The Chairman of the Board of the «Qazaqstan Khalqyna» Foundation, Bolat Zhamishev, has proposed a reform in the law on organ donation in Kazakhstan. Currently, thousands of Kazakhs are waiting for donor organs. The majority are relying on organs from foreign donors whose relatives are not asked for permission to extract the organs of the deceased. What are the prospects for such a proposal in Kazakhstan?
Silence is consent
«Doctors say that no funds from the foundation are needed; the law needs to be changed to revive cadaveric donation in our country. We held a relevant conference. Together with the Ministry of Health, we participated in this conference — to finally push both the government and the public towards amending the transplantation and cadaveric donation law,» said Bolat Zhamishev, the Chairman of the Board of the «Qazaqstan Khalqyna» Foundation.
It is this foundation that Kazakhstanis ask for assistance in purchasing organs abroad. Obviously, this is an expensive option, and therefore, funds are insufficient for everyone on the waiting list. If our country allowed the extraction of organs from the deceased without the consent of relatives, thousands of people would have a chance at life. Currently, 4,000 Kazakhs, including 90 children, are in line for organ transplantation.
Until the government makes legislative amendments, those in need of transplantation must rely on the level of donation already established in Kazakhstan. There are few options: either wait for their turn or accept help from adult relatives (if available), but only when it comes to transplanting paired organs such as kidneys. In the case of organs like the heart, transplantation from a living donor is impossible for understandable reasons.
If we had a developed cadaveric donation system, the organs of one posthumous donor could save the lives of around 7 people.
As of January 17, 2024, Minister of Health of the Republic of Kazakhstan, Azhar Ginyat, commented on the situation with cadaveric donation in the country.
«To know the opinion of the population, to understand if they are ready, the Ministry of Health has an electronic register; through E-Gov, any citizen can express their desire. Today, 40,000 have expressed their desire, of which 15% have agreed to donate organs to save the lives of the sick,» said Azhar Ginyat in the corridors of the Mazhilis. The Minister also confirmed her willingness to donate her organs posthumously: «Agreed. Expressed the desire.»
Take by Force?
The news about possible amendments has not been warmly received by Kazakhstanis. Comments on this matter often include expressions such as:
«They took everything, and now they are going after organs. Let them donate their own,» «So people will start disappearing without a trace,» «Where is the guarantee that they won’t start gutting the living?» «Let them just try to pass such a law!!! They will see the people’s anger!»
On one hand, it’s understandable why Kazakhstanis feel this way: essentially, citizens are being deprived of the right to preserve the body of their relative in its original state. On the other hand, Kazakhs are not deprived of choice: they can sign an electronic refusal for posthumous organ donation right now; the key is to approach this issue responsibly.
Incidentally, Belarus has the same laws as Kazakhstan, with the exception that consent from relatives for posthumous organ donation is not required. Around 400 surgeries are performed there annually. Meanwhile, the country is not mired in black market organ trafficking. Essentially, permission for transplantation is only sought here. Among patients awaiting their turn, there is a speculation that regional coordinators, responsible for finding potential donors, do not approach their work entirely conscientiously. Instead of diligently searching for candidates, they use relatives’ objections as a cover. Meanwhile, in Kazakhstan, 270 Kazakhstanis die annually.
To Take to the Other World
Not all Kazakhstanis are aware that after the death of any citizen, their body undergoes an autopsy – at this moment, the organs of the deceased are extracted and examined to determine the true cause of death. In one way or another, a person embarks on their final journey not in the same form they were born. However, along with them, viable organs that could prolong someone else’s life also go underground, becoming useless.
When it comes to transplantation, images of a carelessly operated and hastily sewn-up body inevitably come to mind. Kazakh transplantologists explain that this is a significant misconception. The operation to remove an organ from a corpse is carried out with the same care as a surgery on a living person. After the procedure, aesthetic stitches are applied to the body of the deceased. Doctors treat the last act of the deceased with great respect.
Meanwhile, while Kazakhstanis are concerned about being used for organs through posthumous donation consent, online platforms are filled with advertisements for the sale of various organs. People are willing to literally «cut off a piece» of themselves, but for a certain fee. «Black market» donors value their organs in millions of tenge and tens of thousands of dollars. However, despite the existence of supply and demand, «black market» transplantation cannot develop in Kazakhstan for several reasons.
According to Dr. Bolatbek Kayupov, Doctor of Medical Sciences, a surgeon in the Department of Transplantology and General Surgery at the National Institute of Cardiology and Internal Diseases in Almaty, the issue of «black market» transplantation is greatly exaggerated in our country. Perhaps it exists in some countries, but Kazakhstan is a relatively small country where everything is visible, and hiding such an operation is very difficult.
«Simply taking and transplanting an organ is not possible; there are many factors for conducting this operation,» says Bolatbek Kayupov, referring to the fact that for both parties involved, this is a criminally punishable offense.