Prominent Kidney Transplantation Expert, Dr Colonel Mukhtar Hamid Shah (Retd) has emphasised the need for establishment of Authorised Kidney Transplant Centres or Hospitals in Pakistan along with creation of "Donors Welfare Fund" for payment to unrelated Kidney donors to save millions by breaking the long Queue of waiting list of the kidney patients.
Talking to newsmen, he suggested that Kidney Hospitals should maintain the list of donors or volunteer especially those hundred needy persons who are committing suicide due to non-employment and poverty. Quoting the figures of Human Rights 2007, Dr Mukhtar said that more than 1272 persons committed suicide due to poverty while our society including government had no plan to solve their poverty problems.
Dr Mukhtar Hamid Shah, who is the pioneered kidney transplantation in Pakistan and performed first operation in 1979, claimed that he performed more than 2000 transplant in Pakistan. His Name has been included in "Who's Who" being highest number of transplantation in the world performed by one single surgeon.
In our society, Dr Mukhtar Hamid said that the Cadaver Transplant Programme can not be established because of the costly infrastructure. The person who meets an accident is transported to a trauma center. Where the patient is treated by specialists (surgeon, neurosurgeon, chest surgeon and other specialists) the patient who develops brain death is kept alive with the help of CCU respirator (artificial respiration) while the heart is still beating.
We shall require about 525 Trauma Centres in the country for the supply of donors for 15000 patients who suffer from the end stages renal failure at end stages each year. The patient who develops brain death should have consent, which should have been written before death. After death the consent of relations of the dying patient should be asked for.
The patients whom death is because of other then accident develop multi-organ failure and are not a fit person to be used as donor. The organ harvested from the dead is to be perfused with 4c perfusion solution to cool the kidney and should be carried to the place where the facility for transplantation exists and has to be transplanted in a minimum time. For these we also require services of helicopters and aero plans, he added.
Dr Mukhtar Hamid Shah disclosed that the cost for establishing such an infrastructure initial investment would be Rs 120 billion. The countries like Pakistan cannot afford to establish such an arrangements. We also require arrangements for keeping alive 15000 patients on dialysis while they are waiting for transplant. Cost of maintaining one patient is Rs 900,000 for one year.
The cost of keeping alive 15000 patients a year would be Rs 9 billion. For the first year and a sum of 16 billion next year. This cost will be ever increasing, he added. Dr Mukhtar Hamid said that the fact is no cornial transplant has been performed by our own donors. We have to import corneas from Silence. In spite of the fact there is minimum mutilation and cornea can be harvested within 8 hour within death.
Inspite of the efforts of the Eye Donors Association for the last sixty years. We have not been successful in motivating the people to donate cornea for transplantation, Dr Mukhtar Hamid added and said that secondly we respect our dead. Dr Mukhtar mentioned that our Nabi Kareem (S.A.W) said "if we break the bone of the dead he feels pain but he cannot express himself.
He used to keep standing till the dead body leaves". He says, when you pass a grave yard say, "Aslam-o-Alaikum Ya Ahlelqaboor". He says dead answers this salaam but we can not hear. Don't put your feet on the grave. It hurts the dead but he cannot express himself. In our society, Dr Hamid said that the relatives of the patients do not donate their organs for the following reasons.
a) Husbands tell their wives not to donate their organs to their relations.
b) There may not be any relative to donate their organs.
c) The family members have mismatched blood and typing and as such can not donate.
One can say there is no relation for poor. The only choice remains between cadaver donor (no such programme exist in Pakistan), related donors, unrelated donors and in the absence of these donors the only choice for the patient is death, he added.
Dr Mukhtar Hamid suggested that authorised transplant centres/Hospitals shall created a donors pool and will create welfare fund, which will be generated through recipients, hospitals, government and Bait-ul-Maal. Hospital shall constitute committee to evaluate donors and patients and the donors shall be accompanied by his close relations.
The donors consent will be witnessed by two persons out of whom one should be close relation, while the government will fix the compensation to be paid to the donor and this amount should be equivalent to that of "ARSH".
Answering the questions, Dr Mukhtar Hamid said that the donors are being exploited by the land-lords and by the restrictions imposed by the government. They cannot purchase their meals for their children because they don't have the money to marry their children and cannot provide education. During the year 2007 Human Rights Commission reported that 1272 patient's committed suicide.
These donors were solving their financial problems by uniting one kidney and save one life getting compensation in lieu of the kidney donation. The world is changing their views so for paying the donors. Dalton Mc Guity, premier of the Ontario sanctioned 4 million dollars for payment to the unrelated donors who save lives of the patients.
He fixed Dollars 5500 to be paid as compensation to the unrelated donors. In Western Europe Human Albumen is being sold, Human Semen and ovum is being sold in the Market. Saudi Government has fixed 50,000 Riyals to be paid to the live unrelated donors.
In Israel the Bodies of the Palestinians are purchased and the organs are transplanted in patients who visit Israel from Eastern Europe. The Human Rights activists and WHO is silent on the issue. We do not have any alternative other than using Live Unrelated Donors. There is no health problem to the live donors while the patients get life.
The patients from Middle East should pay a sum of 200,000 $ to meet the cost of treatment. Out of this $30,000 should be paid to the Hospitals and rest of the money the Government should retain in improves the Foreign Exchange Reserves, citing the various examples by Dr Mukhtar. He mentioned that these patients shall respect the Pakistani for getting life.
According to the Islamic Fiqah the criminal who damages organ is excused when the criminal pays an amount equivalent to the 'Arsh'. That does not mean that the inflicted person has sold the damaged organ. At the end fail to understand the Western Morals are being imposed on our patients. Whereas their life standards and religion is different, he concluded.
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