Why not use IAF's fighter fleet for organ transport?

By undertaking medical mercy missions, the Indian Air Force will win immense political and national goodwill, explains Group Captain Murli Menon (retd).

Sitting far away from home shores as I do now, the heart aches to hear and read the media rambling about the ongoing travails of the Indian Air Force as a system, the shenanigans of the politico-bureaucratic nexus and the supposed wrongdoings and vulnerabilities of our equipment procurement processes.

Be that as it may, perhaps now is the time to refocus on the strengths of the service and how better it could serve the nation and its people in the years ahead.

The existing IAF doctrine does talk of missions such as aid to civil power and casualty evacuation.

Recently, we saw IAF choppers in action in Uttarakhand fighting forest fires, an altogether new role for the service. Nothing, indeed nothing, is beyond the pale of possibility when one talks of employing national air power.

Two recent events have contributed to this particular article -- the first being an unplanned exposure this author had to the tremendous leaps taken by the Indian medical fraternity in handling highly-advanced organ transplants, such as those of the heart, lungs, eyes, kidneys and other critical body parts.

The civic consciousness and expertise in heart transplants are remarkable in cities like Chennai and Kochi, some excellent pioneering work having been done by some highly-dedicated doctor-support staff teams in these 'golden heart' cities.

The second contributing factor is what the Norwegian air force did recently -- flying across a heart-lung machine at supersonic speeds to a patient 450 km away, reportedly cutting down on the critical time factor available to 25 minutes from several hours otherwise by road.

Fortunately, the F-16 fighter had a convenient external hold to transport the equipment. For critical organs, the space required would be considerably lesser of course.

Some veterans would recall (though this example should only be taken as one to illustrate the availability of space in a fighter and not otherwise) the considerable space even in a MiG-21 gun bay that was ingenuously exploited by some occasionally to transport valuable cargo such as frozen pomfrets to parched palettes in the interior hinterland, from their fresh catchments in the Bay of Bengal!

Newer fighters such as the Su-30 would have much greater wherewithal in this context, with an additional cockpit to boot.

I learnt from my recent experience at Chennai that a harvested human heart needs to be inside the recipient within three hours.

There are a whole slew of other key activities that need to be gone through before a heart is transportable, such as cross matching of the donor-receiver blood, assessment of receiver lung capacity to accept the heart, time frames to convey the organ from the donor ICU to the nearest airport etc.

These other intangibles often lead to many a useful organ going abegging in our country.

Also, currently the radius of action for acquiring a donor organ is limited by the speed of the chartered aircraft -- normally, in India, a Beechcraft type -- or an even slower helicopter.

Thus for a heart transplant in Chennai we could have donor hearts being brought in from maximum Mumbai or Hyderabad at best. But if we had a high speed fighter jet at our service -- like indeed demonstrated by the Norwegians -- the envelope expands dramatically, perhaps even to areas such as Delhi, Calcutta or Ahmedabad.

Of course, the harvesting drill would need honing by the concerned organisers so that no time is wasted. Another key aspect is that of cost. Presently, only the affluent could afford a heart transplant in India.

But should we be able to bring in IAF fighter/transport/helicopter assets into the equation, many a dire situation could be salvaged, especially for the underprivileged and marginalised sections of society.

The political and national goodwill that would accrue from such humanitarian efforts would be intangible and out of proportion to the manpower and other operating costs for the IAF.

Needless to say, operational priorities would reign supreme, the medical mercy missions being undertaken only when they permit.

It may be pertinent to mention that a heart transplant in Chennai costs Rs 20 lakh (Rs 2 million) today with an additional Rs 10 lakh (Rs 1 million) for the air charter.

In New York, the same could cost $2.6 million (around Rs 20 crore/Rs 200 million) and a similar amount for post operative care! For outsiders, there is a near two year wait period too, something which most patients would not have the luxury of.

Besides, it has been established recently at international symposia that Indians are a reasonably homogeneous race as far as chances of organ rejection are concerned, as compared to the Americans or Europeans. Koreans and Japanese, of course, are the best for homogeneity.

In every way therefore any Indian wishing to have a serious organ transplant procedure should only look at India.

In the developed world one sees an altogether nuanced approach of the establishment and civil society to social issues and human rights. It would surely take India a while to get there.

I saw a video at a small Chennai hospital that said, 'We are soon going to be in a global visa-free regime. The HEART will be the visa.'

Indian medical tourism has come of age and coupled with the immense cost differential between the West and us, makes India even more attractive as a destination to treat sophisticated medical ailments.

Every citizen has a role to play in enhancing this reputation even further. The armed forces medical establishment and organs such as the Air Force Wives Welfare Association and the Army Wives Welfare Association need to be energised to address local requirements in organ transplants and to coordinate with the operational staff and leadership.

Besides the Athithi devo bhava tradition and the leapfrogging economy, our country would only get stronger in this field in the future.

Russian President Vladimir Putin sent a 10-year-old Siberian girl to Chennai to get an Indian heart! Pakistanis have been coming to India for a while now for heart, kidney and eye transplants.

My suggestion to rope in the IAF's fighter fleet to beat the time frame conundrum involved in major organ transplants should be seen in this light.

Technology is advancing by leaps and bounds, but there still would be occasions when human ingenuity and cooperation could help things along.

We are soon going into an era where in Unmanned Aerial Vehicles would be used to transport human organs across large distances. Some Chennai doctors are already working on this concept.

Then again, can you imagine the diplomatic pay off, of an Indian heart being flown to Karachi or Dhaka or Colombo in an IAF fighter to save a life in one of these countries?