Kathmandu, Nepal – When the kidneys of Sushi Thapa failed at 19, she expected a single operation to repair everything. Instead, his world has narrowed with two -legged machines and dialysis sessions three times a week, replacing manuals and career ambitions.
Finding a donor turned out to be brutal. The blood group of his mother did not correspond and his father refused. When Sushila Thapa, her mother, discovered organ transplants from the optional brain patients, relatives fell: “How could you accept organs of someone who is dead?” “It’s against our religion!”
Without being discouraged, Sushila Thapa added her daughter to a waiting list of 500 people. For months, they have conscientiously updated medical reports each quarter. Then one evening in June in 2022, the phone rang: “Come immediately. We could have a kidney. “
If you need a kidney transplant in Nepal, your ratings vary considerably depending on the donor type. Between 2017 and 2024, more than 1,000 people were waiting for kidney patients who died of the brain, subordinate to the approval of the next parents, while more than 7,600 has been listed for living donors, according to information provided by the Ministry of Health and Population.
Each year, 3,000 additional Nepalese undergo renal failure, but only 10% find living donors in the midst of a shortage of critical organs in the country. Although demand far exceeds supply, the deep cultural resistance remains in the gifts of dead brain patients.
Since Nepal legalized the donations of organs of dead ends in 2016 and that the first transplant took place in 2017, only 13 people received organs in this way, against nearly 1,900 living donors, according to data provided by Mrinal Canhahary, the head of information technology at the Ministry of Health.
Behind these figures is a struggle where tradition comes up against medicine.
“People fear being renowned incomplete,” said Dr. Kalpana Kumari Shrestha, a nephrologist at the Shahid Dharmabhakta National Transplant Center in Katmandu. “Some even accuse me of organ trafficking when I explain the process.”
More than 80% of the population of Nepal is Hindu, a religion which includes a belief in reincarnation. In Hindu communities here, immediate cremation is sacred. This practice, where the soul begins its journey after death, comes into conflict with organ donation.
“This contradicts Hindu Vedic Teachings. Death only occurs when all organs ceases to function – it is only then that the soul can leave, “explains Ram Chandra Gautam, Sanskrit professor at the University of Nepal Sanskrit, Valmeeki campus (Viddyapeeth).
In a culture centered on reincarnation and Moksha, belief maintains that life continues while the heart beats.
“We are looking at wild lives escape,” said Dr. Pawan Raj Chalise, associate professor and head of the Urology and Reine Registry at the Tribhuvan University Hospital in Katmandu.
The landscape of transplantation of Nepal transformed in 2016. Although the 1999 law on organs transplantation of the human body (regulation and prohibition) limits the options of donors, the 2016 amendment extended “close relatives” to include 51 relations and also recognizing cerebral patients as sources of legitimate organs.
The Shahid Dharmabhakta National Transplant Center successfully succeeded in the first renal transplant of Nepal from a deadly brain donor in 2017 and remains the only hospital in the country with this capacity.
Dr. Pukar Chandra Shrestha, director of the transplantation center, pleaded for eight years for legal change, but says that many things must be done.
The government changes cultural attitudes thanks to awareness of the officials, the heads of the community and the religious figures, while integrating the subject into the school programs. He increased financial support for donor families and participating hospitals.
Since the adoption of the 2016 law, 2,627 people have registered to give their bodies after the death, according to figures confirmed by Shrestha.
When Kopila Bhujel lost her 24 -year -old husband in an accident, she was pregnant with their third child. Initially horrified by the demand for organs of organs from doctors, she thought that only the cremation of the whole body as it would bring peace to her soul. “I thought they were trying to sell his body,” she recalls.
After 12 hours of internal struggle and a lot of convincing by doctors and hospital workers from the hospital, Bhujel chose differently. Her husband’s kidneys saved two lives, and her liver, another.
“There is no greater religion than donation,” she said now, at 30, working as a worker to educate the children they dreamed of. “He may be gone, but I feel his presence when I dream of smiling, finally in peace.”