Albania: The Gift of Life09 January 2008
As kidney transplants become a reality, experts warn that legal loopholes could turn Albania into a hotspot for organ trafficking.
By Blerina Moka in Tirana
“I have been bed stricken for the last six years, sometimes it feels as though I was born on these white sheets,” says Adrian Hoxha, a 38-years-old dialysis patient in Tirana’s Mother Teresa University Hospital, QSUT.
With tears dropping from his deep brown eyes, his memory flashes back to the day where he learned that he was suffering from kidney failure.
“You never now where your next trial in life will come from,” he adds, recalling his long with the failing filters of the dialysis machine that dilutes the toxicity from his blood.
“Sometimes you have to wait for hours and hours when the old device breaks down,” explains Adrian, while he evokes the excruciating ritual.
The successful completion of the first transplant operation in Albania’s medical history in November in Tirana’s Balkan Alliance Medical Center, lights him up.
Although organ transplants hold out hope for hundreds of patience like Adrian, many worry that the current state of the Albanian public health care system cannot assure the required level of safety for such complex operations. Even worse, the absence of a legal framework on transplants could turn Albania into a source of organ trafficking.
Albania is one of the poorest countries in Europe, with a quarter of the population living under the international poverty threshold of $2 per day.
The publicly-funded health care system suffers from a lack of expertise, outdated equipment and grossly inadequate financial resources.
Albania’s public expenditure on health was 2.7% of its GDP in 2007, less than one-third of the average in the European Union.
Until recently, patients suffering from kidney failure had no choice but to opt for a costly transplant in a neighbouring EU country or somewhere else.
Adrian, whose brother has stepped forward as a donor, is already hoping he will be the next patient in line to receive “the gift of life”.
The cost of a kidney transplant in the Balkan Medical Alliance Center, a private hospital in Tirana, varies from €12-15,000, a sum often out of reach for many Albanian families, including Adrian’s.
In order to bridge the income gap, the Albanian government has funded a project through Italian expert assistance to train surgeons at QSUT so that they can carry out transplant operations through the public health care system.
“The Albanian government will support patients [financially], in order to provide for the demand for transplants in the country,” Prime Minister Berisha declared during a visit to QSUT in December.
According to Minister of Health, Nard Ndoka, transplant operations are to start in January at QSUT, as the final preparations for installing the new medical equipment in the operating theatres are on schedule.
Apart from a donation of €500,000 in the form of equipment, Italian experts will perform the first transplants in the public hospital, with Albanian surgeons assisting.
Profesor Francesco Paolo Selvaggi, the Italian surgeon who will lead the operation, believes that his Albanian colleagues will need to go through a trial period before they can perform the operation without being monitored.
“This will be a test for the surgeon and the whole supporting team of doctors that we will train,” Selvaggi says, underlining that they all have to perform to the highest standards to carry out a transplant.
Selvaggi is concerned that the Albanian health care system may fail patients, when it comes to such a complex operation.
“The hospital, for its part, has to assure at least the uninterrupted supply of electricity for the operating theatres,” he says, after noticing that there are still problems with such an essential requirement for a surgical intervention.
Patients are worried that Albanian doctors may not be up to the task.
“Look at my arms,” points out Adrian, “they can hardly find my veins, and they think they can perform a transplant.
Well aware of the challenges facing the public health care system, the Ministry of Health has initiated a study on the cost of outsourcing transplant operations to private hospitals.
“We are considering all our options, including cooperation with private hospitals,” says Ndoka, pointing out that operations also incur additional costs if they are performed within the public health care system.
The Ministry of Health estimates that over 180 patients are on the waiting list for a kidney transplant.
Although it seems that this operation is about to become a reality in Albania, experts and politicians alike are worried that the lack of a legal framework regulating transplants could turn the country into centre for trafficking in organs.
There is an urgent need to fill the legal loopholes in this field admits, Tritan Shehu, the head of the Albanian parliament’s Health Committee.
“Transplants bring forward a set of legal, ethical and economic issues that should be addressed,” Shehu says.
“We are dealing with the human rights of both patients and donors,” he adds.
Experts warn the current law, passed in 1997 does not deal comprehensively with issues that arise from this area of medical practice.
“Organ transplants, as such, are a good thing, but without a regulator, a complete legal framework, they could easily turn into organ trafficking,” Shehu explains.
Although Prime Minister Sali Berisha has promised to press on with moves to close the legal loopholes on organ transplants, the 1997 law has yet to be amended.
According to Shehu, the Ministry of Health needs to take the initiative by forwarding draft proposals to parliament’s Health Committee.
Albania is often identified as a source country for organ trafficking by various international organizations.
According the American Medical Association, Albania is one of the countries identified as destination for the so-called “transplant tourism.”
In one of the most notorious cases, an Italian doctor, Mario Spallone, was arrested in Italy in 2004, for an alleged conspiracy to open clinics in the Albanian cities of Durres and Fier with the purpose of harvesting organs that would be eventually trafficked to Italy and the EU.
Dr Sulejman Kodra, the head of the unit for transplants at QSUT, feels uneasy as he admits that trafficked organs could be used in his hospital.
“We shouldn’t be held responsible for such an eventuality,” he says.
“If a donor shows up, we would call a lawyer and fill the necessary paperwork, but we couldn’t be sure of what is happening behind our backs.”
Blerina Moka is a reporter for “Top News” television. Balkan Insight is the online publication of the Balkan Investigative Reporting Network. This article was made possible through the support of the National Endowment for Democracy.
http://www.balkaninsight.com/en/main/analysis/7271/
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