HEALTH-SRI LANKA: Helping the Living With Tissues From the Dead

By Feizal Samath Reprint | | Print |

Feizal Samath

COLOMBO, Sep 4 1998 (IPS) - A doctor who spent a lifetime building up from scratch one of the world’s finest eye donation institutions has now turned his hand to collecting human tissue.

No one doubts that the diminutive Dr. Hudson Silva has made a massive impact on the world of medical science by alleviating human suffering through his eye-bank. But he was not satisfied.

“In the course of meetings with other medical specialists and scientists, I discovered that there was a serious shortage of human tissues which could also be collected from donors,” Silva told IPS in an interview.

Today, Silva’s tissue bank is a model in the Asia Pcific region and is worthy of his Sri Lanka International Eye Bank which has since inception in 1961 donated 40,000 corneas to 168 cities in 62 countries besides thousands to local recipients.

The Sri Lankan doctor’s success and entrepreneurial spirit has been captured by many newspapers and magazines all over the world. The U.S publication, the Reader’s Digest featured him in several of its issues.

Silva has been honoured by many countries and has helped raise funds for government eye hospitals. An eye hospital in Pakistan has been named after him.

It was in 1957, when Silva was a medical student, that he first saw a cornea grafting operation being done by a Sri Lankan eye surgeon, who remarked that if only people donated their eyes, there wouldn’t be long waiting lists for cornea transplants.

Sri Lanka passed the Cornea Graft Act in 1955 under which only the eyes of prisoners on death row could be removed for this purpose. But the following year, the government suspended the death penalty which cut off supplies.

Watching the operation in 1957 changed Silva’s life and he decided to donate his eyes, on death. His mother followed suit. He then wrote articles in the newspapers urging people to donate their eyes.

Since Sri Lanka is predominantly Buddhist, it was not difficult to persuade people that donating eyes was a meritorious deed and the public response was good, he said.

Passing out of medical school, Silva was posted as a doctor at the government hospital in the southern town of Kalutara where he continued to canvass for eye donations. He received his first set of eyes in 1959.

“It was ironic. The hospital head was a Roman Catholic but he allowed me to remove the eyes of an unknown civilian who had died in hospital,” Silva recalls.

In 1960, Silva moved to the Colombo Eye Hospital, the country’s premier eye institution but continued to operate his small eye bank at home, helped by his wife.

Word spread about the doctor’s efforts and soon the act of donating one’s eyes caught on and the numbers became much more than what was required.

According to estimates, about two percent of Asia’s population suffer from blindness and a fourth of this figure have corneal blindness, which can be cured by a corneal transplant.

“I was criticised for overdoing this collection of eyes,” he said, adding that because of the excess he wrote to unnamed eye surgeons in the United States, Britain, Japan, Singapore and India offering free eyes.

“I just put letters in the post addressed to – The Eye surgeon. There were responses from Singapore and India,” Silva said. On May 25, 1964 which was Vesak Day marking the birth, enlightenment and death of Gautama Buddha, the founder of Buddhism, the first set of eyes was sent to Singapore.

As Silva’s fame and credibility spread, many more countries sought eyes from hisinstitution. Eyes from Sri Lanka have reached all corners of the world, giving vision to thousands of people.

While the Eye Bank is now housed in a fully-equipped multi- storey building, Silva still continues to maintain the one he started at home. “We keep it to show foreign guests that you don’t need a posh or sophisticated building to run an eye bank,” he said.

Pakistan is the largest recipient of eyes, taking over 16,800 of the total of 40,000 eyes sent abroad. India, Indonesia, Malaysia, Singapore, Japan, South Africa, Taiwan and the Middle East have been among other large recipients.

Eyes are sent abroad only after Sri Lanka’s own needs are met

and the annual excess is 1,500-2,000 corneas at present.

Silva’s Eye Bank operates on donations from rich countries and benefactors. Most receiving countries pay for transport costs but the Eye Bank sometimes spends its own money to send eyes to poorer countries. Often airlines offer free transport.

During the interview, Silva gets a call from the southern Indian state of Tamil Nadu, urgently requesting a pair of eyes. He responds quickly and sets his staff in motion.

In a few hours, a pair of eyes will reach a patient there and restore his sight. Modern technology has extended the life of an eye – removed from a donor after death – to two weeks from 5-6 days. earlier.

“An organ culture machine that was gifted by the Netherlands has helped us to increase the life span of the eyes we receive,” Silva said.

The tissue bank was opened two years ago and received financial and other support from the International Atomic Energy Agency (IAEA) to promote the use of radiation and gamma rays, to sterilize donor tissues.

Tissues presently handled by Silva’s bank include skin, bone, heart valves, meninga or the covering of the brain, tendons, ribs and knee caps.

The facility has so far received 59 bodies for dissection and use but Silva says the capacity is under-utilised. “The number of dead bodies that we receive is small in relation to our capacity.”

“Doctors are still hesitant to use these tissues. The concept is still new to many of them,” he said.

The Vienna-based IAEA stepped in and offered overseas scholarships to Sri Lankan doctors to be trained in the use of tissue culture. Awareness created by the media on collecting tissues from the dead for the living also helped.

Eye bank technicians who visit homes to collect the eyes from dead donors say they are usually able to convince relatives to donate the rest of the body.

The eye and tissue banks, both run by Silva’s Sri Lanka Eye Donation Society, are open day and night to receive donor eyes and dead bodies.