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Say YES to EYE donation
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How many of us have the strength to look beyond our grief? Eye donation has yet to catch on.
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IF YOU think you are doing a good deed by pledging your eyes on paper, you think wrong. You need to take a reality check for the odds are against it happening.
The wide gap between the need and availability (demand supply ratio) in obtaining corneas for treatment as compared to the vast requirement is fast becoming a significant problem in the State, especially in Thiruvananthapuram. The lack of awareness regarding eye donation and the willingness to pledge the eyes has led to the unavailability of corneas in the eye banks of Thiruvananthapuram.
For instance, the eye bank at the Ophthalmic Hospital, near the General Hospital, has a team on call 24-hours a day, waiting for that elusive `eye donation call' that rarely comes in. "There have been weeks when we don't get a single call. There have also been times when we have responded to eye donation calls and return empty handed because just one member of the deceased's family has objected to the eyes being donated," says Dr. Chitra Raghavan, who is in charge of the eye bank. 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 this means bad news for the thousands of visually impaired awaiting a donor.
It is the lack of public awareness that has many people balking at the prospect of donating eyes. Dr. K. G. B. Nair, director, the Chaitanya Eye Hospital in Thiruvananthapuram, says, "Lack of motivation is one of the main reasons why people hesitate to come forward." Once a person is dead the body ceases to be his, it belongs to the next of kin. Often, the kith and kin of the deceased fail to honour the declaration of the prospective donor. "Creating awareness is the only solution to overcome this problem," says Dr. Nair. "The reason for the hesitation are mainly emotional; in some cases it is religious beliefs," says Dr. Susheela B. Nair, director and superintendent of the Ophthalmic Hospital.
Most people are unaware of the significance of the cornea to a corneal blind person and hence have reservations about donating eyes. Doctors and social workers in the city attribute the lack of awareness and misconceptions about the medical process involved in retrieving the cornea to unscientific beliefs. This proves to be a major deterrent in cornea retrieval programmes and campaigns for eye donation. "The primary misconception is that the eyes are `pulled out' and there would be a hole. People consider this as tantamount to mutilating the body. This is a wrong notion," says Dr. Chitra. The process by which the corneas are taken out is called `enucleation', and is carried out in a manner to avoid the so-called `mutilation'. "If the whole eyeball has to be taken out, it is replaced with a plastic one. After the procedure, the eye is sewn up with an invisible suture. The face looks the same, with no visible signs of `enucleation'," says Dr. Chitra.
Religious beliefs or the fear that the body would be defiled prevents people from giving their consent for the donation of the eyes of the deceased. The Ophthalmic hospital sends teams for `enucleation' to other hospitals and homes that inform the hospital about a death.
Another notion harboured by people is that all forms of blindness can be cured through a corneal transplantation. However, this is not so, says Dr. N. Pravada, RMO of the Opthalmic Hospital.
For instance, cornea retrieved from people who succumb to diseases such as HIV/ AIDS, hepatitis, and cancer cannot be harvested. The suitability of donor eyes also further narrows down the possibility of harvesting cornea to restore sight in the corneal blind. "People donate the eyes of a deceased elderly member without any hesitation. We welcome it but suitability is our prime concern," says Dr. Susheela. The cornea of a 65-year-old individual cannot be used to help restore vision to a 20-year-old with corneal blindness. "It is limiting in that sense." However, corneas are retrieved from persons succumbing to accidents, though these are few in number. "It is not possible to ask parents to donate the eyes of their child." Yet, there have been instances in the past when parents have come forward on their own accord to donate their child's eyes. "This is quite rare," says Dr. Susheela.
The trauma unit at Thiruvananthapuram's Sree Chitra Hospital has `grief' counsellors who counsel and console the family members of those who are on their deathbeds. The `grief' counsellors prepare the family for the inevitable, if it were to happen. These counsellors also make an effort to convince the kith and kin about eye donation and how their decision could offer a vision of hope to those with corneal blindness.
Hospitals in India do not have their own cornea retrieval program because of the medico-legal implications. Thus, the demand for healthy cornea keeps increasing. Earlier, corneas were `imported' from Sri Lanka and were donated by the Buddhists. However, the strife in Sri Lanka country has rendered it infeasible. Now, hospitals in Thiruvananthapuram such as the Ophthalmic Hospital and the Chaitanya Eye Hospital depend on Angamaly's Little Flower Hospital to meet the demand for corneas. The Little Flower Hospital is said to have the State's best eye bank.
On the flip side, the eye banks in Thiruvananthapuram run short of `stocks'. K. P. Balaji, who runs the Kochi-based voluntary organisation `Abhayam', points out that there is no shortage of donor eyes in Kochi. "When `Abhayam' started the eye donation program (in 1980) we did not get any corneas, until 1988. But soon things changed. Ninety-nine per cent of the eyes that we get are not `officially donated', eyes pledged on paper."
Campaigns on eye donation and increased awareness gradually changed the mindset of the populace. "Today people call us at `Abhayam' and inform us of the death and express their desire to donate the eyes of the deceased," says Balaji.
The Ophthalmic Club of Cochin, IMA and the Rotary Club have formed `Naina Eye Bank'. The Little Flower Hospital's self-sufficiency is seen as an effective propaganda for eye donation. "The success of its eye bank besides other factors, also demonstrates how religious leaders such as Preists can play an active role in spreading the message," says Balaji.
Eye donation is the only way you can help someone after your death. Children too, should be made aware of its importance.
Dr. Pravada is of the view that concerted efforts to promote eye donation is imperative. Voluntary organisations and residential associations could play a key role in spreading awareness, say Balaji and Dr. Nair. "The mindset of the people has to change. If a person is willing the family should also respect their wishes," says Dr. Nair.
Says Balaji, "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 possible. One person can make a lot of difference, that one person can change the way an entire community thinks; but it has to come from within a person."
SHILPA NAIR
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