Gift for donors – Zubeida Mustafa

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GRATITUDE. Pride. Appreciation. These three words sum up the sentiments of the patients I talked to on the occasion of the 20th anniversary of the Donor’s Clinic at the Sindh Institute of Urology and Transplantation (SIUT).

Abida Zahid had given a gift of life to her younger sister four years ago when her sibling had end-stage renal failure. Farman Raza was another donor who gifted a kidney to his brother in 2012 when he fell critically ill.

Both of them, as well as others, were grateful and proud that Pakistan has a health institution that offers an organ transplant programme that saved their siblings’ lives.

They also expressed appreciation for the well-run facility that had benefited them personally, namely the Donor’s Clinic, the brainchild of the director SIUT, Dr Adibul Hasan Rizvi. A unique idea, this clinic is held every Friday when organ donors can walk in for a medical check-up and get themselves treated free of charge for any medical issue that may be bothering them.

The fact that 60 per cent of them are illiterate indicates that the underprivileged are the main beneficiaries. In that respect, SIUT is quite distinct. It is not surprising that patients like Abida and Farman express their appreciation of the services they received. One was treated for tuberculosis of the stomach while the other contracted Covid-19. None of these ailments had any connection with their having been organ donors. Anyone can be infected given the widespread prevalence of these diseases.

In fact, the two donors mentioned here, and the many others who are diagnosed with diabetes and hypertension, are lucky. Their illness was detected at the Donor’s Clinic before their condition had caused any damage. The donors suffer common ailments in the same ratio as their prevalence among the general population. For instance, 27pc of the population of the country suffers from diabetes. Nearly a quarter of the patients at the Donor’s Clinic are diabetic and are being treated for it.

The transplantation programme is the crowning glory of this hospital, which has carried out 6,182 transplant surgeries since 1986. Rasheed from Azad Kashmir became the first transplant patient and there has been no turning back since then. Those who receive a new lease of life at the transplant programme are provided immunosuppressant drugs (costing one million rupees for the first year and nearly Rs500,000 per annum thereafter) for life free of charge. Most of them could not have afforded this.

The Donor’s Clinic was Dr Adib Rizvi’s brainchild. Medical research had clearly established that a person could lead a healthy life with a single kidney. Yet people would express doubts. “So we decided to prove it scientifically to the world and so be it,” he says.

The Donor’s Clinic was opened in July 2000 and it became the focal point for all donors. There are 4,457 of them who are registered with this clinic and visit it at least once a year for an annual check-up. There are some who come more often whenever they are unwell. The doctor running the clinic insists that even a healthy person — whether a donor or not — should have herself/himself checked annually to keep healthy. Many problems are ‘silent’ and become visible only when they become serious. In that respect, she says, the donors are better off due to early detection of an illness. On many occasions, SIUT itself contacts the donors if they have failed to visit for too long.

That is what healthcare should be. It is important that it should be underpinned with compassion and concern for all those who come seeking assistance for a health issue. It is also important that the patient’s dignity be ensured. SIUT does ensure it by not asking for any fees from anyone so that no one has to be apologetic for one’s poverty.

SIUT has played a wider role in Pakistan’s health landscape. It was instrumental in getting the National Assembly to pass a law regulating organ donation in Pakistan. This was designed to halt illegal organ trafficking which brought ill repute to the country and posed a hazard to gullible, impoverished donors who sold their organs for a pittance. The Transplantation of Human Organs and Tissues Act has at least deterred the criminals to an extent.

In the current pandemic, SIUT has served as a major Covid-19 centre. On earlier occasions, natural disasters that struck the country brought SIUT to the forefront to assume wider responsibilities. Dr Rizvi believes that healthcare is a basic right of all men, women and children. But a call from human rights activists to the government to declare health a fundamental right in the Constitution has met with no response at all. Is anyone listening?