Can you sell a kidney to keep 'Janu-worry' at bay?

2018-01-26 08:47
Picture: Peoples Post

Picture: Peoples Post

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True to form, arguably South Africa’s longest financial month of the year is refusing to end. Dubbed "Janu-worry", we keep counting those coins, trying to stretch those notes, but to no avail. Tweeting to his over 9 000 followers, Metro FM DJ and TV producer Rashid Kay offered a possible solution: "get money" by donating a grocery list of organs and body tissue.

The replies didn’t disappoint. Some people were eager to help find new homes for their hearts - but at a fee, of course. Levity aside, what are the legalities of donating organs in South Africa? One of our readers was understandably curious, so we did what fact-checkers do and tried to get to, well, the heart of the matter.

Africa Check tried to get a hold of Kay to find out where exactly he got the information shared, but at the time of publication we hadn’t heard back from him. (Note: We’ll update this report should he respond.)

His tweet listed South Africa’s department of health as the source of information, however. A phone call to the department’s head of communications, Popo Maja, helped set things straight. Maja told Africa Check that this wasn’t his first run-in with this particular claim.

"It did the rounds about May last year. The same tweet. I don’t know where it comes from, but what I’m saying is, it’s part of the fake news," he explained. "That’s because it’s illegal to trade in human organs or parts in South Africa," Maja said. "You can donate organs," he went on to explain, "but not for financial gain, at all."

Only 'reasonable costs' may be reimbursed

Provisions in the National Health Act spell out what Maja mentioned. Receiving "any form of financial or other reward" for donating tissue, blood and blood products and gametes (eggs and sperm) is considered an offence. Payment may only be received "for the reimbursement of reasonable costs incurred" for providing the donation.

Certain regulated institutions such as hospitals may receive payment, but this payment is restricted to covering the costs involved in the "importation, export, acquisition or supply" of the tissue, blood and blood products.

This also applies to people who donate and receive gametes. So, in a nutshell, South African law prohibits you from making a profit from donating your organs, eggs or sperm.

Organs donated free of charge to recipients

Samantha Nicholls is the executive director of the Organ Donor Foundation, an umbrella body that works to educate the South African public on organ donation and to encourage the practice.

The foundation works primarily to promote the donation of organs such as the heart, liver, lungs, kidneys and pancreas, along with tissue donations like corneas, skin and heart valves, Nicholls noted. Potential donors can be from trauma units and intensive care units.

"If the patient has no hope of recovery and is on a ventilator and has been confirmed brain-dead by two doctors who are independent of the transplant team, this patient would be considered a possible organ donor," Nicholls said.

Tissue donations could also come from people who died out of hospital.

"In the case of someone passing away at home, tissue is still an option. Corneas, as an example, can be removed within 12 hours after death," Nicholls says.

In either scenario, she noted that the organs would be donated "free of charge to the recipients".

'Certificate and a bunch of flowers or the equivalent'

An independent consultant with the Organ Donor Foundation, Maryn Reyneke, commented on the other organs, tissue and bodily fluids mentioned in Kay’s tweet. (Note: We’ll get back to you about hair.)

"Wombs are not being transplanted in South Africa and I have never heard of testis transplantation," she said. "Composite tissue transplants, for example face and limb transplants, are not done as a routine in South Africa."

The world’s first successful penis transplant, carried out at Stellenbosch University’s medicine faculty in 2014, was part of a study approved by its ethics committee, Reyneke explained.

Although Kay’s post claimed a bone marrow donation could earn you R36 000, marrow donors are not remunerated either, Terry Schlaphoff, the deputy director of the South African Bone Marrow Registry, told Africa Check.

"It’s voluntary," Schlaphoff clarified. The costs of donating, however, are covered directly by the registry.

"The donor has to take a medication in order for the stem cells to be what we call 'mobilised' to get out of their marrow and into their blood. That medication is very expensive and it’s not right for the donor to pay for that," Schlaphoff noted.

Apart from the satisfaction of knowing that your contribution could save a life, you would get a "certificate and a bunch of flowers or the equivalent", Schlaphoff told Africa Check.

Donating breastmilk won’t fatten a woman’s pocket either. "Breastmilk, like blood, is donated as a charitable exercise to save the lives of premature babies and not for financial gain," Deidre Smith told Africa Check. She is a registered dietician and certified lactation consultant with the South African Breastmilk Reserve.

Ministerial approval required

In the case of some organs, mainly the kidney and liver, living donations can be made. But following South Africa’s "Kidneygate" scandal - which involved local medical practitioners, executives from healthcare company Netcare and international organ traffickers - approval by the minister of health is required when the donor is unrelated to the recipient.

The scandal involved traffickers paying living donors "a modest sum" for their kidneys. Between about 2000 and 2003, close to 200 patients with kidney disease received these trafficked organs, the Mail & Guardian’s investigative wing exposed.

Ntebaleng Morolo is the deputy director of organ transplant and dialysis in the department of health. She is in charge of processing applications for live organ donor transplants. Once Morolo and her team have verified that an application is complete, it is sent to an eight-member ministerial advisory committee on organ transplantation.

They assess it and recommend whether or not the transplant can go ahead, Morolo added. Written approval is then obtained from the minister of health. The approval process ensures that donors aren’t in it for the money, Morolo assured.

"That’s why we have psycho-social assessments on the living donor and the recipient and that’s why sometimes we also have social work assessments on these two candidates to see what drove this live donor to part with an organ whilst still alive. It’s not an easy decision to take, to have an operation that you do not need."

So in short, if you’re looking for a payday, keep your organs. But if you’re in the market for a saving a life, consider donating.

What about eggs and sperm?

In South Africa, it is illegal to trade in egg and sperm, Dr Sulaiman Heylen told Africa Check. He specialises in reproductive surgery and is the current vice-president of the Southern African Society for Reproductive Medicine and Gynaecology (SASREG).

"That’s the law. So we cannot pay egg or sperm donors. But what we can do is to compensate them for their expenses."

Heylen said that the valuation of donor compensation is determined by the donation process itself. Tweeting that egg donors get paid R96 000 is "completely incorrect", he told Africa Check.

Potential egg donors would need to conduct a number of tests including a medical history, blood tests to screen for infectious diseases along with psychological testing, Heylen explained. Potential donors would also need to sit down with facility nurses for an information session. This first screening takes "quite a while". If cleared, a potential female donor would then start with fertility injections. Eggs would be harvested from the potential donor "normally after two weeks of injections".

"They have to take a day off of work for that and it’s done under mild general anaesthetic," he said. This process informs the calculations of costs the donor would need to be compensated for.

"A few years ago the compensation was R4000 and it’s gradually increased and it’s ended up at about R7000 at the moment. That’s the maximum."

The amount is set by SASREG. The amount applies to sperm donations too.

"Instead of going on the fertility injections, [donors] must just donate several sperm samples. Normally, they donate 6 to 8 sperm samples," Heylen noted. Donor sperm is frozen for three months and is only released following repeat blood tests for infectious diseases such as HIV, hepatitis and syphilis.

This article was researched by Gopolang Makou for Africa Check, the continent's leading fact-checking organisation. Read it on their website here.

Read more on:    organ donation

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