the lack of information and knowledge and desperation gave rise to illegal organ trade. This perpetuated organ and human trafficking, and this very often involved both doctors and other medical practitioners and institutions, and money-hungry people who illicitly identified and provided people for their organs.

As recently as 10 years ago, the National Library of Medicine reacted with shock when the South African medical establishment found itself at the heart of an international scandal involving the sale and transplantation of kidneys on three continents.

It said at the time: “The donors were mostly poor Brazilians willing to sell a kidney for up to $10 000 (£5 400; €8000; about R183 000) each, and the recipients were Israelis who paid up to 10 times that amount for a kidney.”

At the time, a senior nephrologist stood trial in Durban facing charges under the Human Tissues Act. “It is alleged that the Brazilian donors and Israeli recipients had to sign fraudulent documents stating they were related. Several other surgeons and medical staff have also been arrested and are facing trial,” the library found.

But, main financial beneficiaries were intermediaries who organised the transplantations, matching donors and recipients and arranging the logistics in South Africa.

They found, with the international law, that most of the transplantations actually number in the hundreds, and were alleged to have taken place in two local hospitals. In recent years, there have been reports from other countries, indicating that donors and recipients did come from internal and outside the country, to harvest organs in South Africa.

The Department of Health emphasised that it remained illegal to trade in organs outside of the formal sector. International reports indicate that vulnerable people remain exploited, deceived, coerced, or abused for the illicit use of their organs.

The multi-billion Rand illegal industry required an internationally coordinated clampdown, the WHO said, as people desperate for life were willing to pay anything for organs, and traffickers did everything they could to find, secure, and transport organs across the world.

ntando.makhubu@inl.co.za