Christmas, MOTTEP, and the New Lease on Life
By Aurelio Solver Agcaoili, Ph.D.
There is one thing by which we can put into a proper perspective how to understand the nexus of three seemingly disparate realities that are, as in many other places, the everyday concerns of the people of Hawai’i as well.
The Ilokanos, the bulk of the people of the Philippines and those descended from them who have come to Hawai’i, call this daton—that nexus that glue as well what Christmas means, what National MOTTEP envisions and does, and what, in exact terms, is required when we speak about ‘a new lease on life.’ As a national organization “designed to educate minorities on facts about organ/tissue transplantation”, it has local sites across the United States.
National MOTTEP—or National Minority Organ Tissue Transplant Education Program—of course, is the national organization that has been fired by the idea that organ donation is a bioethical practice that needs to be pursued more and more even as it needs as well to be continually imbued with the virtues of care and concern for others. National MOTTEP is the public education program of the Organ Donor Center of Hawai’i.
The idea of daton linked with Christmas, with the new lease of life metaphor and reality, and with the work of National MOTTEP, is a means to come to terms with the enormous challenges of pursuing the message of the Yuletide season, of organ donation, and of having a second chance at life.
Daton is offering.
Daton is an oblation as well: a sacred act of giving of self or part of that self, the act of giving always done in freedom and in the generosity of spirit of the giver, the donor.
What grounds the sanctity of that act of giving is the freedom it involves, the freedom that is its core, that freedom that provides the context through which the giver understands that his or her act will lead to something noble, grand, beautiful, and true.
There is sacredness in this act of giving because it is invocatory of the higher energies we summon to be able to understand these things—difficult as they are—more fully in the round, these things that have something to do with seeing ourselves beyond ourselves, mirroring ourselves in others, and wishing the others well.
Because the giver must understand that what is given will lead to something new.
Because the giver must understand that the act of giving will open a new door to the recipient of the gift.
Because, as in the act of organ donation, the donor gives the recipient a new lease on life, and that gift of life is an ultimate gift.
These thoughts hit me hard when I sat down with Tony Sagayadoro, program coordinator of the National MOTTEP of the ODCH, for an interview at a Filipino-owned restaurant on Kalihi one late morning. The interview segued into the early afternoon hours, with not any of us minding the time, with Sagayadoro ever present in the to-and-fro of our ideas.
He came armed with the documents about MOTTEP and the organ donation program of ODCH.
He came armed with his vast knowledge about the needs of the minority groups of this state for a more informed knowledge about organ donation and its pluses, including the hopes it offers to people.
And he came armed with the beautiful truths of his experience as program coordinator, a community educator, and a living witness to what organ donation could offer to transform the lives of peoples and communities, even a state like Hawai’i, with the challenge it poses because of its relative geographic isolation from the United States Mainland.
This relative geographic isolation makes it less possible for organ donation to happen when donors or recipients come from either parts of the country. The vital organs surgically removed for possible transplantation can only last for hours, with the maximum, at 72.
This means that a fast transportation of surgically removed vital organs to the place of the recipient must be done and transplanted as quickly as possible or that Hawai’i must rely more and more on its people, on the generosity of organ donors from its population to be able to respond to the need for prospective recipients to have a second lease on life.
The Organ Donor Center of Hawai’i has reported that as of November 2008, the national waiting list for kidney is at 77, 746; liver at 16, 053; heart at 2, 703; lung at 2,122; kidney-pancreas at 2, 258; pancreas at 1, 609; heart-lung at 98; and intestines at 231 or a total of 100, 363.
Of these figures, Hawai’i has a waiting list of 320 for kidney; 49 for liver; and 4 for kidney-pancreas or a total of 368.
The rise of those on the waiting for Hawai’i has risen almost three times, with just about a little over a hundred on the waiting list in 1995, and this rise reflects the seriousness of kidney troubles affecting the population of Hawai’i at present, with about 3,000 kidney problem sufferers undergoing dialysis.
In the case of those on the waiting list, more than one-thirds are people from or descended from the Philippines, but with an initial percentage pegged at three willing to become organ donors but now has grown to 71 percent because of the continuing and sustained effort to educate the various Philippine communities in Hawai’i.
The key strategic approach adopted by MOTTEP is to define the medical parameter that says that organ donation tends to have a higher rate of success when the donor comes from the family of the recipient, or comes from the same minority group.
Aware of this, MOTTEP has been in the forefront of a multi-partite approach to public education, with Sagayadoro himself providing a public face what organ donation is all about, he himself being a recipient of a kidney from a young civil engineer who had so much future ahead of him but, on Mother’s Day in 2000, died in a freak accident at a time when Sagayadoro, at the prime of his life in his 40s, had gone through five years of dialysis because of ESRD or end stage renal disease.
Diagnosed in 1994, Sagayadoro, a healthy man with no family history of diabetes and other predisposing sicknesses, suddenly became a sick man with three young children, the eldest graduating in high school and the youngest in the early grades.
At that time, Sagayadoro could not find a support group to help him get by—not the kind of a group that he was thinking could help him go through his pain and ailment. That opened his eyes to the extreme need to volunteer his services to MOTTEP and came out as a public face to organ donation and the need to aggressively address the prevention of kidney and other diseases.
That involvement at MOTTEP eventually became a commitment. He was invited to serve the program on a part-time basis, and then eventually full-time. Sagayadoro credits his engagement with the nitty-gritty work of organ donation to Angie Ieaiea, his predecessor at the MOTTEP.
Passionate as ever with the duty to educate the public, and to dispel among the peoples of the Philippines various misconceptions and myths about ‘bodily integrity as a precondition to their going to the heavens after death’—a false interpretation of the ethics of organ donation as espoused by the Catholic Church, the religion of the majority of them—Sagayadoro would eventually take on a key role in creating a committed awareness of the public of the virtues of organ donation.
In 2002, with the Bayanihan MOTTEP Grant, Sagayadoro began to work full-time as program coordinator.
Part of the campaign at MOTTEP and which campaign one would not miss in various gatherings involving minorities, particularly the public gatherings of peoples of the Philippines, is the signing up of organ donors, the issuance of organ donor cards, and the education of donors that their driver licenses, if they so desire, would identify them as organ donors.
Juxtaposed with the message of Christmas, the announcement of a new life for all people, the message of salvation made incarnate in the God-Child, and the announcement of a new life, a second chance at life, a new lease on life, National MOTTEP’s vision is an ethical idea whose time has come.
ASA: Tell me of the situation of organ donation in Hawai’i with roughly one-fourth of the population representing the various peoples of the Philippines.
TLS: There is a need to continually campaign for organ donation. The waiting list is a proof. We have about over 5,000 deaths in Hawai’i annually. Just about a hundred are potential donors. Of that number, just about half have consented to become organ donors.
ASA: If one has consented to become an organ donor, let us say, he or she carries a card, he or she does not automatically become a donor after death?
TLS: No. Out of respect for the next of kin—the immediate family—they have to be asked, and they have to give their consent.
ASA: What is a sensitive issue in organ donation?
TLS: It is the respect for the body of the dead.
ASA: How should a recipient look at this organ donation from another person?
TLS: It is a gift. A gift of life.
ASA: Tell me of your experience as recipient of a kidney.
TLS: I can only have gratitude, endless and overflowing gratitude. This second chance of life, this second life, is always a cause for a joyful recognition of what organ donation can do. This is a miracle, as far as I am concerned.
ASA: You were afraid to die?
TLS: Dying was easy. But the thought of my responsibility to young kids was most difficult to let go. That was why I had to fight—and fought hard to have a crack at life once again. And I was given this second chance to live life anew.
ASA: Do you know who gave you your kidney?
TLS: Now, I know. But it took me a year, as well as the others who received from that young man the gift of their life, to eventually get to know who that generous person was through his parents and other family members.
ASA: How does it feel to be carrying with you—to have in your body—another person’s vital organ?
TLS: I can only feel gratitude.
ASA: How did you deal with it?
TLS: I carried his picture: in my office, in my house, in my wallet. I talk to him, in good time and bad times. I ask—and I constantly do that—for his grace and guidance. He is part of me now.
ASA: Who is he? Tell me about him?
TLS: Steven Ginoza. He was of Okinawan ancestry, at 29 when he had the accident, an engineer and a full life ahead of him.
ASA: What was a miraculous moment for you when you had the organ transplant process?
TLS: When they had transplanted Steven’s one kidney to me and I heard the medical team say the kidney was working. I could only thank God and Steven at that time.
ASA: You have so much passion for this work.
TLS: I need to be reminded to slow down. My middle child is getting married in May next year. She reminded me to go slow, take time out. She told me, and this always makes me teary-eyed, that this cause and the people that need me have more of me if I took care of myself. She also told me, on a personal note, that she wanted me to be the person to give her away at her wedding when she gets married next year. You see, this daughter and her siblings, these are the young children I was praying and I was hoping I could have the chance to see them grow up, become mature people, and lead their own productive lives. I am blessed.
ASA: Tell me of your work to educate our people.
TLS: It is a difficult work, with its fair amount of challenges. But I have the advisory board working hard with me, always supporting me. I have also individuals who have always been on the same page as I am. Their unconditional support makes the load lighter. I credit them for what MOTTEP has achieved so far.
ASA: Your message to our people?
TLS: We need to go out and tell exactly what we need: that organ donation will give other people a new lease on life. It is the ethical thing to do.
FAO Features/Dec. 2008