Children undergoing dialysis for kidney disease.
By Dr. Harriet Etheredge and Dr. June Fabian
2016 marks the 50 year anniversary of solid organ transplantation in South Africa. The first organ to be transplanted was a kidney, and this happened in Johannesburg in 1966. This landmark event was followed closely by the first heart transplant in the world, in 1967, which was performed in Cape Town by Dr. Christiaan Barnard and his team.
This supplement is designed as part of a larger set of projects to recognise this anniversary. It is a celebration of medical skill, the great generosity of organ donors and the remarkable tenacity of the human spirit. It is also a reminder that the more things change, the more they stay the same. The supplement aims to highlight some of the challenges and triumphs of organ donation and transplant in South Africa today.
Challenges revolve around inequities, which still exist 20 years post-democracy. These include (to name a few) geography – where rural areas have far fewer health resources; socioeconomics – where impoverished individuals are compromised (through no fault of their own) because of bad nutrition, unemployment or lack of money for transport; and the two-tiered healthcare system – where differences between the state and private sector are stark. Persistently low donor numbers are concerning because there are thousands of people waiting for a transplant across the country, few of whom will be fortunate enough to receive a life-saving organ. In spite of concerted public education efforts by committed organisations, donor numbers have remained static over the past decade. This is unlikely to change until political will is clearly demonstrated through a dedicated, national awareness and education campaign and implementation of mandated organ donor referral in our hospitals nationwide. For this to happen, South Africans need to hear the voices of our elected leaders, with a show of commitment to drive such initiatives in the long term.
Yet, in spite of these challenges, achievements in transplant are noteworthy, and sometimes exceptional. In this supplement, you can read the stories of transplant recipients who, against overwhelming odds, have flourished in competitive sport at an international level. You can read about the organ donors and the families of those who give the ultimate gift — literally saving the life of another through their decision. You can read about the individuals committed to bettering transplant care for our children, and who continue their work while continuously battling funding and resource shortages. You can also read about the health professionals who work tirelessly to ensure that transplants do take place.
Of course, transplantation in South Africa still has some way to go. Supplements like this remind us where we have come from, and thus help us to see more clearly where we are going, challenging us to consider how we get to where we want to be.
Dr June Fabian a clinical researcher and nephrologist at Wits Donald Gordon Medical Centre, University of the Witwatersrand
Dr Harriet Etheredge is a clinical research fellow at the Wits Donald Gordon Medical Centre, University of the Witwatersrand and was one of the Mail & Guardian’s 200 Young South Africans for 2016