There are over 5000 people in South Africa on the waiting list for organs, many for kidneys, but others for all the other organs including liver, lungs and heart, as well as skin tissue, corneas and other body parts.
Dr Terry Adams
“With the ushering in of a new pope, there is concern amongst Catholics as to whether he will uphold Pope Francis’ support for ethical organ donation as an act of mercy. Prof Francis was known as a liberal pope but each successive Pope has their own set of norms,” says Dr Terry Adams who graduated in April with her PhD in Anthropology from the Faculty of Humanities at Nelson Mandela University.
For her PhD, Adams researched the concepts and practices of organ donation in the Catholic Church in Gqeberha, Eastern Cape. She interviewed a diverse range of practising Catholics from five churches in Gqeberha to find out what they think about organ donation, and whether they would be donors.
“As a medical anthropologist with an interest in public health and as a Catholic, I established that organ donation has been approved by the Catholic Church since John Paul II who was Pope from 1978 until his death in 2005,” she explains.
“He said it is a gift of human love, but he made it clear that there should be no payment for organs and if it is a live donation it cannot bring harm to the person donating the organ, and neither can there be harm to the recipient.”
Organ donation is the only option to save someone’s life if they are suffering from end-stage organ failure. The high level of non-communicable diseases in South Africa, such as hypertension and diabetes too often leads to heart disease and failure, and kidney or multiple organ failure respectively.
“Knowing the low transplant rates in our country necessitated investigating how knowledge, values, and beliefs influence organ donation acceptance or rejection in the Catholic community which comprises approximately 3.8 million people in South Africa from a wide range of cultures,” Adams explains.
Her research was also motivated by her personal experience. In 2014 at age 19 she had the first of several episode of chronic kidney stones. “It put me in hospital every six months and the situation was distressing but fortunately the chronic medication I was put on worked,” she says.
“During this time, I started questioning my belief and values with relation to organ donation, and, if it came to it, whether it would be permissible for me as a Catholic to receive an organ.”
Despite the approval for organ donation from the Catholic Church, and something Pope Francis gave many talks on, Adams’ research revealed that the Catholic Church’s acceptance of organ donation is not widely known and remains something of a taboo subject that is not generally discussed.
“The Bible speaks about the body being a temple and that we are created in the image of God, so there is a lot of sacredness about the body, and some of the people I interviewed felt that organ donation is too invasive and ruins the image of holiness,” Adams explains.
“One interviewee who is from a traditional African background and a Catholic said that he could not be a donor because in his traditional belief system the body must be whole to reach the ancestral plane where you are greeted by your ancestors. In this instance the traditional belief system took precedence.”
Other people from African and other traditional and western backgrounds said that in line with the principles of the Catholic Church they support organ donation on death, and that they would also be prepared to be live donors if a family member needed this.
She adds that several of the interviewees questioned the definition of ‘brain death’: “Three doctors have to declare a person brain dead, in other words that there is absolutely no brain activity and the only reason the body looks alive is because the patient is on a ventilator. However because of the belief in miracles, several interviewees said they were against the brain dead declaration, and questioned whether this is really death.”
Several interviewees also voiced their concern about organ trafficking which has become a commercial enterprise in Africa and globally, as highlighted in Mariana van Zeller’s documentary ‘Trafficked’.
“Ultimately, as my research established, our religious, personal beliefs and values all influence whether we support organ donation,” says Adams. “As a Catholic I support it, but I need to know the new Pope supports it too, as I want to be buried as a Catholic.”
And so, even though the Catholic Church has supported organ donation for almost half a century, there are very diverse opinions among Catholics and it comes down to personal choice.
Adams adds that for those who would like to find out more about organ donation, South Africa has the Organ Donation Foundation, and becoming a donor is a simple process. You need to be 18 and above and below 65. And South Africa law specifies that you have to get familial consent, in writing is best.
Adams is now pursuing her postdoctoral research on organ donation and she will be including interviews with medical doctors in the public and private sector who deal with organ transplants, and a diverse range of people across the belief and non-belief spectrum.