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Organ Donor- Vast Majority are women

Introduction: India has become the largest country where vast majority of women are organ donor. 

India has emerged as a hub living donor organ transplants in south and southeast Asia. In 2011, India performed the second highest living donor organ transplants in the world after the U.S.

According to the World Health Organization data, the current cadaveric donation rate is 0.56 per million, this mean one cadaveric donor on per 2 million persons. Comparatively, in Spain the rate of living donor is 34 on per million of population, which is the highest in the world. This is approximately 68 times the India rate, for a population that is 4% of India's. So, the situation is if there were no living donors, the chances of dying while waiting for an organ in India are very high.   

What is organ donation? 
To understand organ donation, first important to understand organ transplants. A transplant is a medical procedure where one person’s dysfunctional organ or tissue is replaced by that of a healthy person, thus restoring its function. In certain cases, despite major advances in medical science, transplant is the only alternative. Transplant drastically improve the quality of life of the patient and give them another chance to live. 
Vital organs such as the heart, pancreas, liver, kidney, eyes, skin, bone, bone marrow, nerves, brain, heart valves, eardrum, ear bones, blood and lungs can be transplanted to those whose organs are failing. 

Why women are in the large majority of organ donation in India? 
In India where gender inequality is still an ongoing issue, the data shows that the majority of women in India are living donors, that constitute 74% of kidney donors and for liver surgeries. And surprisingly all the transplants by women living donor happens almost entirely in private hospitals, which do not come under RTI. 
Women are 60.5% of the donors, based on figures for 2009-2017 from 5 centers. 
Not only in India, women are the in the higher proportion of living organ donor around the globe.  
The proportion of women donors is higher in India than in the U.S, which performs the highest number of living donor organ transplants in the world. Whereas in the U.S, women constitute 62% of kidney donors where in India the rate is 74% of kidney donor, and 53% of liver donors in U.S and 60.5% in India. Another organ donor transplants rate is also higher than U.S.

In-accessible Data 
Health data in general is inaccessible in India, difficult to get even through RTIs, but data on women and health, outside of child sex ratio, maternal mortality and fertility rate, is non-existent. It would appear that what happened to women- other than birth and birthing health- is like not known or not worth knowing. 

What can be the causes? 
There can be a possibility of putting pressure on women to donate their organ, it is entirely legitimate for daughters-in-law and sisters-in-law to donate organs, but the question to ask is are brothers-in –laws and son –in-law donating organs similarly like women does. 
Family members put emotional pressure on women without worrying about her bad health consequences. New generation and society talk about gender equality men claims that women are equal to men nowadays, women are not victim, as the whole report and data shows women can be seen as a victim. This is a bitter truth. 

Have a look on gender equality reports 
According to the United Nations Development report 2017 on gender inequality, India ranked 125 among 159 countries, transplant figures in context of the country’s record on gender is an issue of concerned. 
India's own estimate of female employment is lower at 24% yet the Indian women spends an average of 297 minutes a day on unpaid labour including care work, the 11th highest among 67 countries rated by the International Labour Organization, while the India man spend 31 minutes, the 4th lowest on the list. 
Expenditure on ‘major morbidity’ -( illness more serious than cough fever and diarrhea) for an Indian woman is on an average 28% lower than for a man. The average expenditure for a man was 10,165 rupees and for a women 7,383 rupees. Simply put a woman’s life is 28% less valuable than a man's life. 

A way forward 
According to Transplantation of Human Organ and Tissue Rules, 2014, permits related and unrelated person to become living donors, but strictly for non-commercial purposes. The donor and recipient must prove their relationship and emotional closeness through documents and photographs. There is a need to do strict scrutiny in private hospitals to check that a woman who is donating organ is a close relative, wife, sister or an imposter. Aggressive action should be taken on such private hospitals who are in indulge in such unethical practices. Poor and vulnerable women are the main part of such activities who donate their organ for money.