JERUSALEM — Too many Israelis in need of new kidneys, hearts, lungs and livers must go to Europe or North America to get them — or die waiting.
But the situation is starting to change. Though organ donation has been slow to catch on among Israel’s most observant Jewish and Muslim populations, the country’s sluggish record for organ donation is, at last, on the upswing.
Whereas two years ago, an average 300 healthy people were signing themselves up each month as potential donors, today that figure has increased tenfold.
And at the Hadassah-Hebrew University Medical Center in Jerusalem, where no organs at all were donated in 1996 and most of 1997, there was a donor a month in one recent three-month period — and no less than 10 people have received a new lease on life from their organs.
Several factors contribute to the upsurge, according to Sari Gotthold, Hadassah hospital’s transplant coordinator since last fall. One is an ongoing education effort conducted in Israel for some 20 years. Another is the recent centralization and coordination of this campaign.
“A few years ago, the Health Ministry looked around and saw that organ donation in this country was a disaster,” said Gotthold.
The ministry discovered that Spain had a program that had, in just a year, upped the number of organs donated from seven for every million people to 27 for every million. Israeli health officials adopted a similar plan, which provided for the appointment of a transplant coordinator in every hospital in the country.
The coordinators “run ongoing seminars to help us coordinators function effectively, and they computerize the details of all those waiting for organs so that they can be rapidly matched with donors,” Gotthold said.
“At first, the thinking was that it’s a job for social workers. But we’ve seen that that’s mistaken. What I do as transplant coordinator is essentially a nurse’s job, much as I’ve worked for the past 20 years.”
And a nurse’s job, she says, is supporting families through the ordeal.
One recent potential donor was a 19-year-old woman doing her Israel Defense Force service. She had suffered a brain aneurysm, and had no chance for recovery.
“Her parents were Russian immigrants,” said Gotthold. “I spent several days with them, trying to help them come to terms with the approaching loss of their daughter. Once the hospital committee formally declared this beautiful girl brain-dead, I brought up organ donation. The parents wept.
“I waited till they were calmer, and then said, `You’ve told me so often these past few days how wonderful a girl she is, how all she ever wanted to do was help others. If you could ask her now, don’t you think she’d take this last chance to help?”‘
The parents agreed to donate her organs.
In the case of another patient, Gotthold didn’t succeed in securing the organs, but she sensed a shift in the family’s previous opposition to organ donation.
The potential donor was a 70-year-old Chassid. “He’d been hit by a bus, and was already brain-dead when he was brought to the hospital,” said Gotthold. “His heart and lungs were too old to help anyone, but his kidneys were in good shape.
“I spent a lot of time with his wife and four grown children. With one son in particular, I connected very well, and it was with him that I first raised donating his father’s organs.”
After giving him details, she told the son, “and you’ll have the mitzvah of saving a life.” The son took the idea to his mother and siblings, Gotthold said. “Their reaction: `How can you even think of it without asking the rebbe!’
“Well, their rebbe has never yet agreed to organ donation, and he didn’t on this occasion, either. His advice was to continue treatment and there would be a miracle.”
There was no miracle. Two days later, the patient went into cardiac arrest, and his heart followed his brain into death.
Gotthold was encouraged nonetheless. “That one son heard me, and understood,” she said. “Perhaps this is the start of a softening” in the fervently religious community.
Gotthold, herself religiously observant, is one of only 130,000 Israelis with signed donor cards in their possession — as are her five grown children.
“It’s something I believe in passionately,” she said. “I worked for 20 years in the open-heart surgery recovery room, and cared for many heart-transplant patients. I’ve seen with my own eyes what a new heart does for a desperately sick patient. I think that my total conviction helps me persuade others.”