New medical program could reduce organ trafficking

Saudi Arabia took a big step forward in seriously treating renal disease patient with an announcement earlier this week that a campaign has been launched that among other things publicizes a program that allows renal patients to be treated in villages instead of traveling to urban areas.

Prince Salman also announced that the program will include fund-raising efforts to help the Prince Fahad Bin Salman Charitable Society for the Care of Kidney Patients. Perhaps the most important aspect of the program is that the charitable society has developed a plan to make it easier for renal patients to obtain treatment.

Consider that two years ago the number of kidney patients, a great many suffering from diabetes, was pegged at about 8,500 in Saudi Arabia. That number has increased to 11,000 this year and is expected to jump to 15,000 by 2015. Diabetes accounts for as much as one-third of the country’s renal failure cases. Liver disease stemming from hepatitis also is expected to increase by as much as 10 percent
annually.

When I last wrote about treatment for renal failure in March, the Kingdom was facing a crisis with only a fraction of kidney transplants taking place. The King Faisal Specialist Hospital and Research Center, for example, performed 152 kidney transplants in 2008 with 96 kidneys taken from living relatives and 56 from deceased donors. An estimated 2,900 kidney patients were waiting for transplants.

The crisis is actually two-fold: Obtaining kidney donors for a transplant, especially from a deceased donor, is difficult in Saudi Arabia due to cultural issues. And if a transplant is not a priority, simply getting patients with few financial means from poor, rural areas to Jeddah, Riyadh, Madinah and Dammam is almost impossible.

My family is lucky. My mother, who must undergo dialysis several times a week, is treated in her hometown of Madinah or when she visits my brothers in Jeddah. Other families, however, must travel sometimes hundreds of miles for treatment. At one point, however, there was a discussion in my family whether a transplant was needed and whether that transplant should be performed abroad. But it’s a risky venture.
According to the India News, about 500 patients, mostly from the United States, had kidney transplants in India. We decided against the transplant, but other Saudi families don’t have the option or are desperate enough to seek illegal surgery outside Saudi Arabia.

Prince Salman’s fund-raising efforts for the charitable society is expected to aid patients at the end stage of renal disease to access treatment not usually available to them outside of urban areas. What I’m hoping for is that the program will minimize transplant tourism among Saudis who believe there are not enough options available in Saudi Arabia to save the life of a loved one. The society’s program
also could help minimize the conflicts Saudi Arabia is experiencing within the international medical community.

The World Health Organization (WHO) issued a plea in 2004 for countries to “to take measures to protect the poorest and vulnerable groups from transplant tourism and the sale of tissues and organs, including attention to the wider problem of international trafficking in human tissues and organs."

In 2008, “The Declaration of Istanbul on Organ Trafficking and Transplant Tourism” was established. The declaration defined organ trafficking as the “ recruitment, transport, transfer, harboring or receipt of living or deceased persons or their organs by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving to, or the receiving by, a third party of payments or benefits to achieve the transfer of control over the potential donor, for the purpose of exploitation by the removal of organs for transplantation.”

Many Saudis are reluctant to participate in transplant programs involving deceased donors. In addition, many Western medical experts are uncomfortable with Saudi Arabia’s policy of compensating families of deceased donors because it could lead to exploitation of poor expatriates and also encourage the commercialization of organ
donations.

Saudi Arabia’s medical community has addressed these concerns by arguing that the selection process of using an organ from a deceased donor and the resulting compensation to the family requires a thorough vetting process and is in compliance with our cultural and religious obligations. Prince Salman’s awareness program will educate Saudis about the options available to them and help reduce transplant
tourism. The program should also help bring acceptance that organ donations, whether from a living or deceased donor, is a viable option and acceptable in Islam.

As reported recently in the Saudi press, Grand Mufti Sheikh Abdul Aziz Al-Asheikh described the donation of cash for the awareness program and the donation of organs as not only acceptable but noble gestures.