A half win for science

Published: May 13, 2012
The writer teaches physics and political science at LUMS. He holds a doctorate in physics from MIT

The writer teaches physics and political science at LUMS. He holds a doctorate in physics from MIT

First the good news: Pakistanis are increasingly eager and willing to act rationally, set aside traditional human body-related taboos, and embrace possibilities offered by medical science. Many Muslim clerics are now on board too. Although most still oppose contraception, they are willing to make concessions considered unthinkable a century ago.

Significantly, cadaver dissections are permitted in all Pakistani medical colleges; no screams of outrage accompany a dead body being cut to bits. Medical professors complain, however, that it is hard to get one’s hands on hands — as well as feet and spleens and brains — demanded by both research and teaching. So, courtesy the Edhi Foundation, some dead beggars make it to lab tables. I am also told of the availability of dead Americans who have willed their bodies to science. With no local donors, the morbid cottage industry of grave-snatching supplies the remainder.

And, hooray, now there’s blood everywhere! Remember the time when people thought that blood was a non-transferable sacred inheritance? Even today bloodlines determine honour-shame dynamics in our ghairat-bound culture. And yet every hospital in town has a blood bank where you can buy, donate, or sell blood. Few notice the contradiction of the “wrong” kind of blood being injected into their veins.

The sheer benefit of life-saving blood supplies has trumped earlier objections. Clerics have only mild recommendations to make: “one should abstain from the blood of non-Muslims, transgressors and sinners, when reasonably possible, for there is a risk that the evil effects found in such people may affect the one in whom the blood is transfused”.

The news on organ transplantation is even better. The very thought of implanting another human’s organs inside one’s own body was once utterly abhorrent. But today, it is (almost) uncontroversial. Is your kidney about to conk out? Well, take a hike to the SIUT (Sindh Institute of Urology and Transplantation) in Karachi and get another one. The hospital motto reads: “No patient is turned away from our hospital or asked to pay for our services. The SIUT does it free — with dignity”. Indeed, the SIUT does hundreds of free kidney transplants a year.

Fitted with a spanking new kidney, you can then hop across to one of LRBT’s (Layton Rehmatullah Benevolent Trust) 17 branches and get a corneal transplant. As at the SIUT, all treatment at the LRBT is “totally free so that no man, woman or child becomes blind just because he/she cannot afford the treatment. There should be no discrimination due to gender, caste, ethnicity, language, religion or sect”.

The SIUT and the LRBT are superb charitable institutions; they do Pakistan proud. But, for those who believe in societal progress based upon science and reason, it is an additional delight to behold the triumph of pragmatism. The Enlightenment-era philosopher Rene Descartes should be especially pleased. About 300 years ago, this Frenchman had hypothesised that every human organ operates strictly on physical and chemical principles. With the Christian Church thinking very differently, what Descartes claimed had placed his life at great risk. And now for the bad news: we Pakistanis don’t seem to mind being fitted with somebody else’s kidneys and eyes, but almost none are willing to volunteer our organs after death.

A young American-trained ophthalmologist, Dr Azhar Salahuddin, who spends his vacations in Pakistan doing free corneal transplants for the LRBT, told me that hardly any corneas (perhaps five to ten annually) are gifted by local donors. Although it is impossible to know true numbers, his guess is that most corneas come from Sri Lanka (80 per cent) and some from Canada.

But imported corneas are no solution. First, there are just not enough to go around; some 300,000 corneal blind Pakistanis could see again if corneas became available. Currently the number of local transplants performed annually is probably 500 to 700, a pittance compared with the 40,000 done in America.

A second consideration is inferior organ quality. Dr Salahuddin says the quality of an organ depends on several factors — the cell count of the donor cornea (which decreases as people age and have eye surgeries), the death to preservation time (the time between death and harvesting of the organ), utilisation time (the time from the harvesting to the time of actual transplantation) and the manner in which the cornea is handled. Usually, the best corneas stay in the country of origin, while poorer quality ones are exported. Therefore, Pakistan tends to get the bottom of the barrel — and even then, there aren’t enough. As a result, even the few transplants that are done locally have a higher chance of failure.

Why won’t Pakistanis donate their eyes, kidneys, hearts, and livers after death? Are we less altruistic than Sri Lankans? I am not aware of any survey done in Pakistan, but one in Iran shows that most transplants are live donations; just 13 per cent of renal transplants performed in 2006 were deceased donations. Eyes are a particularly sensitive matter: some Iranians are told by their clerics that, having given away their eyes, they will not be able to see heaven.

Dispelling such popular prejudice against organ donations was the focus of the 2010 International Congress of the International Society for the History of Islamic Medicine in Istanbul. Attended by some 200 experts on medicine and theology from 15 Muslim countries, the conference said that the majority of Islamic legal scholars do permit organ donations. But it noted that the general public remains distrustful.

Eventually organ donation comes down to a matter of religion and culture. In the US, many Hispanics are uncomfortable with the idea. According to organ donation experts, first and second-generation Mexican-Americans are said to be less likely to donate organs than Americans as a whole. The conclusion reached by the Texas Organ Sharing Alliance is remarkably similar to that found by the Iranian researchers: “They [Hispanics] feel that their loved one will be disfigured, or the person will not be able to get into heaven because their body will not be whole.”

Unreason sometimes appears impregnable. But, just as the hardest of rocks ultimately get worn down by wind and weather, so does every castle of superstition and irrationality crumble before the ceaseless battering by science and reason. Say what you will and think what you want, but science shows the human body comprises interchangeable parts, each made of atoms and molecules in a complex arrangement. That’s just a fact of life; one that could help save your life.

Published in The Express Tribune, May 14th, 2012.

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Reader Comments (59)

  • Danish Habib
    May 13, 2012 - 9:08PM

    The maulvis in pakistan preach against donating your organs.They term it against islam and so a lot of people don’t donate.If people would stop listening to mullahs and started thinking rationally and started thinking for themselves instead of letting mullahs think for them,our society would be a lot better.


  • Irfan
    May 13, 2012 - 9:19PM

    Thank God finally something useful to read. Winds of change coming from all directions. Very very informative. U have convinced me to donate my organs. Thanks Doc


  • C. Nandkishore
    May 13, 2012 - 9:20PM

    SIUT does hundreds of free kidney transplants a year. There is something suspicious here. Transplants may be free but who donates the kidneys? Sold by the poor or snatched from them?


  • kaalchakra
    May 13, 2012 - 9:33PM

    I for one don’t believe this. When we rise on the Judgement Day, are we going to dare stand without our kidneys?! May Allah protect us from the very thought!


  • Umer
    May 13, 2012 - 9:45PM


    I for one don’t believe this. When we rise on the Judgement Day, are we going to dare
    stand without our kidneys?! May Allah protect us from the very thought!

    Aren’t your kidneys otherwise supposed to become dust when you are dead and buried? May Allah protect us from JI mindset.


  • Shyam
    May 13, 2012 - 9:47PM

    * When we rise on the Judgement Day, are we going to dare stand without our kidneys?*

    Are you going to be judged on the basis of your kidneys or on the basis of your actions?


  • asma
    May 13, 2012 - 9:52PM

    @C. Nandkishore: The organs are donated by family (relatives).


  • Apokolips
    May 13, 2012 - 9:54PM

    The mullahs jargon has nothing to do with ordinary people not donating their organs.Most people ,myself included don’t want to donate their organs period Recommend

  • Mullah
    May 13, 2012 - 9:56PM

    In Pakistan (or whole world I must say) when an INDIVIDUAL with beard commits some crime or un-ethical thing, all blame is put upon Mullahs. I guess even with the permision of mullahs, many will not donate their eyes. If you do not believe me then check the % of people donating blood voluntarily.

    In case of when mumtaz qadri killed salman tasir, why not a stereotype developed against all securiy forces? mullahs were the lambs for slaughter here once again.

    Similar is the case of many other incidents as well.


  • S.H
    May 13, 2012 - 9:59PM

    Good article.
    Please try to understand difference between a mullah and a scholar/mufti/aalim.
    We should ask muftis and Islamic scholars instead of jahil mullas, who even themselves don’t know Islam.
    If there is no clear evidence of something in Quran and Hadith, then Islam has permitted ijma. Like for example (I think) donation of human parts is not evident from Hadith and Quran, therefore according to Islamic ijma concept islamic scholars of high qualification can set together and issue a fatwa in the light of Quran and Hadith.
    I think Ulama and Islamic scholars should issue a fatwa on this issue once and for all.


  • HeightsOfDumbness!!!
    May 13, 2012 - 10:01PM

    If after being DEAD you can rise up on Judgement Day, I am sure you would be perfectly be capable of doing it without any kidneys too..
    Just like you are worried of getting up from dead without your Kidneys, I am worried about you having to spend your life on earth without much of a Brain!!!!


  • waqar
    May 13, 2012 - 10:05PM

    @C. Nandkishore : SIUT is against the blackmarket trading of kidneys. All kidneys are donated freely and usually by relatives.


  • non nuclear
    May 13, 2012 - 10:17PM

    the situation in India is no better,the clerics in India declared blood donation as un islamic….
    well i have no idea about their religion,but if that cleric or some one in his family is in dire medical condition and in need of urgent blood transfusion will he/she reject blood transfusion saying that it is the blood of non muslim…BTW there is no difference between the blood of muslim and non muslim,the blood groups are same for both……..i have donated blood once,will donate without any hesitation as many times as i can,i have already registered myself to donate my eyes after i die, but irrespective of the religion i want the recipient of my organs to be unbiased and should be the one who will treat everyone equally…I’m not selling my organs but donating them..he/she should understand that only human thoughts are religious in nature and the rest of the body and world at large stands equal.Recommend

  • Ali Tanoli
    May 13, 2012 - 11:06PM

    Non nuclear,
    AAmir khan movie three Idiots is best example of india class diffrences….


  • Rukhshan Haroon
    May 13, 2012 - 11:13PM


    huh! he thinks his ‘defunct’ organs will help him to rise on the day of judgement , insane thoughts! I completely agree with shyam:”Are you going to be judged on the basis of your kidneys or on the basis of your actions?” donating your organs for a good purpose will earn you more reward, and will also save someones life, it is not always for life, it can also be used to experiment something which may discover something new (a true muslim), and on the contrary (not donating your organ) it may cause someone to loose his life and afterwards you may feel as the convicted responsible for his life (devils friend). The choice is yours.


  • Vinod Motiani
    May 13, 2012 - 11:16PM

    Register your wish to donate your organs and tissues in Pakistan and [most importantly] speak to your family about your wishes so that they contact SIUT immediately after your death.

    I…n the meanwhile all of us could do some good by donationg blood on a volunteer basis.

    I am a tissue co-ordinator at the OUH Hospitals NHS Trust in the UK and take consent for cadaveric tissue donation for transplantation [heart valves and corneas (eyes)] and research [brains and spinal cords]. I am also a vounteer blood and platelet donor and have registered to donate my bone marrow/stem cells. I have also registered to donate my organs and tissues for transplantation, research and/or teaching.

    As Pakistanis, we really need to wake up to this cause and embrace it- for it is no one but ourselves we are hurting by neglecting this cause.

    I am available for any advice.


  • Ali
    May 13, 2012 - 11:41PM

    @Apokolips….who wrote:

    “The mullahs jargon has nothing to do with ordinary people not donating their organs.Most people ,myself included don’t want to donate their organs period.”

    Hopefully you’ll remember this sentiment if you or a loved one, God forbid, needs an organ.
    An organ donor gives the ultimate in charity and saves and improves lives of hundreds of people (if you count the recipient’s family and friends as beneficiaries as well).

    Highest respect to Organ Donors.


  • TalkSensePlz
    May 14, 2012 - 12:17AM

    @ Nandkishore : Please don’t rush into expressing your * suspicions* without doing proper homework!!! As someone explained earlier, SIUT is against black market…


  • Ali Tanoli
    May 14, 2012 - 12:24AM

    I have just one question for Mullahs who opposed the donation of organ God will make us again the way he did first time and its not hard for him to do then why u guys opposed????


  • May 14, 2012 - 12:43AM

    Here is @kaalchakra
    About me
    If you have seen the Mahabharatha serial, you should know the drill. I am Time.
    Random Thoughts: It is stupid to fight against people (I am often stupid). We must fight against wrong ideas.
    Favorite Reading: Kamsutra – the only book humanity needs
    Favorite Writers: I am more fond of thinkers than of writers. Most writers couldn`t think their way out a zoo.


  • oliver
    May 14, 2012 - 12:51AM

    I think the thought of being dead is disturbing enough ! I am not prepared for the death, donating your organs after death needs to accept the inevitable. This is the only thing stopping me from donating my organs ! I pray to God for courage !


  • politically incorrect
    May 14, 2012 - 1:34AM


    Actually @kaalchakra is right, but his line of arguement is a bit dicey giving you an window to poke fun at him.Let me try it differently.
    We all owe our life and existance to the Almighty God.He is the Creator and the Owner of our body.So all the parts kidney,heart and all other parts/instruments belongs to Him.We have no right to donate something that doesn’t belong to us.
    It should revert back to the Creator, who in His infinite wisdom can decide whom He would favour with those parts.For humans to interfere in His job is sacrillege.

    It’s just commonsense, why bring mullahs into it.Recommend

  • American
    May 14, 2012 - 3:09AM

    I think the masses in Pakistan have mixed old outdate cultural norms with Islam and are now somewhat inhibited from changing. A good trick would be to use Islam itself to promote science. Since most of us here believe that Islam is being distorted by scholars who don’t understand modernity (and thus view everything with skepticism), you could instead change the Pakistani mindset by promoting the Islamic culture present in the early years.

    Set up a counterculture, where you promote the likes of Avicenna (Ibn Sina), and show that Islam promotes science and modernity (albeit with some constraints on vulgarity). Try to show that the common “literal” interpretations used by the Mullahs goes against the pursuit of knowledge that is promoted by Islam.

    This way you can win over the masses to your side of intellectual pursuit and slowly toss out this Mullah culture of literal interpretations that is being used to oppress people. They have to be convinced that this is what Allah would want them to do. Then, when they are liberated from their ignorance, they will let go of old cultural norms that inhibit them from doing good (like donating organs).


  • American
    May 14, 2012 - 3:11AM

    By the way I’m pretty sure kaalchakra was being sarcastic……


  • Shehzad Shah
    May 14, 2012 - 3:22AM

    @C. Nandkishore:
    At SIUT, all kidneys donated are from donors or unclaimed cadavers. The founder of SIUT, Dr.Adib Rizvi, was the moving force behind legislation that outlaws the sale of body parts in Pakistan.


  • Imran Ahsan Mirza
    May 14, 2012 - 4:43AM

    I live in Australia, and have registered for A class donor where any of or all of my organs can be used once I die and have prepared my wife for this. I am 38 years of age and who knows when this day may come. I don’t see my religion barring this Will. A dead body is all dead and once buried only memories keep it alive amongst relatives and friends and nothing more. The living organs can benefit the Living and nothing better than that, keeping some part of your body alive even after your death.


  • May 14, 2012 - 4:43AM

    I would go as far as to say that direct consent for organ donation should be implied for every dead body, even if the relatives object to it.

    A corpse is a corpse, with or without its corneas. Not to be callous, but a dead body isn’t a person…it’s a vacant, protoplasmic shell once occupied by a person.

    A pancreas doesn’t fly off to heaven to secrete insulin for the soul of the newly deceased. It lies rotting away in the grave. It is wasted, while somewhere in the city, a person continues to suffer due to the lack of availability of that organ. It almost feels like a criminal offense.


  • Zeeruck
    May 14, 2012 - 4:45AM

    Because everything is sold out well before they are finally dead. Sorry! :-(


  • Imran Ahsan Mirza
    May 14, 2012 - 4:48AM

    Well, you die because one or few of your organs stopped functioning, so it is better not to resurrect with those faulty organs. You mus demand new ones from God, you know your Omnipotent Master. I am sure He will give you good organs if need be.


  • Khalq e Khuda
    May 14, 2012 - 4:54AM

    It more like where do you donate your organs? There is practically no information anywhere.
    I tried to find online if I can donate my corneas but couldnt find one.


  • Zeeruck
    May 14, 2012 - 5:09AM

    KC kaisee baat kar rahay ho!, “When we rise on the Judgement Day, are we going to dare stand without our kidneys?” U can’t be serious!
    All who are buried or cremated or fed to birds shall rise that hour and face the music. Meaning, one’ll have to: “Accept the unpleasant consequences of one’s actions.”


  • Zalim singh
    May 14, 2012 - 5:29AM

    kudos sir, two great articles in a row,


  • Imran Con
    May 14, 2012 - 5:51AM

    If you look at most of his past comments on here you might rethink that. At the very least there will be no confusion as to why people didn’t respond to it as sarcasm. He has some screws loose.


  • vasan
    May 14, 2012 - 6:22AM

    politically incorrect : Just to extend your argument, I totally disagree though

    “Since our own body does not belong to us, there is no way other bodies belong to us humans”
    Why bother studying anatomy etc by dissecting body parts and learn
    How can u kill and maime others ?
    Just curious to know.
    Religion is taken to the extreme in your ideas to prevent a safe and healthy life here on the earth


  • mr. righty rightist
    May 14, 2012 - 8:11AM

    @Kaalachakra who writes “I for one don’t believe this. When we rise on the Judgement Day, are we going to dare stand without our kidneys?!”

    That’s funny!

    I have beginning to like you even more than Zaid Hamid. Your sense of humor is amazing.


  • trinity
    May 14, 2012 - 8:34AM

    may or may not. but what about this guy ‘politically incorrect’
    @politically incorrect:
    smelling stone age with retarded, reverse geared mentality. lol.


  • gp65
    May 14, 2012 - 8:49AM

    @American: “By the way I’m pretty sure kaalchakra was being sarcastic……”
    If you read other posts by him you wil know that this is how he actually thinks.


  • goof
    May 14, 2012 - 10:14AM

    Because there are all ready too many humans on earth. Why give them the tools to keep reproducing. If I could donate any organ to a Bengal Tiger for example. I would.


  • sars
    May 14, 2012 - 11:38AM

    @C. Nandkishore:
    No actually the SIUT has a strict family only policy and only organs from live related donors are transplanted after vetting both donor and recipient carefully. It may be a cultural bias that many women are donors and men recipients but no bought kidneys transplant happens here. It is all due to the diligence of its founder, Dr Adib Rizvi.

    One comment is that if we arent ready to dontae why are we ready to recieve organs when we need them??


  • Nasir Hussain
    May 14, 2012 - 12:52PM

    Good one. Keep doing Dr.


  • M A Hussain
    May 14, 2012 - 2:28PM

    @C. Nandkishore:
    SIUT does it for FREE, so no business going on here. I have worked in SIUT as my clinical rotation in medical school, and it is true. So clear up your mind :-)


  • khan
    May 14, 2012 - 4:03PM

    Lets not exaggerate Mullah’s influence.
    Pakistanis never voted for any religious party to give it power!


  • AhmedMaqsood
    May 14, 2012 - 4:33PM

    I believe the donation of eyes is definitely problematic since our mayats are “open-casket” in nature.


  • Uza Syed
    May 14, 2012 - 5:43PM

    I’m glad to notice a public discourse on something as serious and important and necessary—-and only some one as enlightened and bold and passionate as Dr. Hoodbhoy could initiate it here. Thanks to him and Express Tribune for this. By the way, I’ve already signed my consent to donate my cadavar and all of it or whatever from its remains are of any value to anyone be a sinner or pious from whatever faith and ethnicity.


  • faraz
    May 14, 2012 - 6:34PM

    Dr Sahib, there are broader and more serious issues to discuss and find solutions about than this one.


  • faraz
    May 14, 2012 - 6:39PM

    @Faraz Talat: This is kinda an extreme philosophical thinking; let the right to donate be with the body itself and not to (criminally) blame him for not donating!


  • haris
    May 14, 2012 - 8:06PM

    Fatwa about Organ donation has been issued long ago. Probably at the end of 1980s or early 90s, scholars from all Fuqaha, Medical Officers, Surgeons and doctors were invited in Saudia Arabia to discuss this matter in detail. And as far as I understand, Fatwa issued in the conference has highlighted few important things;
    1. Donar should not forced to donate his/her organ and must not be kept in dark from the truth about the deficiency or disease that might affect him after transplantation.

    The life of donar must not fall in danger after the transplantation. The Organs are classified in two classes; Singular on which the life heavily dependent upon e.g. Liver, Heart etc. So donation of such organs with or without the will of donar is forbidden in Islam.

    Donation of Organs must be done with an intention to save a life of another person and must not be meant to earn any monetary benefits.

    these are some of the issues quoted in the Fatwa, however, I urge everyone to read it by themselves.


  • May 14, 2012 - 8:11PM

    @Faraz Talat:

    “I would go as far as to say that direct consent for organ donation should be implied for every dead body, even if the relatives object to it…..”

    I do not know whether how widespread is the implementation but European countries, for some years, have been gathering data about organ donation. Ministry of Health, has asked every citizen, whether the person consents to organ donation, after death. An overwhelming majority has responded yes but many are still quite conservative in this regarded.

    (It is quite common for people to donate blood regularly, as thanks they get a cup of coffee.)


  • khan
    May 14, 2012 - 8:24PM

    had the writer been a doctor he wouldnt have written such a essay in first place.
    why? because even if people want it other than the eyes (cornea) no other organs can be harvested in our system , there are no facilities here.Recommend

  • Yuri Kondratyuk
    May 14, 2012 - 8:34PM


    Lets not exaggerate Mullah’s
    influence. . Pakistanis never voted
    for any religious party to give it

    But, they have the influence to induce violent crimes. And that’s considerable power.


  • Farhan
    May 14, 2012 - 10:33PM

    @Khan “no other organs can be harvested in our system , there are no facilities here.”

    I don’t understand where people get the nerve to comment about something that they are blatantly ignorant about. We do have the ability for organ harvesting and there is a very vibrant black market for kidneys in Pakistan.


  • sana
    May 15, 2012 - 4:00AM

    im amazed at the knowledge of the people cursing mullahs and talking rubbish about the judgement day, surely u dont have the knowledge that according to islam even after death the body can feel the pain as if it were alive. now think of the SAW movies becoming a reality after death once u donate yr organs. islam has a reason for everything. bt its only fr the people who give heed.


  • badsha
    May 15, 2012 - 12:45PM

    :) lolz….you made my day with you laughable stock! May Allah help you in understanding humanity (huqooq ul ibaad) which is the best way to get closer to Allah. Huqooq-Ullah should never be ignored as well.
    Hats Off to Dr sahib for this eye opener.


  • Zeeruck
    May 15, 2012 - 2:22PM

    If I could donate any organ to a Bengal Tiger for example. I would.

    Great Idea goof! The Tiger might like the taste and may even pay you a visit to thank… and ask for more!


  • G. Din
    May 16, 2012 - 11:40PM

    Recently, an initiative by Facebook has sparked a huge amount of interest in organ donation in the US. It has been suggested that the shortage in harvested organs (yes, there is one in the US as well) is not caused as much by any factor other than inadequate familiarity with the process. I read also about an initiative by a doctor in Gujarat who let it be known that he would go anywhere at anytime to harvest an eye from a cadaver. He did that on site, even on cremation grounds or a burial site.
    I do believe that the donor (or his/her agent) should have some say in disposal of a donated organ. After all, donated organ only benefits someone and if the donor has some say in the matter, it may remove some reluctance in the matter and benefit someone instead of being denied altogether. However, complete anonymity is also desirable except of course where donor and donee know each other.
    I also believe that there should be some financial compensation for the same reason(s) as above and to avoid a huge black market in this area. ( How do you think wealthy sheikhs get their organs in American hospitals at a short notice. )If you are paying a nominal amount, not subject to negotiation or haggling, these days for sterilization, why should there be any reluctance in doing so in this matter. Again complete anonymity is much desirable.


  • Azhar Salahuddin
    May 29, 2012 - 10:00PM

    Excellent article! No one needs their eyes and kidneys after their dead – give them to someone does.


  • Azhar Salahuddin
    May 31, 2012 - 8:55PM

    @M Baloch:

    Actually, I think he got the facts right. Even based on your recommended articles, there is a lot of controversy regarding organ donation and I think Dr. Hoodbhoy highlighted this very well.


  • Ashfaq
    Jul 7, 2012 - 5:06PM

    In today’s connected world, it’s a lot easier to get the latest Scholarly Opinions.
    I wonder how come some like Dr. Hoodbhoy missed that & concluded in putting most of the blame on Islamic Scholars (Mullah, as he likes to call them).

    Let’s see what those Mullah have been saying about the issue


    PS: Above post refers to the conference occurred in 1988 (24 yrs from now)


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