Organ donation coordinator ensures life after death

Li Cuiying walked quietly through a cemetery during China's ongoing Tomb-sweeping Day holiday, stopping from time to time in front of gravestones and mourning.

Thinking of those under the gravestones, the 31-year-old was sure of one thing: in a way, they were still living somewhere in the world.

Li is an organ donation coordinator in central China's Hunan Province, and she was viewing the graves of people who had made donations. "Organ donation means rebirth, as well as continuation," she says poetically.

Organ donation coordinator is a new profession in China, with the first such positions created in 2010, when an organ donation system was introduced nationwide. By setting up a registry system for donors and a distribution mechanism for recipients, it aimed to speed up organ transplants.

With this being a time of year for honoring the dead, Li has been in reflective mood lately on how the late donors she has dealt with have brought new life to the living, those patients in desperate need of transplants in a country that faces a great shortage of such resources.

A coordinator's job is to convince relatives of potential donors and help with the entire process of donation.

In 2010, Li was a nurse in the organ transplant section of the Third Xiangya Hospital of Central South University.

"Please, when can I have the transplant?" she was frequently asked by patients who, haggard and worried, were waiting for donated organs to save their lives. Many of them finally passed away in despair.

In China, an average of 300,000 patients need organ transplants a year, but only 10,000 of them are lucky enough to get the operations.

Human organs are typically procured via three channels: donations from executed prisoners, patients' relatives and other ordinary citizens.

Although the State Council issued regulations on voluntary organ donation in 2007, it has not proved easy to popularize the practice, as Chinese customs call for people to be buried or cremated intact.

"As a nurse, I felt really sad for the patients," Li recalls. "So I said to myself, 'How can I help them?'"

In March 2011, she became a coordinator.

The job is a difficult one.

"With your relative dying in bed, a stranger approaches you and asks if you would like to give up their organs. How would you feel?" Li asks.

She is used to being misunderstood or even reviled. Once, a man pushed her away and yelled, "Fuck off, you're nuts!" On another occasion, a group of people surrounded her, demanding to know how much money she could rake in by selling organs.

Even those who had thought of organ donation often hesitate at the last minute.

In one case, Ou Wuzhang sat outside the intensive care unit housing his 22-year-old son, Ou Liang, who was barely kept alive on a life support machine.

Dying from brain cancer, the younger Ou had told his father to donate his organs, but the grieving dad couldn't bear to sign the agreement.

Li gave him two contrasting photos. In one of them, a uremic patient looks miserable while waiting for a transplant. In the other, a patient beams as he is ready to leave hospital after a transplant operation.

Three hours later, Ou Wuzhang wrote down his name on the donation form.

Another time, a five-year-old boy was dying after a fall. His parents wanted to donate his cornea. But when Li talked about other organs, they refused.

"I am a mother myself, and I know exactly how they might have been feeling," Li says. Looking at the child, she didn't know how to comfort the grief-stricken parents.

But she still called the father the next day. "I understand that you don't want to leave your son, but he is suffering on the life support machine," she said. "I'm not trying to persuade you to donate his organ. But as a mother, I want to say, 'Let him go in peace.'"

Finally, the couple agreed.

Sometimes, she buys clothes for the deceased to show her respect. And she never turns down invitations to memorial gatherings.

Her mobile phone is seldom switched off, so donors' relatives can contact her at almost at any time.

During the interview with Xinhua, she gets an incoming call. "It was an old woman," she says. "She just called to ask about the patient who accepted her son's organ."

In the past four years, Li has been involved in 80 donation cases, over half of the total number in Hunan.

However, she admits that she is always under great pressure.

Xinhua asked an official with the China Organ Donation Administrative Center about working conditions for organ donation coordinators. Most leave the job after just one year, and very few survive for more than four years, according to the official, who declined to be named.

After signing an agreement, Li usually retreats into a hospital garden where she can be alone for one or two hours.

"I sometime ask myself why I do what I do," she says. But the patients thanking her after a successful organ transplant make it all worthwhile.

Since its introduction, the organ donation system has helped with 1,611 cases across China, with 4,382 organs donated.

But in Li's view, that is still far from enough.

"In some developed countries, like the United States, the ratio of supply and demand of human organs is one to three, but in China, it is one to 30," she explains.

Li notes that she has a dream that more and more people can break with tradition and understand the significance of organ donation. "I hope more people can write their names on a donation agreement form, so that when their lives come to an end, they can give another person a chance to live."