Most Indian Live Donors are Wives and Mothers

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By Sujata B. Shakeel

NEW DELHI, Sep 24 (IPS) - Here's a statistic that reveals the truth about gender relations in India.

Of the roughly 4,000 kidney transplants performed across the country in a year, about 80 percent of donors are women, with wives making up more than 90 percent of spousal donations.

Significantly, 80 percent of beneficiaries are men. "There is gender bias," declares Sandeep Guleria, assistant professor at India's most prestigious government hospital, the All India Institute of Medical Sciences (AIIMS) in New Delhi. "Love is sharing kidneys, but it is very rare for a husband to donate a kidney to his wife."

Anju Babuta, 33, had given up on life. Born with a shrunken left kidney, she was put on a dialysis after the second kidney was damaged during pregnancy. In 2006, the doctors told her her only hope was a kidney transplant.

Still she went on, with the dialysis and her work in an office in Tees Hazari, Delhi's lower courts, praying and hoping her husband, whose blood group matched hers, would keep his promise and donate a kidney to her. But he didn't. When it came to the crunch it was a cadaver that saved her life: a 14 year old whose family decided to donate his organs.

Babuta says her husband's reason was, "there has to be one strong (healthy) person in the family." Wives, however, groomed from childhood to be self-less and serve their husbands and families seem to think nothing about donating a kidney.

Take Vimlesh, 46-year-old homemaker from a small town in Uttar Pradesh state in north India. In 2008, she donated a kidney to her son, Ashok Kumar, an economics postgraduate. Vimlesh had lost a daughter to renal failure. She didn't want to take a chance with her son. "I'm happy to have given him a kidney. I want him to live and do well in life," she says.

"Women never think twice when it comes to making a sacrifice for their husband or their son. The same cannot be said for the man in the family. There is always a subtle social pressure on her to donate the organ, which she does willingly, unquestioningly, almost like it is her bounden duty to do so," observes Dr Guleria, who is also consultant surgeon in the general surgery and transplantation department of AIIMS.

A report in the British Medical Journal (Medicine, Healthcare and Philosophy) says "the predominance of women donors (must) be investigated urgently." It adds: "Instead of simply congratulating women on their altruism there was a need to ask about possible reasons for the existing gender imbalance and check it for matters of fairness and undue pressure on a vulnerable group."

According to the report, "the expansion of living organ donation has been accompanied by an increasing gender imbalance among donors", while attributing the cause to "economic, attitudinal or psychological factors".

Smriti Singh, 36, a former sprinter who ran for her state Bihar, and now a home-maker in Delhi, considers herself lucky. When she needed a transplant, her unmarried sister volunteered to be a live and related donor because "she loves me and her nephew too much," she says.

"We try to convince the husband to come forward and donate, but most often than not there is a pressure on him not to do so as he is the earning member of the family," says Dr Harsha Jauhari, chairman, kidney transplant surgery, department of nephrology, Sir Gangaram Hospital, one of Delhi's top private hospitals.

With growing incidence of lifestyle diseases, like diabetes, obesity and hypertension, one in every 10 urban Indian, mostly male, suffer from a kidney related problem.

A study by Munita Bal and B. Saikia of the Postgraduate Institute of Medical Education and Research, Chandigarh, for the period 2001-05, found a whopping 90 percent of wives were live donors for their husbands as opposed to only 9 percent men. Similar studies conducted in Germany, Canada, U.K., U.S. and Sweden showed comparable trends.

According to Dr Guleria, the number of female donors has shot up since 1995. "Before (that) the wife was not considered a legal organ donor. But after the passing of the Transplantation of Human Organs Act, which authorised us to use the wife as a legal donor, we have seen a sudden increase in the number of spousal donations," he says.

There are more telling figures. In the case of 64 percent of male kidney transplant cases in India, the donor is female, while only 8 percent of men donate to women. About 20 percent of donations are male to male; 8 percent female to female. For every five men who receive a kidney only two women get one; and for every five women who donate only one man comes forward to donate to a woman.

Nirmalini David, 50, who donated a kidney to her husband, feels fulfilled by the experience. "Nothing fills a woman with a sense of completeness than to see her loved ones happy. She goes that extra length not out of coercion or obligation, but to see that smile on their face, even if it means donating a vital organ, or putting her life on the line for her family."

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