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Sushma Swaraj can help change organ donation law in India

It is indeed heartening to know that External Affairs Minister Sushma Swaraj underwent a successful kidney transplant operation at the All India Institute of Medical sciences (AIIMS) on Saturday (December 10) and that she is recuperating fast. In a few weeks time, she should be able to resume her duty at the South Block to guide our country’s relationship with the larger world.

Swaraj has been one of the most successful ministers of the Narendra Modi government. She has succeeded in enhancing India’s international profile through her astute diplomatic skills, her legendary gift of the gab and her exemplary personal conduct. The manner in which she made the world know about her ailment and treatment (compare that with the absolute secrecy in J Jayalalithaa’s case) has endeared her to her countrymen and women.

However, one would hope that when Swaraj recovers completely from the post-operational rehabilitative process, she would spare a thought to around two lakh men and women across the country who have been waiting for years to get the official nod for a kidney transplant. It is common knowledge hat the denial of permission for a kidney transplant to those who carry little personal or political weight is common and thousands are dying every year due to it.

 Sushma Swaraj can help change organ donation law in India

Union External Affairs Minister Sushma Swaraj. File photo. AFP

Consider the rules for being eligible for a kidney transplant in India. If a near relative of the patient is willing to donate his or her kidney, then there is little problem. Private hospitals would expedite the process as they charge a fortune for the transplant. In the government hospitals, the delay could be due to usual red-tape in convening the mandatory meeting of the authorised committee to consider the requests, to examine the relevant papers and to interview the concerned persons. It depends on the relatives of the patients as to how strongly they can push the official machinery to get it going fast. Those who are familiar with the ways of making the government institutions work get the sanction quickly, but those who just wait for their turn not knowing where and how to push the system suffer a delay.

In all such cases, the permission for the kidney transplant may get delayed, but, usually, not denied. That is the advantage of a near relative offering a kidney for transplant. But then the definition of a near relative is quite specific: one’s parents or children, grandparents or grandchildren, spouse or siblings. If the donor is one of them, then the patient can breathe easy.

But, if any "near relative" of a patient is unavailable, unwilling, or unfit to donate a kidney, then the long arm of the law takes its toll. The law provides that a non-relative donor can be considered only if one is willing to offer a kidney out of "affection and attachment" to the donee, or for a special reason, but never out of consideration of money. Such a provision virtually blacks out the possibility of a kidney patient getting a donor.

How many ordinary patients will get a donor who would offer a vital organ like kidney out of "affection and/or attachment" for a distant relative or a non-relative? Such offers, however, may pour in for big celebrities. It was the same case with Swaraj who is a political celebrity. When she broke the news of her kidney ailment over Twitter, she was flooded with the kidney offers from scores of Indians who admire her for her personal and political standing. As the Indian Express reported, her doctors selected a 40-year old woman — out of a brood of non-relative donor offers — to service the need of the ailing political leader.

Now consider the timeline in Swaraj's case: She made the announcement of her ailment over social media on 16 November, her kidney transplant happened on 10 December. In a span of fewer than four weeks, the donor was selected, mandatory testings for compatibility of donor-donee organ were carried out, all official permissions kicked in and the transplant was carried out. It must have been a record of sorts in the history of the AIIMS in showing such alacrity in carrying out a transplant of a kidney offered by a non-relative donor.

But then Swaraj deserved every bit of this special treatment, not for her own sake, but for the sake of the country. However, as a senior leader of the ruling party and the government, now it would be her turn to consider the plight of those waiting for a transplant from a non-relative donor. For most of them, there seems to be no light at the end of the tunnel.

And that is because the official committee to screen such applications is usually not convinced that a non-relative donor is offering the vital organ just out of affection and attachment, and not out of mercenary considerations. The fact that most of these men and women, who come forward to donate, are from the poorer strata of the society and are mobilised by middlemen to offer a kidney in consideration of a certain sum of money, doesn't help either.

Not that the kidney patients like it that way; but the law of the land does not give them any other option; they are left with a Hobson’s choice – either adopt the illegal course or embrace an impending death. Many such illegal transplants happen; but if and when they come to light, the harsh law of the land entails that the donor, donee, their relatives, middlemen and the doctors and administrators associated with the illegal transplant go to jail.

It is a harsh law, which is tilted in favour of the powerful who can manage to find a donor, and whose altruistic credentials, the official committee is ready to endorse. It is a law against the non-elite for whom it is virtually impossible to convince the committee about the altruism of the donor. There are examples such as that of a Delhi professor offering a kidney to a stranger in Kerala as was reported in the media, but they are rare; it has something to do with the elevating religious and moral sentiment of the donor.

The draconian law was envisaged with good intentions — to ensure that the poor are not exploited and made to part with vital organs by organised gangs — but then the illegal racket that thrives ensures that some poor people are misled into extortionist tactics, lose their body part and get a little money in return.

Why can’t the government make a law allowing voluntary donation of an organ in exchange for a minimum stipulated amount of money? The donor can bargain for a higher sum too, and the entire money could be deposited in the donor’s bank account before the transplant process kicks in.

With a proper monitoring mechanism in place that would make the system open and transparent; it would create a win-win situation for both the donor and the donee.

Unfortunately, our political establishment often fails to rise to the occasion to offset the acute problems, especially in the health sector that doesn't promise much political dividend.

However, if Swaraj, who has gone through the trauma behind a kidney ailment, takes the lead to change the law to benefit all, she would win the sincere gratitude of thousands of sufferers and relieve them of their suffering.

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Updated Date: Dec 12, 2016 12:45:50 IST