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The Trouble with Post Mortem Organ Donation in Egypt

Donating one's organs after death can save countless lives and yet it is something not often done in Egypt, despite the harsh reality of the need for organs. Mona Daoud delves into the legalities, societal perceptions, and issues surrounding the health sector when it comes to this vital matter.

“What happens when we die?” This question has been circulating itself amongst the entirety of humanity from the moment it came into existence up to this moment.

There are many answers, speculations, and stories, that range from the peacefully embracing to the ragingly hysterical. However there is only one answer that everyone agrees on and knows for a fact will happen; our bodies will rot. It is because of this indisputable fact that humans who can’t deal with the inevitability of death have gone out of their way to - often in extreme measures - attempt to create alternative realities that cater to whatever speculation they may have about what happens to the soul.

Egyptians across history have excelled at creating this alternative reality. From mummification to carry the body to the afterlife to the contemporary burial of families together in chambers, keeping women on one side and men on the other maintaining segregation even in death, in a last ditch attempt to avoid the reality that it no longer matters, that it’s over.

People all over the world try to romanticise the reality from the concept of the afterlife to reincarnation, to cremation and throwing the dust to the breeze over the ocean or keeping it an urn. Most recently an Italian company even created a business which takes the body in a certain container, buries it beneath the earth, where it proceeds to sprout a tree. All of these are ways of attempting to honour loved ones, while at the same time holding on to the last tangible thing they can hold on to.

It is amazing, that the best way to deal with a dead human body, is not the most obvious or the most popular worldwide, not to mention in Egypt.

The Reality of Post Mortem Organ Donation in Egypt

Post mortem organ, tissue and bone donation can save millions of lives. One donor can save up to 8 to 10 lives in critical condition needing a vital organ transplant, and save up to 50 people many of whom are children, from miserable shorter lives with tissue, eye and even bone donations.

Now that is a reality you cannot ignore, and here is a fact to take in: due to the total lack of an efficient post mortem organ donation system, paired with extreme poverty and a subpar healthcare system, illegal organ trafficking is very high in Egypt. Young, unemployed, impoverished people sell their organs (mainly kidneys) at ridiculously low prices to the rich. They do not realise that within 6 months they may suffer from kidney failure themselves followed by premature death.

This disaster remains unaddressed by a government that has clearly defined priorities that in no way deal with the fundamentals of life, such as healthcare and education.

It's Actually Legal

The shocking fact is, that in 2010, a law was passed making post mortem organ donation legal after years wasted following el Shaaraawy’s fatwa that says that “the body belongs to God” and therefore cannot be donated even in death. After that challenging obstacle was overruled by another fatwa that gave the green light for post mortem organ donation, a new challenge arose. The medical community could not agree on a definition of death and was split between those who define death as death of the brain, and those who define it as death of the heart. Without a clear, agreed upon definition of death, who will be able to decide a person is now dead and therefore their organs can be donated?

“The law is there, but it only exists on paper,” says Dr. Alaa Ghanaam, The Right to Health Program Director at Egyptian Initiative for Personal Rights (EIPR), and previous Assistant Deputy Minister of Heath. He goes on to say “the system is not integrated or regulated in a very fragmented health system. There is no Modus Operandi.”

You Want to Do What With My Dead Body?!

Further obstacles are represented in a society that may not be ready for such a notion, believing in the sanctity of the dead, that most would reject even a forensic autopsy to determine cause of death in inexplicable cases of premature death.

“We are a fatalistic population not a scientific one,” says Ghanaam, “Furthermore, we are a society that lays very little value on life, and a lot of value on death.” A clear example of that can be drawn from every day Egyptian life; a family of four without helmets on a motorbike; destroyed road systems uncatered to by the government leading to one of the highest rate of fatal accidents in the world; imprisonment of people most of whom are young, under false charges, and the society not caring; the lack of safety in any system from malls to factories, and the list is endless.

Egyptians place a lot of hope in the ‘afterlife’. They always have. Reliance on God is almost absolute, numbing people to think or act in a manner that does not serve practicality.

The answers that are given to the proposal of organ donation range between “God is the healer of all ailments” and “Everything is written” and the most famous “No one dies before their time,” - phrases all delivered in a pseudo-wise and nonchalant manner.

That said, this is nothing a major media campaign cannot handle in a short time. Meaning that getting society on to post mortem organ donation is not as difficult as getting the government to budge and take the legislation into motion.

What Can Be Done Now

According to Dr. Ghanaam, what can be done now, practically speaking, is using the law that allows licensed benevolent societies and charitable organisations to set up a panel of patients’ rights  in hospitals. Their job is to monitor the legalities of organ transplants, as well as raise awareness on a one-on-one basis amongst those in the hospital who are dying and their families, bringing them around to accept the idea of post mortem organ donation, granting many people lives, as a better option to the body going into the ground and its organs going to waste.

What one can do now as an individual is inform family and write a will that can donate the whole body after death, or parts of it. Under no circumstance will anyone’s body be donated without their or their families’ consent. Place of death also plays a factor in organ donation, since organs can only be donated within 48 hours of death, after which they need to be maintained in special facilities until ready for a transplant. However as mentioned before, this is all impossible without implementing a solid system that is corruption-proof, and takes into consideration everything from safe and sound transplants, to a fair waiting list with priorities always given to those in more critical conditions and not those with the money, to psychological care directed at the family of the donor.

Death is a terrible inevitability, but one has a choice about what to do with the body, and there is no point in rotting away in a grave when one has the option to give literal life to many other humans.


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