It is now February 2011 and it has been exactly a year since MOHAN Foundation signed an MoU with the Government General Hospital Chennai to place its grief counselors there. The presence of our trained grief counselors has made a tremendous difference to the deceased organ donation programme in the Government General Hospital. From February 2010 to January 2011, the families of 54 brain dead patients were counseled about organ donation. 38 families said “Yes” to donating the organs of their loved ones (70% conversion rate). Even though solid organs could be retrieved only from 27 deceased donors (for medical reasons), the eyes were donated by the families of the other 11 deceased patients. The overall result was that 178 life-saving organs and tissues were donated. The organ were shared between different hospitals through the central registry of Tamil Nadu. Three of our counselors often worked round the clock and stayed with the families till the very end and sometimes even accompanied the body to their homes. The counselors maintained a case history of all the counseling that they undertook. The going was not easy as our counselors faced myriad issues on different fronts. As a first step in fulfilling this need, our counselors organized organ donation awareness initiatives for nurses. 106 nurses have been sensitized and they now carry donor cards. The crucial role that nurses play in the Trauma ward and in the Post Anaesthesia Care Unit has been recognized and the nurses have been felicitated for their contribution to the programme. The counselors also make it a point to emphasize the importance of organ donation to the ward helpers. There are many lessons to be learnt from their work in the Government General Hospital.

Some of these are enumerated below -

a. A lack of awareness about brain death and organ donation exists at almost every level in the hospital.

b. Amongst the medical and paramedical community a clear understanding about brain death declaration, certification, maintenance of a brain dead donor is required.

c. Shortage of equipment, manpower, delays in post-mortem are problems that continue to persist despite efforts at various levels

Organ donation does delay the handing over of the body to the families and 24-36 hours is the time period that is required. Maintenance in a brain death situation is another issue that requires specialized care and if this was possible the 70% conversion would have gone up to almost 90%. In a couple of situations the authority for consent was missing and in another two though the family agreed but because the cases were that of assault the central office decided not to proceed because of the medico-legal implications.

However all this would not have been possible without the support of the Dean, Medical Superintendent, Heads of the various departments and the RMO of the hospital. And, in the final reckoning, what keeps the grief counselors motivated are the families who consent to organ donation even in the midst of heartbreaking grief to help others live.