Unsung heroes: organ donors

September 25, 2005

Road to recovery:

A doctor at the Military Medical Institute in Ha Noi examines Nguyen Thi Diep as she recovers from a liver transplant, the first-ever conducted in Viet Nam last year.

VNA/VNSPhoto Huu Oai

Fresh start:

A woman patient says goodbye to doctors after recovering from a kidney transplant, the first one conducted by Ha Noi Central Peadiatrics Hospital.

VNS Photo Doan Tung

doctors provide care to patients providing kidney dialysis

Waiting:

Doctors provide care to patients receiving kidney dialysis in Ha Noi's Friendship Hospital. Viet Nam has a high number of dialysis patients who are unable to receive kidney transplants due to a lack of donors.

VNS Photos Truong Vi

Traditional beliefs in reincarnation often discourage Vietnamese from volunteering to donate their organs, even upon their death, but Thu Phuong finds that a firm belief in saving lives might be more important, and ultimately, more rewarding.

Are you willing to donate your organs if you die on the road?

If I was asked that question when I applied for a driver's licence, my first instinct would be to say no.

From a superstitious point of view, many Vietnamese people would agree with me. It's said that you shouldn't talk about death when you are about to risk your life by getting on the road. It's a bad omen and it explains why there is a general reluctance to help save others' lives in this country.

The shortage of organ donors is hindering the transplant industry in Viet Nam. Even if a person states his wish to donate his organs, ultimately the donor's relative makes the final decision -- and at the end of the day the family often objects and prevents the donation. Traditional beliefs are a large part of the problem.

Reincarnation beliefs

A cultural researcher from the Ministry of Culture and Information's Cultural Heritage Department, Tran Lam Bien, said because of the belief in reincarnation, many Vietnamese people think their bodies must be kept intact after death.

In the feudal times, after a criminal was beheaded for a felony, their relatives made a wooden head to replace it before burial, said Bien.

This is a commonly held belief not necessarily related to any particular religion.

"Many residents in other parts of the world also believe this, not only the Vietnamese," Bien said.

However, he said there were a number of good Samaritans who genuinely wanted to help other people -- and they were willing to donate their organs.

"Organ donors should be recognised as heroes," Bien said.

One such hero is a young, healthy monk who expressed his desire to donate half of his liver to any child on the waiting list for a liver transplant at the Central Paediatrics Hospital in Ha Noi.

The monk (who doesn't want to be identified) is seen as an exceptional case at a time in Viet Nam when many are loath to cut out parts of their bodies, even to save others' lives.

In a series of letters sent to the hospital, the monk also indicated his intention to donate his heart, kidneys and eyes to needy children and his body to medical research if he were to die during the liver transplant surgery.

"I don't ask for anything from the patient's family. If they ask to give me money, I won't agree, regardless of how much," the monk stated in one of his letters to the hospital's director, Nguyen Thanh Liem.

Medical tests have shown that the monk is eligible to donate organs, Liem said.

The monk's wish would have come to fruition when the hospital conducted its first liver transplant in early July, but the director said they wanted to save his donation for next time since the patient's father was able to donate his liver.

The second case, which would have also used his liver, was cancelled due to the patient's poor health.

But there would definitely be more liver transplants in the near future, the director said.

Science of organ donation

Chairman of the National Organ Transplantation Council, Prof Le The Trung, praised the goodwill of volunteer donors like the monk, saying that using organs from live people could help lengthen the lives of patients following the transplant.

Such cases, however, don't happen often enough to save the lives of the many people still on the waiting list for transplants and grafts.

According to statistics from the Ministry of Health, about 1,500 people are in need of a liver graft in Ha Noi alone and 5,000 to 6,000 patients are waiting for kidney transplants.

Prof Trung said that because the number of volunteer donors is limited and in order to control the "commercialisation" of organ donation, brain-dead people are a better choice.

Brain dead, Trung explained, can be defined as a human brain that is seriously damaged leading to death, but organs are still functional for a certain period of time.

Fatalism:

Millions of travellers take to the road every day without knowing what they would do, in regard to organ donation, if caught in a fatal accident.

Traffic victims, particularly those suffering from brain trauma, are a potential source of organ donations.

Each day, around 20-30 patients are reported to have been seriously brain damaged in Cho Ray and Viet Nam-Germany, two central hospitals that treat accident victims in HCM City and Ha Noi, respectively. Of those, about 10 are brain-dead.

Prof Trung said a dead person can save many lives. A liver can save two people, a pair of kidneys can save two others and a heart can save one.

Those figures make you think about the number of lives you could personally save. Viet Nam still does not require the holders of driver's licences or identity cards to declare their organ donor status.

I do think that even if a majority of people say no to the question when applying for these cards, it would be a very good move in raising awareness about organ and tissue donation.

Prof Trung said Viet Nam so far has conducted 160 kidney transplants and two liver grafts.

Double that figure have gone overseas for transplants at a much higher cost.

In China, for example, a kidney transplant cost around US$35,000 while the price was one-tenth of that in Viet Nam, Trung said.

Vietnamese doctors are also highly skilled in performing transplants.

"Liver grafting is an extremely complicated process, even more complicated than a heart transplant, but we have been successful," the professor said.

Five hospitals nationwide are able to perform kidney transplants and two have been successful with liver grafts. Most of the cases were done using organs from the patient's blood relatives.

Thousands of patients on the list for grafts are hopeful about their future as the legislation regulating organ donation and transplants is expected to be approved by the National Assembly's Standing Committee at the end of this year.

A final poll on the ordinance was held by the Health Ministry earlier this month.

Once the law comes into effect, who knows, maybe I will change my mind and say yes to organ donation and give the gift of life to another person. -- VNS

This article posted October 13, 2005.