Carmen delos Santos smiled meekly as a nurse turned on the dialysis machine that has been keeping her alive for the past five years. The 50-year-old mother of two sons has been visiting a private dialysis centre in Manila three times a week since she was diagnosed with end-stage renal disease in 2005.
"We were hoping for an organ transplant three years ago, but no one in my family is a good match to me except my youngest son, and I will not allow him," she said.
"He just turned 18, and he's too young to give up so much," she said. "I'll just wait for a deceased donor, and if it doesn't come, then I'm ready to go."
Delos Santos is just one of thousands of Filipinos suffering from kidney failure, waiting for deceased organ donors amid a ban on organ donation by non-related living people.
The ban was imposed in 2008 in a bid to stop a thriving black market of poor Filipinos selling their kidneys, especially to foreigners who pay more for the organs.
According to the Department of Health, one Filipino dies every hour from kidney failure while an estimated 10,000 Filipinos are diagnosed with renal disease every year.
A kidney transplant is the best option for most patients, but donors are hard to come by. Family members are often unable to donate because they face the risk of suffering the same disease while deceased organ donation is not popular in the Philippines. According to government estimates, one in 10 million Filipinos donate their organs at death.
Jonathan Martinez, a 40-year-old former software engineer, knows too well the difficulties of finding a kidney donor. His twin sister, an aunt and a family friend offered to donate one of their kidneys to him, but they all failed the rigorous medical tests for donors.
"My twin sister was a perfect match, but her kidneys were too weak, so she cannot donate," he said. "It was devastating for all of us, but I'm still hopeful."
Martinez was a newlywed when he found out about his disease three years ago, prompting him and his wife to put on hold their plans for a family. The dire situation of many kidney patients has prompted new Health Secretary Enrique Ona, a nephrologist by profession, to call for the lifting of the ban on organ donation by non-related living donors.
Ona has instead proposed the implementation of a regulated donor programme that would provide such incentives as money for donors, which he promised would be strictly enforced to avoid abuses.
Supporters of the ban oppose Ona's proposal, warning that many poor Filipinos could be exploited and forced to sell their kidneys for money. They noted that most kidney donors in the past now have failing health because they lack post-operative health care while at least two deaths have been documented in the past 10 years.
But there is growing support for the change in policy. The Philippine Medical Association lamented that there is a severe shortage of donated human kidneys nation-wide with Filipinos still unaware of the need for donations upon death.
"As I speak, there are numerous patients in the country who are fighting for their lives in a death row-like queue, waiting for this life-saving procedure to be performed on them," said Dr Oscar Tinio, the association's president.
"These patients will die without the needed organs to save them," he said. Andrew delos Santos, eldest son of Carmen, said he could not understand why the ban was imposed in the first place.
"If there are people willing to sell their kidneys to help others, then why stop them from doing that?" he asked. "Let's just make sure that the donors are also given medical care after." "If they lift the ban on non-related living donors, I would pay for a kidney for my mother in a heartbeat," he said. "There will be no hesitation."
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