July 5, 2007 - Cape Times
Corneas must be harvested within 12 hours, however, and for the past 30 years the Eye Bank Foundation of South Africa has facilitated the process.
When state mortuaries were managed jointly by the department of health and South African Police Service, the procedures were simple: the body arrived, the mortuary passed the family's details to the eye bank, and the eye bank phoned the family for permission to remove the lenses.
But after the department of health took over full control of mortuaries in April 2006, the process hit a snag.
The department reinterpreted the National Health Act stipulation that all matters relating to a user of a state health facility be kept confidential.
The result was that mortuaries could no longer release contact details for the family of the deceased and the eye bank had to go through the police officer in charge of the case.
Only then would contact information be shared - and during the delay, the cornea's endothelial cells would be dying off.
"We don't have the luxury of time," said Sharon Munnik, director of the eye bank's Western Cape office, where donations dwindled from on average 30 corneas a month in 2005 to a mere four a month in 2006.
"The department of health has authorised us to obtain eye tissue. Now it needs to help us do that, to restore sight to thousands of people."
The DA's spokesperson on health, Mike Waters, has launched an investigation into the feasibility of the requirements. Waters said confidentiality requirements for mortuaries had also been included in a recent health bill.
Sukhthi Naidoo, spokesperson for the deputy minister of health, said that an investigation into the issue was under way and a statement would be released.
Munnik said mechanisms had been put in place to skirt the new requirement - such as the appointment of a third party "tissue co-ordinator" who could approach the family of the deceased on the mortuary's behalf and pass the information on to the eye bank.
"But it's not just mortuaries, it's hospitals and health clinics, too. We need something at the national level."
There are 1 884 people on the national waiting list for corneas but, Munnik said, "that number doesn't account for the majority of patients at provincial hospitals, which maintain their own lists".
She estimated the true number to be around 3 000.
Although South Africa does not have a central donor registry, the eye bank will supply a would-be donor with a card recording their intent and asking that the eye bank be contacted at the time of the cardholder's death.
But problems arise when people die unnatural deaths and are taken to a state mortuary.
"We need to be able to speak to the family," said Munnik.
"We don't pressure them. We simply give them the option. The department of health is denying people their right to make this decision."