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EYE for LIFE
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The question is how many of us have the strength and generosity to look beyond our grief and give sight to a person who needs to see the colour of light. SHILPA NAIR on the strides eye donation has made in the State.
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IF YOU think you are doing a good deed by donating your eyes, you think wrong. You need to take a reality check. The odds are against that happening.
"Ninety-nine per cent of the eyes that we get are not `officially donated', eyes pledged on paper. We have no claim over the eyes just because a form has been filled, the paper means nothing. If a single person in the family objects, then we cannot go ahead," says K. P. Balaji of Abhayam in Kochi.
There is an acute shortage of corneas in Thiruvananthapuram. The eye bank at the Ophthalmic Hospital has a team on call 24x7, waiting for that elusive `eye call' that rarely comes.
"There have been weeks when we don't get a single eye call. The entire team keeps waiting endlessly. And at times it has happened that we go in response to a call and return empty handed because one member of the family has objected to the eyes being taken," says Chitra Raghavan, the eye bank in-charge.
If one goes by the number of corneas that have been pledged, on paper, there should be no dearth of corneas in Thiruvananthapuram. However, the reality is very different and that means bad news for the thousands of blind people waiting endlessly for a donor, hope becomes a luxury.
The dearth of corneas in Thiruvananthapuram district is attributed to a lack of awareness more than the unwillingness to donate. K.G.B. Nair, Director, Chaitanya Eye Hospital in Thiruvananthapuram, says, "Lack of awareness or motivation is a main reason for the hesitation to donate. It is up to the relatives whether they want to honour the declaration of the prospective donor. Awareness is the tool."
Going by the number of forms pledging eyes, it appears that there is intent that rarely converts to action. Ironically, once a person is dead the body ceases to be his; it belongs to the next of kin. If the family is unwilling then, no paper or form is relevant, the pledge is irrelevant.
"The reasons for the hesitation are mainly emotional; in some cases it is religious. People have to instruct clearly express their desire to donate," says Susheela B. Nair, Director/Superintendent of the Ophthalmic Hospital.
Doctors and social workers agree that attitudes and misconceptions about the process involved in taking the cornea is a major deterrent. "There is a notion that once the eyes are `pulled out' there would be gaping hole and that it is tantamount to mutilating the body. Actually, nothing of the sort happens. Firstly, there is the process by which the corneas are taken out, so there is no mutilation, and even if we do have to take out the whole eye, we replace it with a fabricated plastic eye. After the procedure, we sew the eye with an invisible suture. The face looks the same, with no visible signs," says Dr. Chitra. Religious belief or the fear that the body was being defiled prevents people from donating eyes of deceased family members. The Ophthalmic hospital sends teams for `enucleation' to other hospitals and homes that inform the hospital about a death.
Cornea from people who succumb to diseases such as HIV/ AIDS, hepatitis, cancer etc cannot be harvested. The suitability of donor eyes also narrows the possibility of harvesting cornea even further.
"There is no hesitation to donate the eyes of an elderly member of the family that has passed away, since the death is expected. Of course, we welcome anything that we can use, but then there is suitability to consider. We cannot use a 65-year-old cornea on a 20-year-old. It is limiting in that sense. However, there are accident deaths where we can get good eyes. But we don't get as many as we should. How do you go ask for the eyes from parents who have just lost their child? There have been parents who have done that also, but they are rare," says Dr. Susheela.
The trauma unit at Thiruvananthapuram's Sree Chitra Hospital has grief counsellors. They speak to family members of those in the unit preparing them for the inevitable, if it were to happen. They talk about eye donation, if the worst were to happen.
Because of medico-legal implications, the fact there is no hospital cornea retrieval program for hospital deaths also works against meeting the demand for healthy cornea. Earlier, corneas were `imported' from Sri Lanka, from Buddhists who donated their eyes. However, the strife in that country has stopped that source. Now hospitals in Thiruvananthapuram such as the Ophthalmic Hospital and Chaitanya Eye Hospital depend on Angamaly's Little Flower Hospital to meet the demand. The latter is said to have Kerala's best eye bank.
Whereas eye banks in Thiruvananthapuram complain about `no stocks', according to Mr. Balaji, in Kochi there is no shortage of donor eyes. "Today there is no shortage of donor eyes here. When Abhayam started the eye donation program in 1980 we got no corneas, this went on until 1988. But after that things picked up. The reason for this being the vigorous campaign to spread awareness and educate people about eye donation and the need for it. Today we have reached a stage where we have people call us up and tell us that there has been a death and that they want to donate."
The Ophthalmic Club of Cochin, IMA and the Rotary Club have come together to form Naina Eye Bank. He credits Little Flower Hospital's self-sufficiency to effective propaganda for eye donation. "The success of LF's eye bank besides other factors, also demonstrates how religious leaders can play an active role in spreading the message. Priests in churches in and around Kochi and Angamaly talk about eye donation, thereby motivating people to donate. Spreading awareness among children about the nobility of eye donation should also be given priority."
N. Pravada, RMO of the Ophthalmic Hospital, is of the view that targeting society as a whole is an effective tool for any campaign for eye donation. Voluntary organisations and residential associations have an important role to play in spreading awareness. A view that Mr. Balaji and Dr. K.G.B Nair agree with. "What is needed is a change in the mindset of the people, there is no need for reservations about donation. If a person is willing and ready, then the family should also respect their wishes, that act of generosity would give sight to a blind person," says Dr. Nair.
Mr. Balaji says, "If a single person in a locality or family donates his eyes, and people such as family members and friends see that there is nothing grotesque about it, then that is the best eye donation campaign. One person can make a difference, that one person can change the way an entire community thinks; after all, it has to come from within a person."
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