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Rosemund Handler

@ Sunday Times Books LIVE

Body parts

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This piece was published in the Mail & Guardian titled “Don’t harden your heart”

Two men from different parts of the city wait for a kidney donor. Jack has been waiting for nearly three years for a match; Martin one month. They met going to dialysis: Jack daily, Martin three times weekly. They know the drill, and they get chatting. Liquids are one of their first subjects: how much liquid an apple represents, or a bunch of grapes, how little a dried peach. The amount of liquid they are permitted is measured to the last drop. Without functional kidneys, it doesn’t take a lot of liquid to cause damage, and even death. The two men find they have more in common than their illness: both are under 40, married with children, both have big plans for their lives and want desperately to live to see their children grow up.

Death is the last thing they talk about. But death stalks them, getting closer and closer. Unless a donor can be found.

Three months after they met, Martin, who has been waiting for a donor for four months, gets lucky. An unrelated donor match is found from a donor bank. The donor is anonymous, likely somebody who has made a living will in which it is written that should he become dependent on machines to breathe, or deceased, he wants his organs to be harvested and donated to save lives. Kidneys, corneas, heart, lungs, pancreas; any part that may save or improve somebody’s life.

Jack is happy for his newfound friend. Two days after his successful transplant, Martin inquires after his friend, saying he feels badly that he was so lucky after so short a time, and Jack has waited so long. His wife tells him that the day after Martin’s transplant, Jack went into a shop, bought a 2-litre bottle of Coke, and drank it down. He died soon afterwards. He simply got tired of waiting, and made a choice that caused terrible pain to those who loved him.

In another part of the country, a 19-year man lies in a hospital bed, in a coma. He suffered head trauma in a motorcycle accident and his grieving parents have been told there is no brain activity; no hope. Their son is brain-dead.

In the same hospital, a girl is dying, her damaged heart failing. Her family have been trying to find a donor for months and their daughter has run out of time. Yet if a heart transplant could be performed, her life could still be saved.

The doctors, aware of the desperate need, not only to save the girl’s life, but for the other lives that the young motorcyclist’s organs could save, speak with some urgency to the parents of the boy. These people are thunderstruck, horrified, despairing, but ultimately unyielding. Hope is their religion; they cling to it against all logic. Not a hair on their boy’s head may be touched.

The girl dies two dreadful days later. The boy breathes for two weeks with the aid of machines then, mercifully, dies. The parents remain adamant that their son’s body must be left intact, even though he will be cremated. The heart patient’s parents refuse to donate her organs on religious grounds. They say they want her to be buried whole so that in time she will be resurrected in her entirety.

There is an average of over 4,300 adults and children at any given time, waiting for an organ transplant in South Africa. Less than 600 transplants are performed each year and many adults and children die waiting for a life-saving transplant. The Organ Donor Foundation is passionate in its drive to help these individuals and their families. I’m told one organ donor can save seven lives by donating heart, lungs, kidneys, liver and pancreas; the quality of life of up to 50 more people can be improved by that same donor donating skin, bone, corneas and heart valves. Shockingly, in South Africa less than 0.2 percent of the population are registered organ donors, as compared to a country like America, where 40 percent of the population are registered organ donors.

There are a host of reasons people give for not becoming organ donors, most of them religious, superstitious or sentimental. The few people I spoke to shuddered at the thought of dying, let alone parting with an organ. One or two seemed interested in the idea of a living will, and one woman called and joined the Organ Donor Foundation. A man who has made a living will in which he stipulates that he wishes all his organs to be donated is uncertain that his wishes will be carried out. His children know of this living will, and do not agree with it on religious grounds.

The bottom line is that if your son or daughter needs an organ to survive, the rationales become null and void. Most of us would give anything we have to obtain the necessary organ; the rich, I am told, have access to a worldwide black market in organs harvested under suspect, even horrific, circumstances. But that’s a whole other story.

Us and ThemRosemund Handler’s most recent book is Us and Them

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