Genesis

Of all the causes of accidental deaths, be it natural or unnatural, traffic accidents were the cause of 37.4% deaths in India for the year 2014 (National Crime Records Bureau 2014). Tamil Nadu has reported the maximum number of road accidents (67,250 cases). 26.4% of all accidents involved ‘two wheelers’. For the same year there were 136 cases of multi-organ donation (Indian Transplant Newsletter – Issue No.43).

The police play an integral role in multi-organ and tissue donation. They have to identify the accident victim and verify that the family consent is bona fide. They are responsible for investigating and providing accurate determination of the cause and manner of death for each case. It is for this reason that a post-mortem becomes an important tool for their investigation.

MOHAN Foundation has been working closely with the Rajiv Gandhi Government General Hospital, Chennai which receives accident cases from nearby districts. In case the family agrees to donation, the police are requested to come to the hospital for completing the inquest. Here the counsellors faced a major hurdle – the investigating officers from mofussil towns were unaware of the concept of brain death, resulting in delay to start a donation.

Process

To overcome this roadblock MOHAN Foundation worked closely with the police conducting meetings and consultations at the highest level. Mr. K. Ramanujam, Advisor to the Government of Tamil Nadu initiated the process. At a meeting of MOHAN Foundation staff with Mr. T. K. Rajendran, ADGP, Law and Order, Mr. K. Mahendran, ADGP, Training, Mr. Ashok Kumar, DGP, Law and Order, Dr. J. Amalorpavanathan, Member Secretary, Transplant Authority of Tamil Nadu (TRANSTAN) and advisors many of these issues were discussed. It was felt that while the present Government Orders (GOs) and directives were enough to ensure smooth coordination, what was lacking was the awareness about brain death and the limited timeframe to complete the coordination. This resulted in the nomination of a senior state IPS officer as a Nodal Officer for Organ Donation along with the control room.

 The State Police invited MOHAN Foundation to conduct a Training of Trainers (TOT) on the ‘Role of Investigating Officer in Organ donation and Brain Death’. The first TOT was held at the Police Training College in Chennai in May 2015 followed by another in July 2015. The core of the training was explanation about brain death, law, GOs and Police Circular Rc No 21421/Crime(1)/2009 and process of a multi-organ donation. Case discussions illustrated different scenarios. Practice sessions and role plays done by the trainees were critiqued by others. Audio-visual aids in the form of presentations and videos were also included. MOHAN Foundation has also conducted sessions at the in-service training centres in Chennai, Vellore, Villupuram, Thiruvallur and Kancheepuram. Till date around 700 staff of Tamil Nadu police has undertaken the training. A poster designed by MOHAN Foundation will be a part of the curriculum. These interventions have already showed some impact in past three cases – the police investigating officer had been given intimation about a multi-organ donation medico-legal case from the control room.

Future plans

MOHAN Foundation aims to translate parts of the training module into Tamil. We plan to continue with the training sessions at Police Training College.

- Dr. Hemal Kanvinde