The decision to donate organs and tissues of a loved can be difficult during an emotionally traumatic moment in one’s life and those who are able to accept the inevitable end and say yes to donation, do it selflessly. There are no expectations in return for this noble act and this makes it truly a very gracious societal act of giving. The thought process of a grieving relative who faces such an unnecessary death of their loved one, but manages to let go off their roller-coasting emotions that can swing from anger to denial and still go on to say yes to donation is most remarkable.

Brain death in India, is tragic loss of a young life and the death is usually sudden and senseless. Most head injuries that lead to brain death are due to road traffic accidents and over 80% of such victims are between the age group of 20 to 40 years.

Currently only 13 of the 36 states and union territories have so far done deceased donation.  Of these only about 5 to 6 do it regularly and have a proper system for organ donation and allocation.  When we say India’s donation rate is 0.8 per million population (pmp), the bulk of the figures reflect the donations from these few states. If the program was to become pan-India this figure would be at least 10 times higher.

Most publications blame the low donation figure on the public’s ignorance and reservations on the subject as no proper in-depth analysis has ever been done on this subject. Let us understand if Indians are ‘giving people’ and let us move away from solid organ donation rates and look at two other donations that are more popular in India - eye and blood donation.

India’s eye donation rate was around 29 pmp in 2017 - 2018 and 69,343 eyes were donated.   Most donations come from homes and are voluntary when a relative of the deceased calls the nearest eye bank. We only have around 370 eye banks in the country and most are located in the urban tier-one or tier-two cities.  The majority of the population living in 600,000 villages has no access to such an eye bank or collection centre. The states that do bulk of organ donation also do most of the eye donations. This means that the eye donation rate of 29 pmp reflects donation from approximately only 30% of the population that lives in bigger towns and cities. If access was available, this figure could easily become over 90 pmp. India has one of the largest home eye donation programs in the world.

Next let us look at the blood donation rate. Almost 1% of our population donates blood and, in 2015, 11,645,791  units  of  blood  were  donated.    This figure again is from about 30% of the Indian population that has access to blood banks and hence donation. This again could escalate to over 30 to 40 million.

Although organ donation is the most difficult and complex of all the three donations, in the last six years about 3100 families have said yes to donation and over 9100 organs and tissues were donated (2012 – 2017).2  Most donations come from ordinary people who have the extraordinary conviction and courage to say yes to donation despite their own personal loss.

At MOHAN Foundation we have always believed that the Indian public is willing to consider organ donation and this fact is firmly instilled during the training of transplant coordinators undertaken by the Foundation for the last 10 years. Most who work in the hospitals take up the difficult organ donation conversation with confidence and without any prejudice. The conversion rate of such trained coordinators is 66% in some of the hospitals in Tamil Nadu. The donations have come from the poorest of the poor and the richest of the rich. Many who have donated had never heard about brain death and organ donation before, and what mattered was supporting the families in their decision at the time of such grief.

As we celebrate 25 years of the Transplantation of Human Organs Act that was passed on the 8th of July 1994, we Indians should be proud that we are a giving nation, be it blood, eye or organ donation. Let us strengthen our trauma services in the hospitals, get more states and union territories to start deceased donation and improve our donation rates so that we can help many of the patients who wait for a life-saving organ.

Although organ donation is the most difficult and complex of all the three donations, in the last six years about 3100 families have said yes to donation and over 9100 organs and tissues were donated (2012 – 2017).  Most donations come from ordinary people who have the extraordinary conviction and courage to say yes to donation despite their own personal loss.

At MOHAN Foundation we have always believed that the Indian public is willing to consider organ donation and this fact is firmly instilled during the training of transplant coordinators undertaken by the Foundation for the last 10 years. Most who work in the hospitals take up the difficult organ donation conversation with confidence and without any prejudice. The conversion rate of such trained coordinators is 66% in some of the hospitals in Tamil Nadu. The donations have come from the poorest of the poor and the richest of the rich. Many who have donated had never heard about brain death and organ donation before, and what mattered was supporting the families in their decision at the time of such grief.

As we celebrate 25 years of the Transplantation of Human Organs Act that was passed on the 8th of July 1994, we Indians should be proud that we are a giving nation, be it blood, eye or organ donation. Let us strengthen our trauma services in the hospitals, get more states and union territories to start deceased donation and improve our donation rates so that we can help many of the patients who wait for a life-saving organ.