Interview by Youssouph BODIAN

Saturday December 09, 2023

“We have broken the organ transplant taboo”.

After a long process, Senegal has finally carried out its first kidney transplants. How do you feel about having steered this project?

I give thanks to God and to the President of the Republic, who has always been committed to the success of this project. It’s a very satisfying feeling, because we’ve broken the taboo. I’ve always been convinced that transplantation is within the reach of Senegalese doctors. We have the human resources and all we needed was the will.
I can also see the hope that this brings to other patients, because we have a lot of patients waiting. Unfortunately, however, not all dialysis patients can be transplanted. There is a long waiting list, but the operation requires considerable resources.

Is transplantation within the reach of all Senegalese patients?

I think that transplantation should be subsidized by the State. We’ve succeeded in organizing the legal and practical aspects, so now we have to take up the challenge of financing.

The Senegalese government already spends a lot of money on dialysis, and transplantation costs less, with many more advantages. If we want to respect equity in access to care, we’re going to have to introduce a subsidy. Next, we’re going to set targets for the public health establishments that will be accredited.
We’ll give them a number of transplants to perform, and if they do them well, we’ll increase the subsidy; if they don’t, we’ll reduce it. If we don’t, transplantation will become an elitist activity for the wealthy.

How much does it cost to have a kidney transplant in Senegal?

We’re in the process of assessing the exact costs, but initial estimates have been set at 7 to 8 million CFA francs per operation. To remove the kidney, for example, the operation costs around 2 million Fcfa. But it should be noted that for the first three operations we carried out, the hospital fully covered the costs. But no public health establishment can continue to bear these costs alone.
We’ve shown that it’s possible, so we need to create the right conditions for us to continue transplanting. We’ve only chosen three patients to start with, but there are hundreds on the waiting list.

The other challenge is to ensure that the various hospitals have the appropriate technical facilities ?

One of the roles of the Conseil national du don et de la transplantation is to ensure health safety and transparency. A hospital wishing to transplant is obliged to submit an application for approval. There are a number of criteria to be met, including human resources, infrastructure and internal organization. A team then inspects the hospital and makes recommendations. For example, a hospital can’t transplant if it doesn’t have a nephrologist, a urology department or a functional operating theatre. These are the major criteria to be met in order to obtain authorization to transplant. Approval is granted for a renewable period of two years.

How does the committee you head intend to regulate transplantation to prevent organ trafficking in Senegal?

All donors must first give their consent to the president of the district court. The donor must provide proof that he or she is related to the person to whom he or she is donating a kidney. Then, with the help of experts, the judge will check the donor’s motivations. This is what happened with the first three donors.
At the end of this hearing, the president of the court draws up a report to give his approval or not. So the whole organ donation process is well supervised.

As a nephrologist, you are one of the doctors who performed the first transplants. How are your first three transplant patients faring ?

They’re doing very well, and it’s moving to see the renewed hope in their eyes. They are returning to a normal life. It’s wonderful to see that the generosity to donate an organ still exists in humanity, and we must encourage it. The other challenge is information.
We have developed communication tools, but we don’t yet have the means to disseminate them widely in the media. We’re also counting heavily on the press to let people know that donation is possible in Senegal, and above all that there are no religious obstacles to it. To this end, we have drawn up a guide with the imams for Muslims and another with the clergy for Catholics.

Yousouph Bodian – Correspondent Humaniterre – Senegal

Credit photo : Y.BODIAN