Dear Esteemed Prime Minister Modi and Minister of Health Dr. Harsh Vardhan: It’s been two years since the Indian Government announced the creation of the National Organ and Tissue Organization (NOTTO) for sharing of deceased donor organs for transplant all across the country. Crores of rupees have been set aside for this ambitious and absolutely essential initiative. It’s ambitious because a real time database containing pertinent details on all potential transplant recipients, donors, recovery surgeries in every donor hospital, transplant surgeries at every transplant center, and long term outcomes needs to be created and sustained. It’s absolutely essential because a world class national deceased donor transplant network needs to be efficient, transparent, and accountable in order to enjoy public trust and participation.
I’m deeply pleased to see the announcement that NOTTO will sign an MOU with the Government of Spain to share vital policies and procedures related to transplant and organ donation. Please note that the MOHAN Foundation (Multi Organ Harvesting Aid Network)—India’s largest transplant NGO—will sign an MOU with the British Government for a similar flow of transplant related information. Also, the Southern states of Tamil Nadu (established) and Kerala (emerging) can serve as valuable models as to how to carry out a national deceased donor transplant program in the Indian style. So, there are many forces in place to allow NOTTO to be created the right way and to flourish.
Hundreds of thousands of Indian citizens—across all socioeconomic boundaries, not just the rich—stand to benefit from deceased donor transplantation. The current volume of transplant (98% of which are from living donors) can be doubled or tripled with the introduction of a well functioning deceased donor transplant program. Heart and lung transplantation could flourish. The illegal organ trade (still, unfortunately, a reality here) can be tempered or even completely eliminated.
India has the talent to create an indigenous deceased donor transplant program, and I know that you both recognize this. IT and medical expertise abounds here. Many from outside of India are willing to help by sharing information and expertise regarding what works in other parts of the world and how these might be applied to India’s unique needs and ways of doing things. It absolutely can be done.
I encourage you both to pool India’s unique resources to create a world class deceased donor transplant program on the national level. NOTTO’s success would be a crowning achievement in Indian Health Care.
Christopher Taylor Barry, MD, PhD, FACS
Advisory Board Member, MOHAN Foundation
Liver Transplant Surgeon and Organ Donation Advocate
Stanford, UC San Francisco, UC San Diego, University of Rochester
A Lovely Day at the Post Office
I could have entitled this essay “An Infuriating Day at the Post Office”, but the more time I spend in India and the more I become accustomed to the Indian way of life, I found my long day quite lovely and not the least bit infuriating.
My mission began at 11 am to send a parcel of gifts back home to the US. Even in the two and a half months that I’ve been here, I’ve accumulated enough gifts to fill a suitcase. I am deeply touched by the Indian sense of hospitality. Surely there will be more gifts to come. So, instead of lugging around my current booty, I decided to send a big box home. I Googled “parcel shop T Nagar” and found an address close by within walking distance (20 minutes). When I arrived, I was disappointed to learn that the ARC Parcel store does not do international deliveries. They directed me to the “Professional Courier” shop opposite the T Nagar Temple on Venkatanaryana Salai. When I arrived there, I was disappointed yet again to learn that the “professional” couriers only shipped documents (not gifts) internationally. So, it was off to the post office now, fortunately just a few blocks away.
I made it to the parcel packaging and shipping counter at the T Nagar main Post Office and began to wait patiently in line. Nothing happened for 30 minutes. I finally realized that I was on the wrong side of the cue (nobody bothered to tell me this but that’s okay, I figured it out myself). Then I stood patiently in my proper place on the “intake” side of the counter. When they saw the contents of my box (a beautiful—and gigantic—Kerala dancing doll with a green face, a plastic gold shrine of Meenakshi and her parrot from Madurai, various silks and toys from all over Southern India, etc.), they immediately asked me to fill out a disclaimer stating that the post office is not responsible for damaged goods as a result of transport. Fair enough. I signed.
Upon filling out the rest of the paperwork, the woman behind the counter taped my box up, covered it in cloth and sewed the cloth tightly to the box. Then I was asked to write the sending and return address on the box with a big blue magic marker. Almost finished right?
So now I was directed back to my original location, the side of the counter where bills were processed and payment accepted. Another long wait. The women working behind the counter finally took time for lunch which they enjoyed sitting on the floor behind the counter. They chatted with the only remaining active employee, the cashier woman in charge of my fate to wait. But I had already realized that it was no use in becoming angry or frustrated with this strangely slow pace. Maybe if I were a V.I.P. (a beloved status among all Indians) I could have paid someone to do this time consuming task, but I want to live like an Indian man as much as possible so this exercise in patience was good for me.
Nine thousand seven hundred rupees ($160 USD) was the total. I thought to myself: more than the cost of the gifts! But I was willing to pay. No credit card is accepted at the post office. I told the woman in my baby Tamil: “Ippo rubaya podumillai” (Now not enough rupees), “Enneku vangi rhomba pakkatil irrukiradu” (My bank is very close by), “Sikiram poituvaren” (Quickly I will go and come back).
When I returned with enough cash to pay my bill, the (new) woman behind the counter told me that the bill was only 5,100 rupees ($83 USD). Now, although this did not instill great confidence in me for the Indian Postal Service (Rs. 9,700 vs Rs. 5,100 which I would have paid the former if I had enough cash on me at the time), I was touched by this woman’s honesty. Maybe they appreciated my patience (it was 4 pm by now), maybe they appreciated my baby Tamil efforts, maybe they just made an accounting mistake and discovered it in time for my benefit, but I was grateful in the end to have accomplished the task and have paid a reasonable price.
Sometimes I wonder how anything gets done here in India with the relaxed pace of life. But I do notice that most everyone is content here (at least in Chennai). I want to join in this state of being content, so I won’t act like an angry American when I have to wait for something to get done. I will try to appreciate the Indian way of life as much as possible. At its best, it can be a comfortable way of life, an honest way of life, and a spiritual way of life. This is why I enjoy India so much.