The initiative puts the onus on the physician or hospital certifying the patient as dead to ask the bereaved family if they are willing to donate the eyes. Once the family agrees, the doctor or hospital will contact the nearest eye bank that will harvest the eyeballs and clarify doubts the family may have. A circular on this may be sent to all wards by the month-end.
Mumbai records nearly one lakh deaths annually but collects less than 3,000 (3%) corneas on an average. And only 25-30% of those eyeballs can be transplanted. The requirement for corneas that was few hundreds till five years ago has gone up to 2,000, and is swelling every year.
Champions of eye donation in the city have hailed the move and believe its effective implementation will wipe out the city’s waiting list. “It is a great move. Even if 10% families agree to donate, there will be no waiting list at any hospital,” said Jaswant Mehta, trustee of Parel’s Eye Bank Coordination & Research Centre. The city’s biggest eye bank and processing centre has a waiting list of over 600 people. The average waiting list for a good cornea in the city is a year and more.
Mehta, who has been instrumental in getting approval for the move from the union health ministry and subsequently the state government, said most patients on the waiting list are children.
The move has not come without its share of bureaucratic hassles. The Union health ministry wrote to the state health department to introduce the column in February 2011. The state department, however, confused it with the final death certificate that is issued within 21 days of death and even got an opinion from the law department stating that the column cannot be introduced. The department wasted three years before comprehending that it was to simply incorporate the column in the medical death certificate issued soon after death for final rites.
The civic body took nearly six months to accept and implement the idea. A civic official told TOI that orders for rubber stamps for the consent column had been placed. “We have over one lakh death certificates ready and they cannot be wasted. So, we will put rubber stamps on the certificates. Fresh certificates will come with the column,” the official said. “But death certificates with private physicians will not have the column for now,” the official said.
TOI has learned that consent for skin may be added to the form.
“The initiative will definitely work. Many families are willing to donate, but they are not approached at the right time,” said Dr Prakash Katakia, chairman of Arpan Eye Bank in Ghatkopar. He said doctors at public hospitals, which see an enormous workload, must be motivated.
Mehta said the next move should be to go for ‘presumed consent’ in medico-legal cases. “Over 7,000 post-mortems are carried out in the city’s public hospitals. If those families too are asked for eye donations, the results will be encouraging. Cornea removal has no impact on autopsy findings anyway,” he added.