Professor Olugbenga Awobusuyi, a consultant nephrologist at the Lagos State University Teaching Hospital (LASUTH), speaks to SUBAIR MOHAMMED on the reason organ harvesting trade is thriving in Nigeria and what can be done to curtail it.
What is organ harvesting?
Organ harvesting is the removal of an organ from the donor. In general terms, it is in reference to deceased donors but it can also be used in living donors. So, it is the removal of that viable and transplantable organ from one individual who in this case is a donor to another individual. That is essentially what organ harvesting is.
So, basically, organ harvesting is a legal medical process?
Yes, it is a legal medical procedure but its legality depends on the circumstances in which the organ is removed.
At what point does organ harvesting become illegal or criminal?
It is illegal if the consent of the donor is not sought; if the donor’s consent is not sought and the organ is forcibly removed like in the case of those who kidnap people to harvest their organs. In this instance, it becomes illegal and criminal.
Those who traffic individuals out of their countries to harvest their organs are committing a serious crime. It also becomes criminal and illegal when a donor is paid because an organ is not a commodity. It is not a consumable to be sold at the market. If it is harvested in such a situation, it becomes an illegal organ harvest.
In recent times, there has been a surge in the rate at which organs are harvested. How many patients are on the waiting lists for organ transplant in Lagos?
There is no waiting list of patients in need of donors because we don’t have a transplant programme in Nigeria. Each patient is expected to bring a donor and the responsibility of the hospital is to ensure that the donor is eligible and not a paid donor and that they are not touts. During the screening process, any donor that is found to be a tout or is suspected to have been paid would be disqualified. A donor must be willing to donate his or her organ and not forced.
What are the processes involved in organ donation?
The patient would talk to his or her relative and whoever is so moved will volunteer to be the donor. He would bring the donor to the hospital and a transplant team would evaluate the donor. When the donor is found eligible, then the transplantation process is allowed to proceed. There will be a lot of tests to ensure that the health of the patient is not in any way jeopardised.
Why then is there a thriving organ harvesting trade if organs are expected to be donated and not sold?
We have laws in Nigeria that guide that and all over the world, organ trading is illegal. This makes it illegal for anyone to get involved in organ trade. Whoever engages in it engages in illegal trade. The scarcity of donors is responsible for the thriving trade in organ harvesting.
What are the challenges in getting donors?
There are many challenges. The donor must be related to the patient. And a woman can donate to her husband and vice versa. A donor can be a friend or a member of the family, provided there is no financial reward. The first challenge is patient not having people who are wanting to donate. That is the major challenge. Donors are very few. This explains the thriving organ harvesting trade.
Using LASUTH as a case study, what is the estimated number of patients awaiting organ transplantation?
We will probably have between 100 and 150 patients. We can estimate those who require transplantation in Lagos State to be about 0.5 per cent of the population of the state. Let’s say between 0.1 and 0.5 per cent of the state’s population. There is quite a large number of them in the state. There are many Lagosians suffering from kidney, liver and other organ-related diseases.
How can this number be reduced?
I think the major thing is the public health angle that ensures that we have healthy people in our society. There should be more public enlightenment and advocacy with an improved, healthy eating habit. Another thing is regulation of hospitals so that sharp practices would be reduced.
We, the Association of Nephrologists in LASUTH and in Lagos State are currently working on a bill that would allow organs to be secured legally from paid individuals. We want that to be supported by law. It is our hope that it would reduce the issue of organ harvesting trade.
We do transplant in LASUTH but the number of transplants is not that much because we adhere to the law. We have very few transplants because our acceptance is strictly on legal basis.
If you bring a donor and we have our clinical psychologist to interview the donor, if there is any sign that he or she might be a paid donor, such donor would be disqualified.
What now becomes of the patient?
We advise the patient to look for another donor that will be eligible and acceptable to our transplant programme.
What is your advice to Lagosians on healthy lifestyle and to the Lagos State government on how to improve health facilities in the state?
I urge Lagosians to live and eat healthily. They should avoid smoking and excessive alcohol intake. They should also visit the hospital for periodic check-ups and avoid excessive salt and fat intake. They should eat a lot of healthy diets and take water in moderation. They should exercise and ensure that they are healthy and go for health check annually if they are above 40 years.
The Lagos State government is trying based on the level of facilities they have put in place but then the society needs more, especially in terms of personnel.
Although one can appreciate some of the problems, many doctors and nurses are leaving the country and it is becoming increasingly difficult to have doctors and nurses.
When you employ them today, tomorrow, half of them are out of the country; in UK or US. The government should make the salaries attractive to doctors and nurses. Also, the working environment should be made conducive. The staff should be well taken care of and facilities should be upgraded.
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