Out of 72 kidney transplants done in Nepal since Tribhuvan University Teaching Hospital (TUTH) started transplants on August 8, 2008--Bir Hospital started them from December 12 that year--around 85 percent of recipients are male and about 82 percent of donors are female. [break]
Combined figures from TUTH and Bir show that just 11 out of 72 recipients are female and only 13 of the donors are male. The figures are even more unsettling if we take just the data for Bir. Out of 23 kidney transplants done there, only one recipient was female and just two donors were male.
“My mother is weak, so my father donated for me,” a 21-year-old man, who is recovering at Bir after transplant surgery on February 27, said, underlining the lop-sided gender equation in the country.
The facts show that while men are reluctant to donate kidneys to family members--Nepali law forbids kidney transplants outside the immediate family to curb illicit trade--while they rarely take women to hospital for transplants.
Bir´s Dr Vijay Kumar Sharma disclosed that kidney problems are not gender-specific and half of around 750 kidney patients requiring transplants at any given time are female. “There is also no medical reason why women´s kidneys should be better suited for transplant,” Dr Sharma said.
“Ours is a male-dominated society where men are the bread-winners,” Dr Sharma added. Anthropologist Om Gurung concurred. “Females are just food-makers in our society and they have been made to believe that they can be protected only in the presence of a male,” Gurung opined.
Senior nephrologist at TUTH Dr Dibya Singh, like Dr Sharma, argues that the caring nature of women may also have to do with the high number of female donors. “A mother or a wife will readily agree to donate her kidney to her son or husband out of her love for them,” Dr Singh said.
As a woman herself, Dr Singh doesn´t have much problem with gender disparity in the case of donors as transplants ultimately save lives, but she can´t stand the disparity in number of recipients. “I have strong reservations over the lower number of female recipients as there is not much gender disparity in the number of patients requiring kidney transplants,” Dr Singh added.
She said there is no practice of spending a large sum of money--a kidney transplant requires around Rs 500,000 in Nepal--on a female. “They can marry another wife for a much lower amount of money (than required for a kidney transplant) if she dies, and on top of that they even get dowry,” one medical practitioner said, trying to explain the lower number of female recipients.
The data on kidney transplants also reveals an interesting fact about the level of awareness among various ethnic communities. Out of 11 female recipients in Nepal, one is a Giri, two are Newars, and the rest Mongol (Rai, Limbu, Magar, Tamang and others).
There is also greater gender disparity among Khas (Brahman/Chhetri) donors. “In case of Brahman/Chhetri donors, just 15 percent are male but there is not much gender disparity among Mongol donors (55 percent female and 45 percent male),” Dr Singh disclosed.
Anthropologist Gurung expressed no surprise at the relative gender equality in case of transplants among Mongol ethnicities. “Janajati women enjoy equal rights to a certain degree in our society. Janajati women have fewer cultural restrictions and also traditionally have to look after the family in the absence of the menfolk who are generally outside the country for work,” Gurung argued.
Dr Singh, while admitting that gender disparity in kidney transplants in Nepal was far from being reason for complacency--she recalled how her Western counterparts expressed surprise about the disparity during a conference of the International Society of Nephrology in Milan, Italy last year -- said the Nepal figures are still progressive in comparison with India. “There are fewer female recipients and male donors in South Asia and India has more lopsided figures than ours at TUTH,” she said.
premdhakal@myrepublica.com
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