'Burn what is left of me and scatter the ashes to the winds'
Give and let live, seemed to be the uplifting theme on a dark, rainy afternoon at the Indian Merchants Chamber (IMC) Churchgate, recently. The Walchand Hirachand Hall on the fourth floor of the building, was the venue for Rotary International Dist. 3140’s meet, for the inaugural function of their Skin Donation Awareness Week.
The meet was hosted and supported by Rotary Club Bombay North, with a slew of other Rotary clubs co-hosting the programme. Though the focus was skin donation, the meet had a raft of experts and doctors speaking on the larger subject of organ donation, with some speaking specifically on skin donation.
The programme anchor or Master of Ceremonies as the introductory sheet citing Dr Sunil Keswani, cosmetic surgeon and Director, National Burns Centre, described him, took over as the seminar began post a tea session. Citing statistics that made India look poor compared to other nations when it came to organ donation “pathetic” was the word used by Dr Keswani about the numbers, he introduced Dr Pragji S Vaja of Tarun Mitra Mandal (TMM) as first speaker.
TMM is a Mumbai-based (Chinchpokli to be precise) Non Governmental Organization (NGO). Dr Vaja spoke about, “the power of youth being the power of tomorrow,” pointing to, TMM’s four-decade old journey on the path of donation. Of this, blood donation shone like a jewel in the Mandal’s crown. “We collect 12,000 units of blood in a year,” said Dr Vaja, adding that they also have a robust eye donation awareness movement, launched on August 15, 1997. “Our slogan was: ‘Blindness, Quit India’ in keeping with the Independence Day theme. Now, of course, skin donation is the need of the hour. Skin is the organ which stands between the human and the outside world.”
Dr Vaja then described the modus operandi of creating donation awareness. His statement, “Nearly 80 per cent of organ donation is done by the Gujarati Jain and Kutchi community,” evoked applause. An important point he made was enlisting religious heads to appeal for organ donation.
Talking about the power of youth, it was children as the theme for next speaker, Meera Isaacs, who spoke from an educationist’s perspective. Isaacs, who is the principal of Cathedral & John Connon School in South Mumbai, confessed that she really knew nothing about skin donation but it was a subject that had intrigued her. “A couple of weeks ago, we had actor Swaroop Sampat come to our school in connection with school plays. She told me she was the brand ambassador for skin donation, this further piqued by interest in skin donation.” Isaacs stressed that educationists’ need to be very sensitive when dealing, “with children ranging from 5 to 13 years. You need to show you care and really reach out to them. We also spoke about this to slightly older children in senior school at assembly and most of them were very moved at stories of young ladies being disfigured by acid attacks.” Isaacs emphasized “gentleness” while dealing with the issue. Isaacs added, “why only children? Even grown-ups are afraid of donation. I remember 30 years ago, I pledged my eyes and got a donor card. I told my husband who was aghast that I had pledged my eyes. He did not rest till he had taken my card and destroyed it. I told him this was very childish!” The anecdote had the audience laughing.
Isaacs continued that just recently she pledged all her organs, “what need do I have of them, after I am dead?” she asked rhetorically and said, “when I informed my friend, she told me, no, no don’t do that, but I asked her, why not?” Through all that, Isaacs did say that though much needs to be done, attitudes have changed and some awareness had seeped in. “When I told my husband this time that I have pledged my organs, his response was, ‘I want to pledge them too’,” she said this time greeted by more laughter. Isaacs added that this is one way of realizing that the world is much bigger than our individual selves. She also reminded the audience that as educationists, they could sensitize children to the issue, “but we can tap parents of children who can be a huge bank for donation. Of course, I am not leaving out the teachers too. All of us must walk the talk.”
It was all eyes (pun intended) on renowned ophthalmologist Dr Queresh Maskati who had a crisp ‘n’ crackling presentation aided with slides on eye donation. Dr Maskati stated, “Lots of people are awaiting eyes, right now the numbers donating are peanuts.” He then explained the logistics of donation, illustrating his points with diagrams on slides and said that the success rate is a rousing, “more than 80 per cent.” The doc stressed that, “The eyes must be removed up to six hours post death and the earlier, the better. It is good to keep the eyes cool. There is also no need to transport the body to a clinic or hospital. The team comes home.” Dr Maskati then made a valid point that often, “a person has pledged his eyes, but, when the team arrives at the residence post death, it is met with stiff resistance or rebuffed by the family. The family simply refuses to honour the pledge. That is why it is of utmost importance that the person who has pledged must tell the family that he has pledged his organs, and his wishes must be honoured.”
This point was a common thread in the seminar, with several speakers stressing the importance that relatives must know and respect the wishes of the person who has pledged. Dr Maskati infused humour into a sombre topic by talking about a former governor of this state who had pledged for donation. “The team reached his home after learning about his death, only to be driven away by his wife who refused to donate the organs. In such cases the donor card has no meaning.” Dr Maskati also stressed, “No holy books forbid organ donation.” Since time is of importance in donation, Dr Maskati said it is vital that the team is able to access the home in time. “Give the team proper directions,” he said. “Once, we got an address and the landmark was, there is a bhajiwalli selling fresh dudhi (pumpkin) on a cart outside the home. It’s not such directions but immovable landmarks that we need,” he said, evoking laughter from the audience.
Skin was the focus of Dr Madhuri Gore’s (ex-professor, surgery, Sion Hospital) presentation. Dr Gore stated that levity had its place but here, “the audience may be in for some serious talk, knowing that this is a heavy topic. We had the first skin bank and for the first five years we had to run awareness programmes. I would say that people should not rely on doctors to counsel families but have trained counsellors for the subject. Today, awareness is growing slowly but surely. We have already crossed 100 donations this year.”
Dr Gore too spoke about how those who pledge have to convince relatives that their wishes be honoured, rather than simply make a pledge and leave it at that.
With so much emphasis on the C and D — Convince (relatives) and Donate — it was apt time for Zonal Transplant Coordination Center (ZTCC) Transplant Coordinator Dr Sujata Asthekar to step in. The coordinator facilitates convincing relatives to go ahead with the donation.
Dr Asthekar made a case for donation in the case of brain death. “Brain death can only occur in the Intensive Care Unit (ICU). Being in a vegetative state or deeply comatose is not the same thing as being brain dead. All brain dead persons are deeply comatose but not all deeply comatose patients are brain dead,” she explained. In fact, she added, “Denial is very common in the case of brain death. Yet, relatives must understand that brain death is death, there is no chance of coming back. Take this message home.”
Dr Asthekar added that there is a myth that, “If we pledge a certain organ and then it is donated after death, one is reborn without that body part in the next life. All these are baseless fears and misconceptions.” She wound down with, “Just like we have a pan card, debit/credit cards and driving license in our wallets, maybe, it is time we have a donor card too.” Putting the final moving flourish on her presentation, she quoted a poem by American Robert Noel Test called, ‘To Remember Me — I Will Live Forever’ (see box).
With those poetic words still ringing in several ears, Dr Samir Shah (gastroenterologist, Global Hospital) was last up speaking about the complex issue of liver transplant.
“Several people want to donate but do not know ‘how’ to do so, how to pledge their organs, how to go about it,” he said. He gave the example of a patient who was now hale and hearty after a liver transplant post an operation where he had a tumour on the liver. “He (Mr. Panjabi) looks like he did more than 10 years ago, while I have aged,” he joked, showing slides to the audience. “He now uses his time to counsel people about donation. In fact, when he was diagnosed with his ailment and we had suggested a liver transplant, he had come to me and told me: ‘doctor, I have wound up my business. I am ready to die’. I told him, a transplant is for you to live, not to die.”
Dr Shah also said that the liver is one of the organs which one can donate even when alive. “It is safe to give one part of the liver. It has the capacity to re-grow.” Dr Shah also added that, “cadaveric (brain dead) transplant has not come of age in India. We need to catch up with the rest of the world.”
With that, two hours seemed to have melted away for the audience who were taken through an evening that went the full arc — from awareness, to how to ensure that one’s pledge is actualized.
>> Only a thin layer of skin from the thighs and back is taken.
>> There is no disfigurement.
>> No bleeding.
Potential candidates for donation
>> Over 18 years.
>> No skin disease.
>> No HIV/Hepatitis ‘C’.
>> No skin cancer.
>> Call 24-hour Burns Helpline No: 27793333 within 6 hours of death.
>> A skin recovery team will reach the home of the deceased within 2 hours.
>> Skin will be harvested from thighs and back in about 45 minutes.
>> The donor area will be bandaged properly and then handed over.
>> Keep death certificate ready.
See website: www.burns-india.com for more details
Remember Me: I Will Live Forever’
Give my sight to the man who has never seen a sunrise, a baby’s face or love in the eyes of a woman.
Give my heart to a person whose own heart has caused nothing but endless days of pain.
Give my blood to the teenager who was pulled from the wreckage of his car, so that he might live to see his grandchildren play.
Give my kidneys to the one who depends on a machine to exist from week to week.
Take my bones, every muscle, every fiber and nerve in my body and find a way to make a crippled child walk. Explore every corner of my brain.
Take my cells, if necessary, and let them grow so that, someday a speechless boy will shout at the crack of a bat and a deaf girl will hear the sound of rain against her window.
Burn what is left of me and scatter the ashes to the winds to help the flowers grow.
If you must bury something, let it be my faults, my weakness and all prejudice against my fellow man.
Give my sins to the devil.
Give my soul to God.
If, by chance, you wish to remember me, do it with a kind deed or word to someone who needs you. If you do all I have asked, I will live forever.’