SA needs to grow a thick skin when it comes to organ donation
Asking people to donate skin may make you flinch, but for hundreds of burn victims it's a matter of life or death
If speaking about death is an uncomfortable conversation for most, veering into the territory of organ transplants is sure to halt the discussion.
Asking people to donate skin may make you flinch, but for hundreds of burn victims this will mean the difference between life and death.
Cultural objections to donating organs sometimes also come into play.
“Imagine getting a call that a child was heavily burned and skin is urgently needed and we have none. And there is nothing we can do. It’s really sad,” says Cleopatra Ndhlovu, a manager at the Tshwane University of Technology Skin Bank.
South Africa has a relatively high occurrence of burn injuries mostly due to socio-economic factors, which includes lack of electricity, housing and substance abuse. However, skin injuries affect people across different classes, not only the poor, she says.
The demand for skin transplants is more prevalent in winter, when people get injured due to open fires.According to Ndhlovu, the bank started operating in 2016, and they were able to supply hospitals with over 65 packs of skin.
In 2017, they supplied over 108 packs. While it is unclear how much skin is needed at the moment, Ndhlovu said there is a serious shortage.
“This could translate to a slightly smaller number of people who got treatment because sometimes, depending on the degree of burn, one patient may require two batches instead of one.
“The number of people willing to donate are few but there are also some people who want to take a couple of days to make a decision.
“This means by the time they say yes the opportunity to donate skin has passed. We only have 24 hours before retrieval of skin for it to remain viable.”
Burn injuries can be as a result of car and household accidents; “it could be you; accidents happen all the time,” said Ndhlovu.Organ Donor Foundation spokesperson Samantha Nichollis said they started the Uluntu Awareness Project a year ago because of the need for organ donors.
The aim is to educate marginalised and vulnerable communities that do not have enough education and information about organ donations.
“They make sure they understand the cultural or spiritual belief of the communities they go and speak to,” said Nichollis.
The Director at the Centre for Applied Ethics at Stellenbosch University, Professor Anton van Niekerk, said there is no scientific evidence to prove that people are reluctant to become donors.
However, he says, the problem comes when a family, already carrying the burden of grief, has to deal with such decisions. “And particularly having to face up to the fact that, for example, part of their loved one is still functioning in another person’s body.“Other people find this realisation to be a source of consolation and comfort – that a body part of a deceased has actually saved another life or prevented prolonged illness or disability.”
Van Niekerk said the fear of not being “really dead” before organs are removed, together with cultural biases against the idea of removing parts of a corpse before burial, tops the list of why some people are reluctant to become donors.
Despite reaching out to vulnerable communities, Ndhlovu said people do not want to have conversations on the issue of death. “Some people refuse to talk about these things; they feel as if they are signing a death warrant, which is not true.”
She also said it is problematic that only 0.2% of South Africans are registered to become donors.
“It really is unfortunate and shocking in a country with over 55 million people,” Ndhlovu says.
• People interested in becoming organ and tissue donors could do so by registering on the website