Transplant surgery came into its own in the sixties when Christian Barnard, a South African surgeon working in the Groote Schuur Hospital in Cape Town performed the first successful human to human heart transplant. The patient lived for eighteen days after the operation and died, not as a result of the transplant but from pneumonia, an infection which he could not survive because of the drugs he had been given to prevent the rejection of his new heart by his vigilant immune system. The drugs undermined his immune system to such an extent that an infection which would have been easily treated took his life and demonstrated the importance of immune suppression to transplants. Barnard became world famous for this feat, so famous that his domestic life changed completely as he found it difficult to cope with his new found fame but that is not of interest here.
Barnard was not the first surgeon to perform organ transplant surgery as seventeen years earlier the first successful kidney transplant had been carried out but it did not attract as much attention as a heart transplant probably because, in the first place there are two kidneys in the body and also, mankind has always regarded the heart as the seat of human viability. By 1967 when the first heart transplant was carried out, kidney transplants had become so common as not to raise the kind of blazing headlines which greeted a heart transplant when the procedure became available.
In Nigeria, kidney transplants generated lurid headlines following the case of Abraham Adedire, a postgraduate student who was suffering end stage kidney failure far away in the United States. The case created such widespread interest because it was reported that he needed a kidney if he was not to die. In those days the market for kidneys had not been thought of and the only acceptable response was for someone to step forward to donate one of their kidneys in order for the young man to have a chance, any chance at life. As soon as this news was received in his hometown of Ile-Ife, the family swung into action and his father, mother and siblings stepped forward as donor candidates but only his father, mother and sister were found to be successful donor candidates. Further tests however showed that the only one of them who showed blood compatibility with the stricken Abraham was the mother who showed no hesitation in pledging one of her healthy kidneys to her son, as long as there was any chance that he would be restored to good health even if she was to lose her own life in the process. As soon as arrangements had been completed for her journey she went off to the USA on her mission of redemption and cheerfully went under the knife in an operation to pass on one of her kidneys to her son. The operation was successful but the story did come to a fairy tale ending as her precious son lived for only five months before he cruelly succumbed to death caused by a kidney unrelated affliction.
Our story of altruism was not confined to the heroism of Abraham’s mother as his wife, an American, did not at any stage in the long running saga of her husband’s battle against illness give up hope of his eventual recovery. It was she who facilitated all the arrangements for getting her husband back to America to take advantage of the advanced medical facilities available there to her husband. And that was not all, as she moved from pillar to post to ensure that enough funds were raised to defray the huge cost of treating her husband and nursing him back to health. She worked tirelessly to bring their story to a large audience and to appeal to their human feelings to come forward to donate the money needed for the delicate operation that had to be carried out if her husband was to live. She appealed to her own white constituency in the USA as well as to black Americans who were moved to help out one of their own and so, blacks and whites were united in a common cause during a period of acute racial tension. Back home in Nigeria funds were provided by a large number of people who were moved by the plight of the young man and the heroism of a mother who was desperate to save the life of a precious son roaming unprotected in the valley of the shadow of death. The Adedire family was poor, very poor in pecuniary terms but were buoyed up by the empathy which was lavished on them by all those people whom they had never and would never meet in person but who were firmly on their side in a demonstration of unity in a course which had taken over their everyday existence. Many donated their money, their time, their expertise, their knowledge and their feelings for a fellow human being in an impressive show of human solidarity. They contributed all these and more without hope of any reward and doing so reminded the whole of humanity that the human race would have been wiped off the face of the earth countless millennia ago but for cooperative attitude of our joint ancestors who gave a human face to the evolution of modern man and laid the foundation for the civilisation which has grown to such an extent that the exploitation of the sophisticated surgical manoeuvres represented by kidney transplantation was now a possibility. In the early days of human civilisation, development would not have been possible if the spirit of cooperation did not exist and be placed over and above narrow individual interest.
It is quite clear that human beings have never controlled their environment as they are now capable of doing. So complete is our success that we need fear no other species of creation as we must fear what we as a race can do to each other and the earth which is our collective home. That we are approaching the magic number of eight billion people on earth speaks to our success as inhabitants of the earth. That we have achieved something glorious is shown up by the fact that it was not until 1830 that human population cracked the one billion barrier. Even more impressive is the fact that the next one billion stage was reached in 1920, a mere ninety years later. Human development has grown so massively that only hundred years later we have added more than five and a half billion human beings to the tally, a period that fits into the life time of quite a few people. It is not surprising therefore that most people alive today have taken the continued and heady growth of our planet for granted even though there was a time when the total global population was under one million.
Kidney transplantation, at least in Nigeria, has over the last couple of weeks caused a great deal of excitement all over the country in the same way that it did almost sixty years ago when a Nigerian mother with the selfless input of her foreign daughter-in-law, moved the nation in an unprecedented manner over the plight of an individual. That story is unforgettable because of the heroism shown by practically everyone involved in it especially that of a mother who refused to give up on her son and all she wanted was for him to be cured. There was no talk of money passing hands and the kidney which was made available at the point of transplantation was a genuine donation, a gift rendered up only in the expectation that it would turn out to be the gift of life itself.
In the extant story, the narrative matches the earlier case only in the sense that a young lady was suffering from potentially fatal kidney failure and was in dire need of a kidney. There is no information about the willingness or otherwise of her dearest and nearest offering to give her one of their kidneys in the hope that she would be saved from dying and so up to that point, there was no mention of heroism from any quarters, not even from her mother who nevertheless was most anxious that her young daughter would not pre-decease her as is the case with most other mothers. She was however prepared to spare a considerable part of her assets to procure good health for her daughter and is the way of achieving this objective that the whole saga descended into tragic farce. To put a complex case as simply as possible, a young man was allegedly persuaded to part with one of his kidneys so that it could be transplanted into the ailing young lady. The details of this arrangement are obscure but what is apparent is that the young, or perhaps not so young man was not a willing donor; that is, he was not in the business of giving out a kidney out of the goodness of his heart, in which case it will be doing grievous injury to the use of the English language if the term of donor was conferred on him. What has provoked the law to step into this case is that if he was not a donor, it was a case of organ harvesting, placing it firmly within the purview of the law. The issue of the age of the boy or young man involved is a rather greasy red herring, the crux of the matter being that the young man did not give his consent to the use of his kidney and was on the verge of being violated by persons who had the power and the means of doing so. If he was not a donor, the only other thing he could be was a victim and the law exists to protect the weak from the unprincipled activity of the powerful. The validity of our common human status is that nobody should be allowed to display any sign of impunity in their interaction with other human beings, the reason or reasons for that behaviour notwithstanding. This case will be dragged to its logical conclusion if only because it borders on the application of ethical principles to shedding some light on the discussion of the future of human existence in an increasingly cynical world.