:o Here was a shocker.

[Rona LD]

I've been asking a lot of questions.
Private sector and State.

I have been enquiring as to being a Living Donor for a Non-related person. Was fully prepared to go via a state hospital.


The quote I received;

"A Living Donation to a Stranger/Unspecified Recipient.
In many countries you can donate an organ to an unspecified recipient as a living donor. These organs get allocated to a patient on the waiting list and often this organ is used for a domino transplant where there is a list of people with living donors who are not the same blood group or have antibodies agains each other. This type of donation requires quite a lot of logistics, as the idea is that it should be allocated very equitably with the maximum chance of success.
In South Africa this type of donation has not happened up to now, mostly because we have both state and private patients on the waiting list and we do not feel happy to only have this system available for private patients.
Many altruistic non-directed donors do not want to have an operation done in the state sector and this makes it logistically a big problem.
Even if all such donations would be done in the state sector, it still requires significant vigilance and surveillance and a policy in place to protect the living donors (and their identity) as well as a policy to protect the health care workers, as it is a high-risk procedure from a medico legal point of view.
At this point in time such a policy has not been made available by the Dept. of Health. If this is not in place, it is impossible for us to offer you a service where you either donate a kidney to an unknown recipient or in any other way where you and the donor are not known to each other."

Here is how I would do it.

Have a list of people who are prepared to donate, state/private. Whatever they choose. Keep all their details. And the next person on the recipient list that matches up to a Living Donor on the Living Donor list gets partnered up. Is it that difficult?

In my mind, it is, then fair and square and no one is cheated. 

I can not be the only person in RSA who is willing to be an "anonymous/non-related" Living Donor?

Yes I know first hand the issues of state hospitals in RSA, but come one, we have one awesome state hospital that was used for the first Heart Transplant in the world..

Well, this is just my opinion. My thoughts on the matter.
 
Somehow change must happen, to change to odds...

[Fr Pat]

Dear Rona,
      I donated a kidney to a stranger in the U.S. 13 years ago, but I don't know anything about the situation in South Africa. However I will pass along this experience in case it might be helpful:
       About 12 years ago Tom Falsey wanted to donate a kidney to a nephew in the U.S. He passed all the tests and the surgery was scheduled. But at the last minute the final cross-match failed and he was eliminated as a donor for him. Fortunately another relative came forward and the transplant was done. But by now Tom ws very aware of the shortage of donors, and knew very well that he was a good candidate to donate a kidney. So he approached the hospital and offered his kidney to whoever they might pick from the waiting list. But at that time such a thing was still uncommon, and the hospital had no procedures in place to handle such a request.
     Rather than give up, Tom offered to work with the hospital staff to develop a program for non-directed donors. It took a couple of years to investigate the practices of other places and iron out the details, but finally the hospital was able to establish its set of norms, requirements, safeguards, etc. for non-directed donors, and Tom was the first one to donate a kidney there.
     So perhaps in your situation you might approach one transplant hospital ( or even one doctor) and offer to work with them to develop a program, even if it took time? Or perhaps through your contact with one hospital they might agree to let you meet a suitable matching patient and offer a kidney person-to-person? I don't know, but perhaps you might be able to develop something.
       best wishes,
          fr. Pat

[Rona LD]

Hi Pat

Ta for the input! Its so good to hear of progress.
Well done to Tom, woo hoo! We need more people like him huh.

I'll give you a bit of insight.
(Its a bit of a long one)

Unfortunately here in "good 'ol SA" there is only 1 transplant list for the entire country.

The current percentages for transplants is less than 0.2%.

Current transplant centres in South Africa.

BLOEMFONTEIN

Universitas Hospital – (State)
Transplant Programme:
Kidney – adults

Netcare Universitas Hospital (Private) 
Transplant Programme:
Kidney – adults

CAPE TOWN

Netcare Christiaan Barnard Memorial Hospital - Netcare (Private)
Transplant Programmes:
Kidney – adults 
Heart – adults and paediatrics

Netcare UCT Private Academic Hospital Netcare (Private)
Transplant Programmes:
Kidney – adults
Heart – adults

Groote Schuur Hospital – (State)
Transplant Programmes:
Kidney - adults
Liver - adults 
Heart - adults

Red Cross War Memorial Children’s Hospital – (State)
Transplant Programmes:
Kidney – paediatrics 
Liver  - paediatrics
Heart - paediatrics

Tygerberg Hospital – (State)
Transplant Programme:
Kidney – adults

DURBAN

Inkosi Albert Luthuli Hospital – (State)
Transplant Programme:
Kidney – adults

Entabeni Hospital – Life Healthcare (Private)
Transplant Programme:
Kidney – adults

Ethekwini Hospital & Heart Centre
Transplant Programmes:
Heart – adults 
Lung – adults 
Heart / Lung – adults

Netcare St. Augustine’s Hospital – Netcare (Private)
Transplant Programmes:
Kidney – adults 
Heart – adults

JOHANNESBURG

Charlotte Maxeke Johannesburg Academic Hospital – State

Transplant Programmes:
Kidney – adults and paediatrics
Adult Simultaneous Kidney/Pancreas – adults

Netcare Garden City Clinic – Netcare (Private)
Transplant Programmes:
Kidney – adults
Adult Simultaneous Kidney/Pancreas – adults

Netcare Milpark Hospital – Netcare (Private)
Transplant Programmes:
Kidney – adults 
Heart – adults
Lung – adults
Heart / Lung – adults and paediatrics
Simultaneous Kidney/Pancreas – adults

Wits Donald Gordon Medical Centre (Private)
Transplant Programmes:
Kidney – adults and paediatric
Kidney / Pancreas - adults
Liver – adults and paediatric

PRETORIA

George Mukhari Hospital – (State)
Transplant Programme:
Kidney - adults

Netcare Jakaranda Hospital – Netcare (Private)
Transplant Programme:
Kidney – adults

Pretoria Academic Hospital – (State)
Transplant Programme:
Kidney- adults

EYE BANKS

Eyebank Foundation of South Africa (Cape Town)   
Gauteng Cornea & Eye bank (Johannesburg)     
KwaZulu-Natal Cornea & Eye Association (Durban)   
Goosen Eyebank (Port Elizabeth)
Transplant Programme:  
Corneas – adults and paediatrics

TRANSPLANT STATISTICS:

In South Africa in 2013:

There were 566 organ and cornea transplants.
335 of these were solid organ transplants broken down into the following:
Hearts: 25 adults
Lungs: 7 adults
Livers: 37 adults , 2 adolescents & 16 paediatric of which
1 adult & 8 Paediatric were live related
Simultaneous kidney/liver: 1 adult & 1 paediatric
Kidneys: 222 adults, 4 adolescents & 3 paediatrics of which:
77 adults, 4 adolescents & 3 paediatric transplants were live related
24 adult kidney transplants was live non-related
36% of kidney donors were related to the recipient
Simultaneous kidney/pancreas: 6 adults
Pancreas: 1 adult
Pancreas after kidney: 3 adults
231 adults, adolescents and children had their sight restored through a cornea transplant.

In South Africa in 2012:

There were 573 organ and cornea transplants.
319 of these were solid organ transplants broken down into the following:
Hearts: 24 adults & 3 paediatrics
Lungs: 8 adult
Livers: 28 adults , 3 adolescent & 4 paediatric
Simultaneous kidney/liver: 2 paediatrics
Simultaneous kidney/pancreas: 8 adults
Pancreas after kidney: 1 adult
Kidneys: 213 adults, 14 adolescents & 11 paediatrics of which:
83 adult, 6 adolescent & 4 paediatric transplants were live related
20 adult and 2 paediatric kidney transplant was live non-related
39% of kidney donors were related to the recipient
254 adults, adolescents and children had their sight restored through a cornea transplant.

In South Africa in 2011:

There were 556 organ and cornea transplants.
337 of these were solid organ transplants broken down into the following:
Hearts: 25 adults & 1 adolescent o Simultaneous Heart / Lung: 1 adult
Lungs: 4 adult
Livers: 26 adults & 4 paediatric
Simultaneous kidney/liver: 1 paediatrics
Simultaneous heart/kidney: 1 adults
Simultaneous kidney/pancreas: 11 adult
Kidneys: 234 adults, 11 adolescents & 18 paediatrics of which:
84 adult, 4 adolescent & 7 paediatric transplants were live related
22 adult, 1 adolescent and 1 paediatric kidney transplant was live non-related
36% of kidney donors were related to the recipient
197 adults, 16 adolescents & 6 children had their sight restored through a cornea transplant.

In South Africa in 2010:

There were 604 organ and cornea transplants.
344 of these were solid organ transplants broken down into the following:
Hearts: 24 adults & 1 child oSimultaneous Heart / Lung: 1 adult
Lungs: 4 adults
Livers: 30 adults, 2 adolescents & 4 paediatrics
Simultaneous kidney/pancreas: 12 adults.
Kidneys: 244 adults, 8 adolescents & 14 paediatrics of which:
86 adult, 4 adolescent & 6 paediatric transplants were live related
23 adult kidney transplants were live non-related
36% of kidney donors were related to the recipient
231 adults, 14 adolescents & 15 children had their sight restored through a cornea transplant.

In South Africa in 2009:

There were 724 organ and cornea transplants.
376 of these were solid organ transplants broken down into the following:
Hearts: 25 adults & 1 adolescent
Lungs: 8 adults
Livers: 26 adults, 1 adolescent & 10 paediatrics
Simultaneous kidney/pancreas: 11 adults.
Simultaneous kidney/liver: 2 adolescents & 2 paediatrics
Kidneys: 263 adults, 11 adolescents & 16 paediatrics of which:
100 adult, 8 adolescent & 9 paediatric transplants were live related
31 adult and 1 paediatric kidney transplants were live non-related
40% of kidney donors were related to the recipient
299 adults, 33 adolescents & 16 children had their sight restored through a cornea transplant.

It has been said it was due to HIV but now they have been doing transplants on HIV patients as well.

Sadly I have read a note online from a SA man who said he will not take an organ from a non-white.

Also the fact of, Medical aids, do not cover transplant donor costs at all, I could be mistaken, but very few pay for transplants.
One gets options on medical aids. (Simplistic version) Each medical aid has 10 options, when you get to option 5, the cost for a couple is the average monthly salary of one person in a small town. As well as, there are so many things it then does not cover, and if it is covered, you are so limited, for they have cost limits. (If that makes sense)

That is why the law is SA states that a Living Donor may receive compensation in relation to a transplant from the recipient.

Medical costs, lodging, loss of income. For there is no way in hell a normal person/donor, has the cash to pay for such a surgery as well as all the other costs involved. No work, no income as well as normal financial responsibilities to his or her own family.

But, one needs to have a type of emotional bond to donate as a non-related donor. So if they have met, made friends and agreed to do the transplant, its perfectly legal.

When my Husband was diagnosed, we were told by medical aids, he had a pre-existing illness, and said sorry, they won't cover it for up to 3yrs. And after 3 yrs there will be cost limits. Our Doc told us, have 60 grand cash in your back pocket, now and at all times (that was 5yrs ago, its now double). For if you get that call and you can't pay for it, you are then scraped off the list. We waited 5yrs, and nothing, zip, nada!
 
We were running out of time his corneas where thinning, tears had developed and his sight was a blur.

I started phoning around. Here is SA tissue transplants are imported from other countries. But at one hell of a price. My Husbands family helped out. We lost everything financially. But it was well worth it. I'd trade absolutely anything for my husbands sight. (Interesting fact, being a 3rd world country, I was legally allowed to give him a cornea, its a paired "organ").

What outsiders see on TV is not the real SA.

Yes its beautiful and we need tourists to help with our crashing economy.
 
Here where I stay, I have the ocean 2min away and wildlife 20 min away.
But that's kind of, it. The price one pays for beauty is it worth it?.
Oh hell yes, if your living on one hell of a retirement plan.
Word of advice, Just don't get sick.
Plus, don't go outside!
Make sure you have solar power or generators, for when the electricity is cut off often due to the country not having enough, it results in break-ins being rife.
They claim on the news there is no more load shedding for the week, and then bling, the power goes off..
Plus, have a borehole. One often has sludge coming out of ones taps, (no jokes) when you call to complain, the number doesn't exist or no one answers.
Oh wait. You need a mobile, for if you try and call from your landline, the possibilities are good that it won't work due to cable theft.

Another life example.

I worked in a school hostel, girls only. 125 to be exact. It was the children's permanent residence.
Many were orphaned, and most had one parent left due to the HIV/Aids epidemic. Many had HIV/Aids themselves. The percentages of rape and molestation was horrific. This also led to pregnancies, abortions and the ripple effect continues.
One is a mother and a counsellor, and one had to do ones best to try and make the rest of their schooling years as normal as possible.
 
I am still friends with a teacher there. We still have sessions where she unloads, asks for advise and refers students.

They now at present, have one student who's mom was murdered by her dad, she was strangled, set alight and her body was left on a rubbish dump.
Long story shortened.
A year later, the dad has still not been prosecuted, he walks around freely and the child lives in utter fear, he still has full visitation rights to see her. Due to circumstances, the "school" has been made her legal guardian.

The teachers do their best to avoid this, in legal terms (sorry not avail, busy with study, art classes, sport and so one). Its all they can do.

Rape percentages in SA now. One out of every 3 woman/children. (Also thanks to the, Rape a virgin and it will cure you of aids) yip. This is what was said a few years back in communities.
Every week there is news in our local papers of School children walking to or from school, and woman in local communities being dragged into bushes on the side of the road and being rapped.
Fact.
As a woman, one can not, under any circumstances walk in isolated areas/the beach alone.

The other day, last week tuesday to be exact, I went at about at 2pm to drop off a video we had hired the previous day at the local shopping mall. The car was parked on a slope. It was giving hassles and did not want to start, so it rolled back a bit, but there was more than enough space for others to move around.
Broad daylight, peak traffic, packed with people,
As the car spluttered, 3 men in tattered clothing, who had just walked past the car, stopped dead, turned around, and smiled at me and walked towards me. (Its that smile one does not forget, that moment where you know you can not show fear)
I closed the windows (34 degrees) and quickly speed dialled my husband and put him on speaker. We live 2km away. And he ran!
These men, then sat around the car and were glaring at me, looking around for a gap, waiting for that moment to make their move. I put my bag under my seat and sat on my phone. Glaring back at them. They were waiting.
No one around me, did a thing, for no one wants to get involved. I don't know why they did nothing for I was a prime target, a sitting duck, but they knew I was not going to go down without a fight. We have a bakkie, and its a top candidate for hijacking. As my husband came around the corner, they got up and scrammed. He is a very muscular and big man. He jumped in fiddled around and the car started. He knew how and what the problem was. 

I was so relieved!

A few months ago, at the petrol station, which was about 5m away from where I was parked, my husband was filling the car up with fuel, someone came from behind and hit him over the head, and tried to steal the bakkie. Well, that person and his friends that were with him, got the hiding of their lives. What did the spectators do. Nothing. Just stood and watched. People will rather film an event on their cellphone, than help a person in need. 

I have been mugged so many times I have lost count. I have been stabbed once, for my bags contents, whilst on my lunch break. This was in Pretoria a good few years back. I am one of those 3 to 1 odds and I have held a 4yr old child in my arms that was raped, sodamised and beaten up, there was no emotion, no cries, no tears, just eyes..
I have also seen a man being neclaced as a child. (When the community gathers around, says your guilty of an act, and punishes you by putting a tyre filled with petrol around your neck and sets you alight). The more he ran the more flaming petrol spilled over him.

All this plus much more, was my factor of going into counselling and offering it on a volunteer basis to people who can't afford it.

Its an example of, like nursing, you can either study at varsity and have all theory or go via state hospitals, were its hands on practical.

Lack of education and absolutely everything else that goes with it, makes people turn against each other. There are the very few who are the lucky ones that prosper.

Racism is rife, in all colour in all form.
Hatred towards each other, even desperate people who cross our borders in search for a better life are hated, chased and murdered for they are said to be stealing the jobs meant for south africans.

I think with these worries and odds and happenings, transplant issues are the last thing on anyone's mind here in SA.

It is only available for the few who can afford it or the very blessed ones who survive long enough.

But I will continue to create as much awareness as I possibly can.

Welcome to SA.
A beautiful country.