- India faces a severe shortage of organs, with thousands dying while waiting for transplants.
- A Pakistani girl received a heart transplant through a Chennai-based NGO, while Indian citizens wait for years for organs, sparking a heated debate.
- The incident raises questions about the fairness and ethics of prioritizing foreign recipients over Indian citizens.
- Discrepancies in donor demographics, with most donors being non-Muslim, add to the controversy.
- The situation calls for a reevaluation of India’s organ donation policies to address these ethical and practical challenges.
Each year, thousands of Indians die waiting for a heart transplant. Of the 50,000 people who need heart transplants each year in the country, only 0.2 percent – or less than 100 – receive transplants.[1] Despite this dire shortage, a Pakistani girl jumped the queue and received an Indian heart free of charge through the Aishwaryam Trust, founded by leftist architect Chitra Vishwanath.[2] Additionally, nearly Rs 40 lakh needed for the operation was also raised in India.
The heart – which belonged to a 68-year-old brain-dead patient – was transported via a charter flight from Delhi to Chennai’s MGM Healthcare for the Pakistani girl, Ayesha Rashid, from Karachi. The doctors claimed that nobody wanted the organ in Delhi, but suspicions linger about the veracity of this claim, suggesting the possibility of an attempt to avoid controversy.
The incident raises three key questions:
- Should India ban organ transplants for foreigners, especially those from Pakistan and Bangladesh? After all, the Muslims of these two nations broke away from India in 1947, saying they didn’t want to stay in Hindu majority India. So, if they chose to follow their own separate destiny, why come back to India for their needs?
- Since Indian Muslims are against donating their organs, saying it goes against their Islamic precepts, should they be entitled to receive organs?
- Should India introduce laws to create a level playing field for Hindus, Sikhs, Jains, Christians, Buddhists, and atheists, who are the usual donors?
Against this backdrop, there is a compelling case for having a relook at the entire organ donation industry.
Donor Demographics
Nearly all organ donors in India are non-Muslim. Muslims, for religious reasons, rarely donate organs. This disparity is illustrated by the data collected by Telangana’s Jeevandan, the state cadaver organ transplantation authority. According to a 2016 report, Jeevandan had ensured that donated organs and tissues from 241 brain-dead patients had given the gift of life to as many as 1,000 beneficiaries, but it was unable to convince a single Muslim to donate their organs.[3]
Despite the Islamic aversion to donating organs, Muslims have no issues with being recipients.
Despite the Islamic aversion to donating organs, Muslims have no issues with being recipients. The records show that from 2013 to 2016, Jeevandan authorities donated organs like kidney and liver to as many as 39 Muslim patients.
“We are looking for an ambassador from the Muslim community to take up the cause of organ donation but have not yet succeeded. Though a few prominent individuals from the community are supporting the cause of organ donation, it is not working,” said Dr G Swarnalatha, coordinator, Jeevandan.
This imbalance is highlighted by the case of ex-cricketer Syed Kirmani, who withdrew his decision to donate his organs after facing backlash from fellow Muslims. “I might not be able to honor my commitment due to some religious values,” he said.[4]
Altruism Punished
When organs donated by Hindus and other non-Muslims are given to foreigners, these donors are effectively penalized for their altruism. Indian citizens, who are already in a critical condition, get pushed further down the queue, exacerbating the already dire situation of organ shortages in the country.
Self Entitled Believers
When news of the transplant became public, Lekha was shocked to receive abuse from Shafi, who criticized her because he was now carrying a Hindu kidney inside him. Shafi claimed that members of his community rebuked him for accepting a Hindu woman’s kidney.
In 2009, Lekha Namboothiri, a 31-year-old Hindu woman from the southern State of Kerala, came across an advertisement from a Shafi Navaz, a Muslim man, seeking kidney donors. Lekha donated a kidney to Shafi free of charge despite receiving offers of up to ₹15 lakh and facing dire financial and medical problems.[5]
When news of the transplant became public, Lekha was shocked to receive abuse from Shafi, who criticized her because he was now carrying a Hindu kidney inside him. Shafi claimed that members of his community rebuked him for accepting a Hindu woman’s kidney.
Notably, Lekha’s children were members of the Hindu nationalist organization Rashtriya Swayamsevak Sangh. However, the Kerala media tried to block the news of Lekha’s family RSS connections. The secular media did not want to highlight that a Hindu had done such a selfless act.
Pakistani Ingratitude
“The man who gave his heart to the girl died as a Hindu, so he does not deserve any virtue. However, the girl who accepted the heart is brave. She will now force the non-Muslim heart to kneel before Allah, and that is her courage,” the Imam said.
There is a belief in India that Pakistanis will never be truly thankful to Indians and Hindus for their generosity. Despite receiving life-saving transplants and emergency medical care, the deep-seated animosity towards India and Hindus remains. This is doubly ironic, considering that their lives were saved by the very people they continue to harbor ill will against.
Reacting to Ayesha’s heart transplant, a Pakistani imam (preacher) claimed that the Hindu man’s heart is a kafir – infidel. The Imam said that the heart that once bowed before Hindu idols will now prostrate before Allah. “The man who gave his heart to the girl died as a Hindu, so he does not deserve any virtue. However, the girl who accepted the heart is brave. She will now force the non-Muslim heart to kneel before Allah, and that is her courage,” the Imam said.[6]
Indeed, Pakistani patients, after getting a new lease of life from India, rarely thank Indians for saving their lives through organ donations. Instead, the gratitude is often directed towards Allah, highlighting their ingratitude towards the actual donors. This raises the question: If Allah is so great, why doesn’t he provide surgery in Pakistan and Bangladesh?
Risk of Illegal Harvesting
The case of the Pakistani girl receiving a heart transplant in India has brought to the forefront the ethical and practical challenges of organ donation in a country where thousands of its citizens die waiting for transplants.
Allowing organ transplants for foreigners can lead to potential misuse and illegal harvesting practices. A notable example is the Kerala High Court issuing a summons to Lakeshore Hospital for allegedly transplanting the liver of an 18-year-old Indian accident victim to a Malaysian national. The liver and kidneys were harvested in violation of the law, illustrating the potential for abuse in the system.[7]
That a Pakistani patient got a heart in Tamil Nadu is hardly a coincidence. The State has been the epicenter of India’s organ transplant racket. In 2018, an inquiry instituted by the Tamil Nadu government found that organs from deceased donors were being allocated preferentially to foreign nationals, especially those from the Middle East, Central Asian republics, and Africa, bypassing Indian patients on the waiting list. In 2017, foreigners got about 25 percent of all heart transplants in the State and 33 percent of lung transplants.[8]
Particularly alarming is the data on lung and heart transplants: 25-33 percent of these organs are regularly allocated to foreign nationals. The reasons cited include the depletion of Indian candidates on the waiting list, the medical unfitness of listed Indian recipients, or refusals due to the unavailability of a specific surgeon.[9]
According to Vivekanand Jha, Professor of Nephrology at the University of Oxford, allocating organs to foreign nationals is “a fraud on the Indian deceased donation system.” He points out that deceased organ donation requires that the recipient be identified and the transplant completed within a few hours of the organ becoming available, making it impossible to predict when a matching organ will turn up. This raises questions about how foreign nationals with advanced heart and lung disease are present in India, seemingly waiting for organs unless they expect to receive them due to a lack of suitable Indian recipients. These patients aren’t coming to India for high-quality medical care but specifically to obtain scarce organs unavailable in their own countries. “This is predatory behavior and the textbook definition of transplant tourism.” [10]
Should organs from Indian donors go to foreigners at all? Jha explains why India should crack down on this practice: “The reason countries invest resources in developing a deceased donation program is to address the unmet need of organs to their own citizens with end-stage organ failure. Organs from altruistic deceased donors are a national resource and should not be used to service foreign citizens when hundreds of thousands of Indians are dying of organ failure. It is ludicrous to claim that in a country of 1.3 billion, there are no suitable Indians on a transplant wait list.”
Conclusion
Given the significant religious and cultural disparities in donor demographics and the potential for illegal practices, India should adopt the Singapore model, where organ donors get priority.[11]
The Human Organ Transplant Act (HOTA) of Singapore provides an opt-out organ donation system that allows for the removal of kidneys, livers, hearts, and corneas from deceased Singapore citizens and permanent residents for the sole purpose of transplantation. Individuals can opt-out for all or specific organ(s) listed under HOTA. If they require an organ transplant in the future, individuals who opt out of HOTA will get a lower priority on the organ transplant waiting list than those who remain in HOTA.
The Singapore model is fair and transparent, and if implemented in India, it should level the field for all citizens. Currently, one group is playing the system in the name of religion, and it is time to end this malaise.
Citations
[1] India’s Growing Heart Transplant Requirements: Fresh Insights (mohanfoundation.org); https://www.mohanfoundation.org/news/Indias-Growing-Heart-Transplant-Requirements-Fresh-Insights-1214.htm#:~:text=%22Each%20year%2C%20about%2090%2D,percent%20receive%20transplants%2C%22%20Dr
[2] Sound the Alarm on the Digital Dollar | American Hartford Gold (youtube.com); https://www.youtube.com/watch?v=NuBfwrUIyts
[3] Records show no organ donation from Telangana Muslims | Hyderabad News – Times of India (indiatimes.com); https://timesofindia.indiatimes.com/city/hyderabad/records-show-no-organ-donation-from-telangana-muslims/articleshow/53608829.cms
[4] Ex-India cricketer Syed Kirmani retracts statement after pledging to donate his eyes | Crickit (hindustantimes.com); https://www.hindustantimes.com/cricket/ex-india-cricketer-syed-kirmani-retracts-statement-after-pledging-to-donate-his-eyes/story-zRJV4nNMNOcQEKE9nL1McI.html
[5] When Kidney becomes Kafir: A Hindu women is abused by a Muslim man whom she donated kidney (organiser.org); https://organiser.org/2023/07/07/182640/bharat/the-communal-kidney-shocking-case-of-a-kerala-hindu-woman-who-faced-abuse-upon-donating-her-kidney-to-a-muslim-man/#:~:text=The%20kidney%20was%20donated%20by,media%20user%20shared%20its%20detail&text=Today%20Organiser%20will%20take%20you,kidney%20to%20a%20Muslim%20man
[6] Get To The Deepest Root With A Free Discovery Session From Bridgewater’s Leading PT Clinic (youtube.com); https://www.youtube.com/watch?v=h5jBrZsfuSA
[7] Kerala Court Issues Summons To Lakeshore Hospital, Its Doctors For Allegedly Transplanting Liver Of Brain Dead Patient In Violation Of Law (livelaw.in); https://www.livelaw.in/news-updates/kerala-court-summons-doctors-lakeshore-hospital-ernakulam-liver-transplant-violation-of-law-230618#:~:text=A%20Kerala%20Court%20recently%20issued,Act%20(THOA)%2C%201994
[8] In Chennai, the hearts beat for foreigners – The Hindu; https://www.thehindu.com/news/cities/chennai/organ-transplant-racket-surfaces-in-tamil-nadu/article61538843.ece
[9] The Wire: The Wire News India, Latest News,News from India, Politics, External Affairs, Science, Economics, Gender and Culture; https://thewire.in/health/underbelly-organ-transplantation-india#:~:text=Last%20month%2C%20an%20enquiry%20instituted,Central%20Asian%20republics%20and%20Africa
[10] The Wire: The Wire News India, Latest News,News from India, Politics, External Affairs, Science, Economics, Gender and Culture; https://thewire.in/health/underbelly-organ-transplantation-india#:~:text=Last%20month%2C%20an%20enquiry%20instituted,Central%20Asian%20republics%20and%20Africa
[11] Live On | Who Is Eligible To Be A Donor; https://www.liveon.gov.sg/who-is-eligible-to-be-a-donor.html#:~:text=All%20Singapore%20Citizens%20and%20Permanent,Which%20organs%20are%20included%3F&text=What%20is%20the%20purpose%3F