At a time when Bhutanese are reluctant to donate organs believing that they wouldn’t be reborn as humans, His Holiness the Je Khenpo’s office has called organ donation a noble act.
Hospitals in the country are in desperate need of organ donors. But people still believe that it’s a taboo donating organs.
Dr. Kunzang Getshen, the head of Thimphu Hospital’s ophthalmology department attributes this reluctance to religious beliefs like, “the soul won’t rest in peace if an organ is missing” or “the rebirth of the person will not happen if his organs are missing.”
But His Holiness the Je Khenpo’s office, in response to a Business Bhutan submission, said the belief has no basis in Buddhism.
“This is not true,” the statement from His Holiness’ office said.
“Donating ones organs is noble and equivalent to any other religious practice like visiting temples, lhakhangs or giving alms,” the statement said.
The only transplant that is done in-country is the corneal transplant and there are more than 50 patients waiting for the corneal transplant from 2009 till date.
Six of them are bilaterally blind and are in urgent need for a transplant, said the cornea specialist, Dr. Nor Tshering.
Dr. Kunzang Getshen said all the operation equipments are ready; however the storage facility, which will cost about Nu 1.4 mn, has not yet been ordered. The facility is expected to be ready by next year.
As of now, cornea testing is done only at the Tilganga Eye Hospital in Nepal. With no advanced equipments to analyze the eye and no eye bank in the country, the hospital aims at creating awareness among the public to pledge their organs after death.
“For the medium (storage facility) to be fully installed in the hospitals, it might take at least a year, however, the ground work like creating awareness needs to be done,” said Dr. Nor Tshering.
He said there is no age bar to cornea donation and transplant. The youngest to receive the transplant is a few days old infant and the oldest is 104 years. The oldest donor is 103 years.
He said that a donor will be a person who or his family has given informed consent for their corneas to be used for medical purposes after death. Within six hours after death the corneas are harvested (stored), thoroughly checked for any possible infection or any serious diseases using strict international rules, prepared and stored in special media and if found suitable, used for transplant surgery.
A cost for a corneal transplant in Nepal is about Nu 10,000 where as in the United States, a cornea transplant costs about Nu 45,000.
As of now Bhutan is ready only for cornea transplant.
A corneal transplant is when the diseased cornea is removed and a healthy donor cornea sewn in. One has to remember that it’s only the cornea that is removed and replaced and not the whole eye. The first cornea transplant in Bhutan was in 2002 by a visiting consultant. Now, Dr. Nor Tshering is the only cornea specialist in the country conducting the transplant.
“There are many conditions that affect the cornea, they range from genetic dystrophic conditions to all acquired and senile degenerative conditions,” said Dr. Nor Tshering, however adding that trauma and infections are the leading causes of corneal blindness in Bhutan.
Dr. Kunzang Getshen said farmers in Bhutan who spend most of their lives on the field are prone to eye infection, thanks to the dusty conditions in which they work.
With no donors in the country so far, the hospital has been managing with the little supply of cornea they got from the Tilganga Eye Hospital in Nepal.
The hospital has also extended its outreach microsurgical eye clinics to Bhutan where 3,667 patients were screened, and 558 patients had undergone surgery.
Dr. Nor Tshering added that with no policy in place for donating organs in the country, many are dying without receiving the vision restoration surgery. He further added that blindness is not the direct cause of deaths but indirectly contribute to suffering.
After almost a year of waiting for a transplant, Mani Tshering, 38, a faculty member of the Royal Institute of Management, got his left corneal transplant in October 2004 in Thimphu Hospital. After five years, he was lucky to get his right corneal transplant last September at Tilganga.
Mani Tshering’s first transplant donor was 53 years old. But since it was not successful, he went for another transplant with the cornea of a 16-year-old.
Talking to Business Bhutan, Dr. Nor Tshering said that corneal transplants are not referred outside Bhutan as it can be done within the country.
About six patients have gone outside Bhutan privately for the corneal transplant. In Bhutan Dr. Nor Tshering has conducted more than 15 transplants.
The only transplant cases that are referred outside Bhutan are kidney transplants. Kencho Dorji, the officiating liaison officer at the Thimphu Hospital, said 33 patients have been referred outside Bhutan for kidney transplant from 2007 to May 30, 2010.
He also added that their treatment outside Bhutan cost a minimum of Nu 0.6mn and a maximum of Nu 1.6 mn for a patient.
Business Bhutan, as part of its corporate social responsibility, is initiating a national awareness campaign to encourage people to donate organs.
“Helping a person see the world around him better is the responsibility of a newspaper. With our upcoming campaign we are literally encouraging people to help those who cannot ‘see’ well,” the chief executive officer of Business Bhutan, Tshering Wangchuk said.
With moral support from the Central Monk Body, it is expected that people will come forward to donate their organs.
“If King Dremi Kuenden could donate his eyes to a blind man, why can’t our people donate their organs?” the statement from His Holiness the Je Khenpo’s office asked.