Number of Filipinos suffering from kidney failure increasing–expert
Experts encourage organ donation from living donors,
even those unrelated to patients, but stress that donors should be
informed of potential consequences prior to giving consent
Before stuffing yourself with sweets, oil-rich food and alcohol this Christmas, you may want to take this as a warning.
Approximately one person with kidney failure in the Philippines dies
every hour according to a well-known surgeon who specializes in kidney
National Kidney and Transplant Institute (NKTI) Executive Director
Dr. Enrique Ona said that every year, some 10,000 Filipinos develop
kidney failure mainly from diabetes and high blood pressure. Worse,
their numbers are increasing by about 10% annually since 5 years ago.
Ona presented the data at a health forum organized by the Novartis
Healthcare Philippines, a pharmaceutical company whose products include
drugs that prevent the rejection of kidney transplants in adult patients.
The data came from a study conducted by the Department of Health
(DOH) with the NKTI under the Renal Disease Control Program. The
program studied post-dialysis patients in the country for the past 10
Lead a healthy life
To prevent kidney disease, people should lead healthier lives good diet and regular exercise, according to Ona.
He recalled the experience of former President Fidel Ramos who was
diagnosed with kidney infection during his last year as senior cadet.
Ten months after his graduation, Ramos was commanding a platoon in the
Korean War, Ona said.
This was possible, according to Ona, because Ramos is very cautious about his physique and conscious of what he eats, Ona said.
Ona shared Ramos’ experience because the latter’s kidney problem did
not hinder him from reaching his goals, and going beyond them. “At
almost 80, he still plays golf and does not use a cart. He walks,” Ona
exclaimed. Ramos is also a blood donor and donor to NKTI.
Need for donors
For a person with end-stage organ failure, the only chance for survival is an organ transplant, Ona said.
Unfortunately, he said, that the waiting list for organ recipients
is long because transplantable organs and willing organ donors in the
country are scarce.
Ona notes that of the 10,000 Filipinos who develop kidney failure
every year, only 1 in every 20 (about 500) receive a kidney transplant
Some 70% patients (7 out of every 10) are able to start lifelong
dialysis or blood transfusion, Ona said. After a year, almost half of
them die because they could no longer afford or find a suitable kidney
donor, he said.
Dr. Angeles Tan-Alora, Executive Director of the Southeast Asian
Center for Bioethics, said that “organ donation is good and should be
encouraged.” Many Filipinos, she said, are still ignorant of the value
of organ donation.
This, according to Tan-Alora, is why the DOH and NKTI implemented the Philippine Organ Donation Program (PDOP) last 2007.
Revise the rules
Medical practitioners present at the forum scored the implementing rules of the Anti-Trafficking in Persons Act of 2003 (RA 9208) for making it more difficult for patients to obtain new organs.
In particular, Dr. Antonio Paraiso, medical specialist and
consultant in Nephrology of NKTI, cites Section 5 of the IRR which
prohibits anybody from “any propaganda material that promotes
trafficking in persons.”
Paraiso cited potential problems arising from the new rules.
Paraiso says this might make kidney patients vulnerable to lawsuits.
“What if a person verbally announces the need for an organ? This person
has committed a crime,” Paraiso said.
Paraiso also said that the law prohibits aliens to receive organs
from Filipinos. He asked how it would be possible for a Filipino to
donate his organ to a long-time foreign friend if the law considers his
act a crime.
Another instance would be if the recipient would only agree to
accept an organ if he or she would pay. He asked: “Is that a crime?” He
said that in all 3 scenarios, not one person was trafficked nor
The Philippine organ donation program had been severely criticized over
the past years following reports of rampant sale of human organs that
were allegedly condoned by surgeons and hospital administrators.
This was after the number of transplantations conducted in the
country soared over the past years. The increase was fuelled both by
the influx of foreign patients seeking new body parts and the
availability of “donors” who, due to extreme poverty, are willing to
sell their kidneys at the right price.
Ethical questions have been raised over whether health care
providers have been taking the welfare of donors into consideration
particularly given expected returns from each transplant operation.
In 2008, this prompted president Arroyo to order a ban on the
transplantation of organs from living non-related Filipino donors to
Prohibit organ sale
A staunch advocate of the donation program, Ona said that the program
would ensure the safety of both organ donors and recipients.
Tan-Alora said that payment as precondition to kidney donation and
sale or purchase of kidney, or any other organ, should be strictly
Although sale is not allowed, the donor should benefit from the donation, Tan-Alora said.
“But, you cannot commodify an organ,” she said. Tan-Alora mentioned
this because of the long history of kidney trade in the Philippines.
(Read: Timeline: Kidney Trading in the Philippines)
She said: “It is ‘walang-hiya’ to get an organ from somebody and just say ‘Thank you’.”
Tan-Alora said: “Most recipients (of organs) are rich … Measures have to be done in order for the poor to acquire benefits.”
Tan-Alora notes that while society is quick to condemn the poor for selling their organs, what they really need is protection.
The study entitled “Failure of Informed Consent in Compensated
Non-Related Kidney Donation in the Philippines” published last June
2009 in the Asian Bioethics Review showed that of the 311 Filipinos
they interviewed, the compensation received by the organ vendors is
almost equivalent to average wages of vendors for 2 years. Although
they do get money, there are no remarkable economic improvements in 36%
of the respondents.
According to the study, only a few experience economic improvement briefly after receiving payment for their organs.
In the study, it was also said that 28% of the respondents claim
they never went through any form of health counseling. Forty five
percent of the respondents said that information given to them prior to
donating their organ was not enough for them to fully understand the
implications of selling their kidneys, 30% did not receive any advice
for post-operative checkup.
Reacting to the study, social welfare secretary Esperanza Cabral,
one of the vocal critics of the way the organ donation program is being
managed by local health providers, also batted for informed consent in a recent press release.
Cabral said it is very important that donors are fully aware of the
nature and consequences of their actions saying, “the awareness of the
donor and the validity of his informed consent to the transplant will
help curb exploitation and even save their lives.” (abs-cbnNEWS.com/Newsbreak)