INTERNATIONAL ORGAN DONATION AWARENESS-PHILIPPINES

Vetting P-Noy’s choices 

By Rina Jimenez-David
Philippine Daily Inquirer


P-NOY MAY HAVE WON POPULIST POINTS with his Inaugural Address, which was folksy, brief and hit all the right buttons regarding people’s resentment of high-handed authority and state arrogance.
Actually, I rather liked it, even if some radio texters complained that it lacked the soaring elegance of most speeches on such a momentous occasion. But great speeches—moving, inspiring and beautiful to hear—are easy to write, and easier to deliver. They mean nothing if, some years down the line, the speaker has largely forgotten what they contain and really had no intention of bringing the words to life.
What I liked about P-Noy’s speech was that it did not attempt ambitions grander than our daily tribulations. Most Filipinos, after all, encounter government only on a few occasions, and usually only when they come face-to-face with abusive “wang-wang” escorts and venal traffic cops.
But we can hold President Aquino to actions and decisions he has already made, such as his choice of Cabinet members. Even as he declared the beginning of a “consultative” Aquino administration, he offered little by way of explanation for his choices, especially the grounds for why he appointed that individual to a particular post, and the marching orders he gave.
We’ll have many days to vet the President’s choices, but for now, let’s start with one appointee.
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ONE unexpected Cabinet appointment is that of Dr. Enrique Ona, formerly of the National National Kidney Institute (NKTI), as Health secretary.
Ona is a well-known transplant surgeon and, depending on whom you talk to, is credited—or blamed—for setting up the system of transplanting donor organs, most of them kidneys, from living non-related donors. In response to some columns I had written previously about the concerns raised by members of the health community about the increasing “commercialization” of organ donation, Ona had met with me to explain that the use of living non-related donors was but an offshoot of the increasing demand for donor organs and the lack of donor organs from the deceased.
The World Health Organization and other international bodies have declared that donor organs for transplantation should ideally be sourced from deceased donors, those who have been declared as “brain dead.” If a deceased donor is not available, the next option should be the donation of an organ from a living donor who is either biologically related to the recipient or “emotionally related,” that is, has some sort of personal relationship, be it by marriage, friendship or as an act of charity.
Most bodies have frowned upon transplant transactions fueled almost exclusively by money, with kidneys and other organs “donated” in exchange for promises of cash, often with inadequate counseling on the health implications of donating an organ, and lack of follow-up care and treatment.Philli
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THE PHILIPPINES has earned the title of a “hot spot” of the organ trade mainly because of the easy availability of organs from living non-related donors.
In our conversation, Ona bewailed that so much attention has focused on the NKTI mainly because it was one of the first centers to establish expertise in transplant procedures. But the reality is, he said, many other hospitals and medical centers around the country also perform transplantations, with hardly any supervision.
As the new health secretary, Ona is expected to exercise supervision over both public and private hospitals, and not just those engaged in transplants. But it must be asked whether he can sufficiently distance himself from his former colleagues at the NKTI or his viewpoints on the practice in laying down controls to curb the “organ trade.”
An early test for Ona’s resolve on this issue is whether he will fully implement AO2010-0019 establishing a “National Program for Sharing Organs from Deceased Donors,” which former Health Secretary Esperanza Cabral signed recently. The order lays down guidelines on the creation of a master list of potential organ recipients, and on the establishment of systems that would rationalize the matching of donations from recently deceased persons.
Will Ona put the full weight of his office behind the effort to promote organ donation from the deceased and make sure the matching system is not skewed by factors like influence, connections, wealth or celebrity? Already, he must meet his first test head-on.