Sri Lanka – the country that donates ‘eyes’ to the whole world, including Pakistan

According to the WHO, 4% of the world’s 39 million blind people suffer from corneal opacity (the scarring or clouding over the cornea). In comparison, another 3% suffer from trachoma, a bacterial infection that damages the cornea. To restore sight to damaged eyes, doctors often need to transplant the cornea from a donor’s dead body.

Why is a cornea transplant necessary?

The cornea is the transparent front part of the eye, which lets in light and helps focus images on the retina. When it’s damaged, as a result of injury or disease, a person’s sight deteriorates, sometimes to the point of blindness. Often the only solution is a transplant.

The cornea is one of the easiest tissues to transplant as no matching is required between donor and recipient. It is bloodless tissue, taking oxygen directly from the air. It is also possible to take a cornea from an older person and graft it onto the eyes of a much younger one. If a donor is more than 80 years old, there is a higher chance that the cornea will not be suitable, but it’s reported that in one case, the cornea of an 86-year-old Buddhist monk was given to a nine-year-old Jordanian boy.

However, in many countries, donated corneas are in short supply – a situation aggravated because they have a brief shelf-life.

Sri Lanka saving millions of people’s lives

Unfortunately, there is a worldwide shortage of corneas. However, one country – Sri Lanka – is doing its best to satisfy the high demand without seeking any reward in this life.

According to the Eye Donation Society – a non-profit organization founded by a young doctor, Hudson Silva, in 1961 – one in five Sri Lankans have pledged to donate their corneas. Eye Donation Society’s medical director, Dr. Siri Cassim, whose job is to sign the decorative papers given to donors’ families, said:

It seems like I’ve signed a certificate for every human being in Sri Lanka.

Viswani Pasadi, a student who donated her eyes for when she dies, said:

If I donate my eyes in this life, I’ll have a better vision in my next life.

Like most Sinhalese – who make up 75% of Sri Lanka’s population – Pasadi is Buddhist. She believes in a cycle of birth, death, and rebirth and sees this donation as a sound investment in her future.

Another person who has taken this step is bookkeeper Preethi Kahlewatte. She shared:

Whatever good things we do in this birth, we will take into the next birth. When a person needs something, we like to donate. Without hands, we can work. Without legs, we can work. Without eyes, what can we do?

Six eyeless corpses per month

Surprisingly perhaps, the removal of a dead person’s eyes is not a problem for Sri Lankan families that want an open coffin at the funeral. Jayaratne Funerals in Colombo gets about six eyeless corpses a month. Hasanga Jayaratne, director of the organization, said:

The embalmers take two cotton balls about the size of the eyeballs. They soak it in embalming fluid and put it inside the eyes, and use a bit of glue to shut the eyes. Mourners are then able to see their loved-one one last time before the next life begins.

How did the eye donation process begin in Sri Lanka?

The eagerness of Sri Lankans to offer their corneas to others means that the country has long harvested more than it needs and can send the surplus to other countries. The late Hudson Silva began this process in 1964 by packing a few eyes into an ice-filled thermos flask generally used for tea and having them carried by hand on a flight to Singapore. In 2014, his Society exported 2,551 corneas, including 1,000 to China, 850 to Pakistan, 250 to Thailand, and 50 to Japan.

 

The country’s emergence as a significant donor of corneas is mainly down to Silva’s dynamism. He made his first appeal for eye donations as a student in 1958, in a newspaper article co-authored with his wife and mother, urging Sri Lankans to “give life to a dead eye”. The first corneas he received the following year were stored in his own refrigerator along with the eggs and butter. Then in 1960, his mother died, and it’s said that Silva won the nation’s heart by grafting her corneas onto the eyes of a poor farmer and restoring his sight.

Buddhist monks have also played a part in encouraging donations and teaching people to see them as an act of giving, or “dana”, that will help them reincarnate into a better life. The venerable Kiribathgoda Gnanananda Thero, founder of the Mahamevnawa Buddhist Monastery in Sri Lanka, shared a story from the Jataka, an ancient book of poems about the Buddha’s earlier lives, and said:

In Buddha’s previous life, he became a king. A blind beggar came to the palace and met the king. And he requested, ‘Oh king, give me your eyes’. So he [Buddha] decided to give. The Buddha’s surgeon then removed the Buddha’s eyes and transferred them to the beggar, restoring his vision. Generation to generation, we have been listening to those kinds of stories. So we are very encouraged to give our body parts to others. I have donated a kidney to a woman with kidney disease.

The certificates handed out by the Eye Donation Society to those who pledge their corneas explicitly allude to Buddhist teaching as it reads:

Let the donor have a good rebirth.

Muslims are the primary recipients of Sri Lankan corneas

In Muslim countries, it is generally forbidden to damage the human body before or after death. Therefore, Pakistan and Egypt have been primary recipients of Sri Lankan corneas. Malaysia, Nigeria, Sudan also feature on the list of more than 50 receiving countries.

 

Story originally published in BBC

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