You take my heart away

  • 27/02/1998

It's a man's life they say. Join up and see a man's world, for even when it comes to kidney transplants men have the cake and eat it too. Are the new technologies that are coming up anti-women or is it a question of male behaviour?

This strange pattern of organ donation and transplants has been evident ever since organ transplants began in the All India Institute of Medical Sciences (aiims). Men are perceived as the breadwinners in the family, and because they bring home the bacon, they get the kidneys too.

Of the 378 patients who benefited from such life enhancing procedures since 1972 when the first operation was carried out at aiims almost 84 per cent were men. In contrast women, mainly mothers of the affected men, made up 57.5 per cent of the kidney donors. A paper by Sanjay K Aggarwal, consultant nephrologist at aiims presented at the 10th annual conference of the Indian Society of Organ Transplantation held recently in New Delhi and a study conducted by the Sanjay Gandhi Post Graduate Institute of Medical Sciences in Lucknow highlights this issue of age and gender bias in organ transplants.

In the case of heart transplants the issue is more clearly spelt out. All the six beneficiaries of heart transplants at aiims have been men and the first not surprisingly received a woman's heart.

The message behind the study is all too clear. There is a deep-rooted bias against women and even in a case where a woman is critically ill no real effort is made to find a kidney or heart for her. In such matters society in the northern Indian states can be quite heartless. Even young unmarried girls are discriminated against on the grounds that they won't get married and it would be useless to invest a heart or kidney in them.

The figures are shocking. Ever since kidney transplants began at aiims only the husbands of two women have had the heart to donate their kidneys to further the lives of their wives.

Women in Indian society therefore are sandwiched between carrying the cross along with men when there is a failure in the health care delivery system and they have to suffer alongside their spouses and a general reluctance on the part of society to take care of them if something were to go wrong with the status of their health. But this is nothing new. It is not as if women are suddenly being sacrificed at the altar of the new gods of health care. Long deified as goddesses and confined to kitchens, women have always been the pack animals of Indian society, carrying the burden of the tribe.

On an average a village woman in India treks over 1,500 km, the distance from Delhi to Bombay a year just in search of firewood to cook food for her family. Young girls become assistants to their mothers even before their teens in poor homes and the boys get to go to school. The female child is even discriminated against in the diet she gets as compared to her brother and a girl is usually looked upon as a unwanted burden or the sins of a previous life, something that must be disposed off at the earliest. Given such a mindset it is not surprising that women are discriminated against when it comes to matters pertaining to hearts and kidneys.

Advances in medical science in such a society are bound to have some ill effects upon women. The most glaring example of its kind is the sex determination test which forces women to put an end to the foetus if it was found to be female, under pressure from a male dominated society. But while the government could ban the sex determination test, can the government check the rampant bias in organ transplants and restrict the number of women donors. It obviously cannot. The parameters involved are too complex and too frightening. The social positions too hardened to be softened overnight.

Perhaps what Indian men need is education and of the right kind too. The unnecessary bias against receiving organs from brain dead persons and accident victims should be done away with. This is a potential source of organs in the country. Otherwise the introduction of new technology in the field of medicine will in such a situation end up converting it into an anti-women technology. Not because the science is good or bad, but the intent of those who use that science is questionable and the way it is used is bad.

Of the one lakh chronic cases of renal failure reported at aiims every year about a half are women. With at least 50,000 people dying every year just sitting around waiting for a kidney the gender bias makes things tougher for women. A women needing a transplant often doesn't make it to the hospital. For what awaits her there is no need to.

The moral of the story is simple. If a woman needs a heart or kidney medical science cannot help her as the donors are simply not available and if a man needs a transplant there is always a woman around to take care of it. In the ultimate analysis the universal donor is a woman. Women don't just give birth. They donate organs as well.

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