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03.10.2008 Feature Article

Kidneys For Sale? Asks Dr Gyikua Plange-Rhule

Kidneys For Sale?  Asks Dr Gyikua Plange-Rhule
03.10.2008 LISTEN


The only time I ever listen to the radio is when I am driving. Because of this I tend to be very selective about what I listen to.

In the morning, it is always a newspaper review of some kind, but in the afternoon it becomes more difficult.

 

 I don't like football, I don't listen to music, I switch off all adverts especially when they are about sanitary towels or drugs that can cure everything from diabetes to fibroids (and of course impotence!).

In Kumasi, at least, that doesn't leave very much to listen to, but there are a couple of good programmes.

Driving in town one afternoon a few days ago, flipping the dial from station to station, trying to find something to listen to, I couldn't believe what I heard.

 

A radio station was calling for anyone who was blood group “O” Positive and who was willing to donate a kidney to get in touch with them.

Apparently someone in the U.S. needs a kidney badly. The radio presenter said the person who donated his or her kidney would receive financial compensation and that the surgery would be done in the U.S.A.

For once, I wanted to contribute (mepe se meba mo programme no bi) but never having done so before, I didn't know which number to call and by the time I had found out the number, the programme was over.

I remember a few years ago, a petrol tanker full of petrol was involved in an accident at the Winneba Junction.

 

“Free” petrol was spilling all over and I heard that despite the warnings of the police, the inhabitants of the town just couldn't resist coming near with containers to scoop up the free petrol. Predictably, the tanker exploded and the resulting fire claimed many lives.

 

The moral of this story? Simply this — the desire to make money can cloud a person's judgement so badly that it leads him to make irrational decisions that he might otherwise not have made if money had not been a factor to consider.

Announcing in the middle of Kumasi and beyond, where more than half of the population is “O” Positive and almost certainly have two kidneys, that there is a free, all expenses paid trip to the U.S.A. with some financial compensation thrown in for good measure, is like dropping a lighted match into a tank full of gas.

 

You should expect one big explosion…

Sale of organs is unethical and is also illegal in many parts of the world. In my humble personal opinion it was very unethical for the radio station to advertise for a living donor in this manner.

While it is known that there is a burgeoning underground black market trade in organs, particularly, I believe, in parts of the Far East, for a reputable radio station to involve itself is highly unacceptable.

The donation of a kidney (or any other organ) is a very very serious and a major decision that should never be taken with financial inducements as the main consideration.

 

While it is indeed possible to live with only one kidney, should anything happen to that kidney, the individual has had it.

Many many requirements need to be fulfilled before someone is accepted as a donor. This is because it is important to make as sure as possible that the kidney being donated is absolutely healthy.

This would of course involve screening for HIV, Hepatitis B and other diseases. It is also important to make as sure as humanly possible (which is never 100 per cent) that the remaining kidney is healthy.

 

There are many compatibility tests that need to be done apart from blood groups and it is not at all easy to find someone who is a perfect match.

 

 If this testing is not properly done, the transplanted kidney will be rejected by the body of the host and of course when this happens it cannot simply be returned to the donor like a borrowed shirt.

 

There are also a whole barrage of psychological tests and counselling sessions that need to be gone through.

Several years ago, a patient of a colleague of mine desperately needed a kidney. This patient was on daily dialysis and he had all his children tested.

 

Unfortunately none of them was compatible. A nephew, however, was found to be compatible. The nephew agreed to come to London to complete the final testing process.

 

According to him, his uncle had helped him so much when he was growing up that he “couldn't look on” for his uncle to die and if the only way to save his “beloved” uncle was to donate his kidney then so be it.

The passport, visa and all other travel documents were obtained. The ticket was bought and the affectionate young nephew was flown off to London.

 

On arrival in London however, the young man began to sing a different song. His deep affection for his uncle apparently evaporated in the cold England air.

 

He suddenly did not understand why his uncle did not ask one of his many children to donate a kidney instead of him, a mere nephew.

 

All these issues had been explained to him back home in Ghana. To cut a long story short, the nephew not only flatly refused to give his kidney, but later disappeared into the back streets of London and was never heard from again.

 

 His “beloved” uncle, the patient, who had personally and in desperation funded his trip to London, died a few months later.

We will never know whether this was a cruel and cynical plan to get free passage to London or whether the young man set off with a genuine intention of donating his kidney but developed cold feet later on.

 

This true story, however, illustrates some of the complex realities that can arise when issues of organ donation are handled as if body parts can be advertised and sold like pieces of meat in the market. This was between two family members.

Imagine the potential for this happening between two strangers.

 

The ideal situation is for a patient to look among his own blood relatives mainly because that is where he is most likely to find a good match and also because the best motive for donating an organ is true affection, not money.

Of course not every person has loving family members who care enough to give an organ.

 

There are other possible sources such as healthy organs from a freshly dead person (for example accident victims) who has signed on organ donation card.

 

Every now and then one hears of an individual donating an organ to save the life of a complete stranger, maybe because they were touched by the plight of the person.

 

I remember watching a story like this on TV where a man donated part of his liver to save a baby born with liver disease. The fact that it made the news tells you how rare it is.

Obviously, this is a complex area and a new one in this part of the world. However, to present it in the media as if it is a quick and easy procedure, rather than a serious and potentially life changing one, cannot be right.

 

There is a dire need for organs to save lives, but this need should always be fulfilled in an ethical way. I understand that in some parts of the world where poverty prevails, unscrupulous people take advantage of the desperation of poor people to convince them to sell organs.

Sometimes, after the organs are donated, these individuals are not able to get the aftercare that they need in their own countries and some of them even go on to die.

 

 Sometimes also, the screening is not done properly before the organ is removed and flown abroad, leaving the person donating to face all sorts of health problems for which he cannot even claim compensation because what was done was not legal in the first place.

 

I would like to believe that it is not yet a major problem here and I sincerely hope that this will not mark the beginning of a floodgate of Ghanaian kidneys and other organs being sold abroad.

 

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