PRATIBHA RAWAL
KATHMANDU, March 7: Two weeks ago, Yugeen Thapa, 18, died of cardiac arrest soon after he was admitted to Bir Hospital.
While still grieving the untimely death of his son, Rajendra Thapa, Yugeen´s father, contacted Tilganga Institute of Ophthalmology (TIO), which runs Nepal´s only eye bank, and asked them to collect the corneas of his dead son.
Thapa, who lives in Gatthaghar of Bhaktapur district, said he is proud that the corneas removed from his departed son´s eyes have helped at least two blind people see the world.
“My son wanted to donate all of his organs,” shared Thapa. “As per his own wish, we wanted to donate not only his eyes but all of his body parts for the benefit of those who needed them. However, due to lack of time, only his eyes could be donated.”
Thapa is more of an exception than norm when it comes to donating body organs of a dead family member.
Yugeen Thapa
Many people are still hesitant to donate even the corneas of their departed relatives. Even the otherwise charitable people shy away from donating their or their family members´ eyes which could help blind people see the world.
There is a huge gap between the demand and the supply of corneas. The rate of cornea extraction is far less compared to the people awaiting cornea transplants. In many cases, even the corneas of people who would have agreed to donate them are lost in lack of proper communication at the time of their death.
To reduce this gap between the demand and the availability of corneas, the TIO launched a cornea-collection campaign two months ago. As part of the campaign, five well-trained counselors have been deployed at two major public hospitals of Kathmandu. After the death of a patient, counselors try to persuade the family of the deceased into allowing them to extract corneas of the dead.
The TIO has currently stationed counselors at Bir Hospital and Tribhuvan University Teaching Hospital (TUTH) as part of the cornea-collection campaign. Shankar Narayan Twayana, Manager at the Tilganga eye bank, says they chose Bir and TUTH for the campaign as they are two of the most-visited and less expensive hospitals in the Kathmandu Valley. "Hundreds of people come for treatment at these two hospitals and it is natural that more people would die at the hospitals than elsewhere," explains Twayana. “That is why we have deployed counselors at the two hospitals."
According to Twayana, in the first two months of the campaign its counselors have collected as many as 87 corneas. “It´s a great success," said Twayana. "Had we not organized the campaign, we could not have collected so many corneas in such a short period.”
At the end of 2012, the Tilganga Eye Bank had around 300 blind people in the waiting list for corneal transplantation.
“One third of the people in that list have already got eyesight,” says Twayana. "More people will get corneal transplants in the days to come."
Counselors deployed by the Tilganga Eye Bank said their aim is not just to collect corneas but also to raise awareness about eye donation. “This campaign is dedicated not only to decrease the number of people in need of cornea but also to clear the misconception about eye donation,” shares Suraj Gautam, a counselor.
“Many people still think that eye donation involves pulling out the eyeballs, which is not true,” says Gautam. "We do not remove the eyes from the dead people. In fact, we just peel off the layer of corneas from the eyes."
If the counselors are able to persuade the family of the dead to donate eyes, they contact the experts at the Tilganga Eye Bank, who then reach Pashupati cremation site to extract the corneas.
According to Gautam, they have so far collected 34 corneas from Bir Hospital and 44 corneas from TUTH as part of the campaign. "Doctors, nurses and all hospital staff have been supportive,” he said. "Without them our campaign would not have been so successful. They instantly inform us if anyone dies at the hospital.”
Ram Pyari Karki and Suraj Gautam persuade families of dead for eye donation.
Rama Silwal, in charge of nurses at Bir Hospital, said the campaign is very important because it tries to utilize the corneas which ultimately get burnt along with dead bodies. “This campaign should have been launched years ago," she said. “Patients die almost every day at the hospital. Had the campaign been launched earlier, a lot of people would have benefited by now.”
Persuading the families to donate the eyes of their dead relative is certainly not an easy task. “We meet different kinds of people," said Ram Pyari Karki, another counselor, "Sometimes it´s very difficult to convince them."
Karki said the smile on the face of blind, who become able to see the world after corneal transplants, is what motivates them to go on. “Whenever we see the blind get the eyesight, our happiness knows no bounds," says she. "It is what keeps us going."
Five hindrances for eye-donation
-A significant number of people with corneal problems are in their seventies, which means that restoring their eyesight by transplanting functional corneas in their eyes is usually not possible. Technical experts at the Tilganga Eye Bank say corneal transplant is not useful for people below five years of age or above 75.
-Some people still believe that they would be blind in their next life if they give away their eyes in this life. Such people do not want to donate their eyes.
-Some people belonging to higher-caste don not want to donate their eyes to people belonging to the low-caste. They say they will donate their corneas only if the Tilganga Eye Bank ensures that they are not given to the low-caste people.
-Many deaths that take place at hospitals are police cases, in which it would be impossible for counselors to get corneas. Also, police do not allow the Tilganga Eye Bank to extract corneas from the eyes of dead people whose families cannot be contacted.
-Extracting corneas from those with HIV, cancer, hepatitis, kidney failure, burns and jaundice is fraught with risks.
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INTERVIEW
We are expanding cornea collection campaign
Shankar Narayan Twayana
Manager, Eye Bank
Tilganga Institute of Ophthalmology
How is cornea collection campaign going on?
It is going great. Our main goal is to give eyesight to as many blind people as possible and this campaign has been a success to a great extent. After we launched the campaign, many blind people have got eyesight. I hope people suffering from corneal problems will not have to wait for years go get eyesight in near future.
How difficult is it to get the families to donate the eyes of their dead relative?
In the early days of the campaign, our counselors faced multiple challenges. They have to maintain good relations with everyone at the hospital. By now they have already turned the situation in their favor. They have been getting full cooperation from doctors and nurses. We organize trainings for our counselors every 15 days, which refreshes their skills.
How long will this campaign continue?
The campaign has a long way to go. The outcomes have been impressive as we have collected more corneas through it. We are planning to expand the campaign to other hospitals. In near future, we will send our counselors to other hospitals like Kathmandu Medical College, Patan Hospital and Nepal Medical College Teaching Hospital.
