South African doctors charged with involvement in organ trade
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7459.190-a (Published 22 July 2004) Cite this as: BMJ 2004;329:190All rapid responses
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Organ transplantation added a new hope in the field of medicine but as the
saying goes- bad things follow the good, it brought a lot of problems with
it. Since my school days I am aware of the organ trade that has been going
around this region, South Asia, through media. Most of the poor people who
can't afford to take their children to school due to high cost and even to
earn their livelihood are forced to sell their organs.
Kidneys have been
the frequently sold organ, when the donor gets around RS (Nepali) 50000
equivalent to US dollars 650 per kidney and the 'beauty' of this is that
one can live well with one only. Most of them are bound to go to cities of
India where kidney transplant is done. So poverty has been the main evil
that forces anyone involve in selling organs in the region. There are many
even among doctors who are exploiting innocence and ignorance of the poor
to lure to get them involved in such business. As the government in the
centre is busy addressing the 'important' issues of militarization these
activities are rampant in poor countries. These are indeed against the
existing ethics. The world should be united without caring the national
and regional borders to address these issues and to eradicate such evil
system which would hamper progress of humanity. Let all individuals get
the right thing from the advancement in any scientific field.
Competing interests:
None declared
Competing interests: No competing interests
Response to article on doctor shortages in South African Hospitals
The article reporting on the temporary closure of the Red Cross
Children's Hospital illustrates some of the many health care problems that
are occurring in many developing regions of the world, but inadequately
describes the problem that led to the crisis in Cape Town. Fundamental to
the current problems at the Red Cross Hospital is the restructuring of the
health care system in South Africa, with greater emphasis on the primary
health care system at the expense of tertiary health care facilities.
This redistribution of staff away from the Red Cross Hospital led to
longer working hours, greater case loads and the eventual refusal of
junior doctors to work under the existing conditions.
The debate on how limited health care resources should be distributed
between primary, secondary and tertiary care is a universal question.
Proponents of primary health care argue that an emphasis in this area is
most likely to have the greatest impact on population health. Those
involved with tertiary care point out that for primary and secondary care
to be successful it must be supported by higer levels of care. Moreover
that specialised care will always be required for selected patients. We
believe that in a setting of limited resources, an equitable balance need
to be struck between all levels of care. This balance will need to be
defined in South Africa.
We also hope that discussions on the role of tertiary care will also
consider the important role these facilties play in the education and
training of health care professionals. One of our major concerns is that
the shifting of resources away from tertiary care diminshes the capacity
to educate and train health care professionals. Staff shortages, lack of
resources and increased clinical loads make the pursuit of academic
interest increasingly more difficult. Without proper education the
entire healthcare system risks sliding downward into mediocrity - as
situation where neither the primary, secondary or tertiary systems
functions.
An important question is what role more developed countries and
international agencies might play in assissting at secondary and tertiary
health care levels. In the past there has been a general reluctance of
international donors to be involved at these levels of care. This must
change if healthcare is to continue to improve in less developed regions
in the world. Appropriate support at the secondary and tertiary health
care level might be of assistance with the education and training of
health care professionals.
It is not that places like the Red Cross Children's Hospital lack the
expertise to teach their junior doctors. It is just that the lack of
resources has made it increasingly more difficult to do so. Supporting of
the academic programs of places like the Red Cross Hospital could include
assistance with clinical teaching, education exchanges, skills development
and research training. Outside institutions would benefit from the
immense clinical material and the unique research opportunities afforded
by Africa's largest children's hospital. Few centers in the world have
the clinical volume and pathology that presents to the Red Cross Hospital
on a daily basis.
In conlcusion, although the crisis is real, those of us working in
South African hospitals will continue to do the best we can for those we
care for.
Competing interests:
None declared
Competing interests: No competing interests