All posts by Bruno Mascarenhas

1994, Cardiac, Heart, Kidney, Liver, Singapore

Amendment of the Human Organ Transplant Act

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On 6 January 2004, the Human Organ Transplant Act (HOTA) was amended to allow more Singaporeans to benefit from organ donation. The main amendments to HOTA were (a) to extend HOTA beyond kidneys to include livers, hearts and corneas; (b) to extend HOTA beyond deaths due to accidents to include all causes of deaths; and (c) to extend HOTA beyond cadaveric organdonation to also regulate living donor organ transplants. In this article, we review the amendments to HOTA and the Interpretation (Determination and Certification of Death) Regulationsand examine the impact of HOTA on organ procurement and transplantation in Singapore.Ann Acad Med Singapore 2006;35:428-3

Kidney transplants have been carried out in Singapore
for more than 35 years, with the first cadaveric kidney
transplant operation performed on 8 July 1970.
1
However,
prior to the commencement of the Human Organ Transplant
Act (HOTA) in 1988, there was only a small number of
kidney transplants; between 1970 and 1987, only 85
cadaveric kidney transplants were carried out using kidneys
procured from local donors in Singapore.
2
There are 2 laws pertaining to organ donation in Singapore
– the Medical (Therapy, Education and Research) Act
(MTERA) and HOTA. A third set of legislation, the
Interpretation Act, provides the criteria for determining
death. It allows for death to be defined in terms of cardiac
death or brain death. The Interpretation (Determination
and Certification of Death) Regulations provide further
conditions and criteria for the determination and certification
of brain death.
MTERA was passed by Parliament in 1973. It provides
for a person to pledge to donate his organs upon his death
for the purposes of therapy (including transplant), education
or research. Where a deceased person has not made any
indication of his intent to donate, MTERA also provides for
the relatives to donate the body or body parts of the
deceased person for the above purposes. Between 1973 and
1987, cadaveric kidneys for transplant were obtained either
under MTERA, or from overseas.
HOTA was introduced in 1987, as a presumed consent
law that allowed for the removal of kidneys for the purpose
of organ transplantation from those who died in a hospital
as a result of accidents, and did not object to organ donation
prior to their death. It applied to Singapore citizens and
permanent residents between the ages of 21 and 60 years.
Muslims were excluded from HOTA because of religious
reasons. Persons who were of unsound mind were also
excluded from HOTA. Persons who objected to organ
donation could opt not to donate their organs by registering
their objections with the National Organ Transplant Unit
(NOTU), a central national registry overseen by the Director
of Medical Services.
Several safeguards were provided for under HOTA.
First, the designated officer of the hospital had to ensure
that the necessary criteria required under HOTA were met
and provide his written authorisation before the organs
could be removed from a deceased person. The designated
officer had to be a senior doctor appointed by the Director
of Medical Services. Second, only medical practitioners
who had been authorised by the Director of Medical
Services could remove the organs from a deceased person
under HOTA and transplant these organs. Third, organ
trading was strictly prohibited.
Impact of HOTA
The introduction of HOTA resulted in more cadaveric
kidneys being available for transplantation.
3
Between 1970
and 1987, there was an average of 4.7 cadaveric kidney
transplants per annum. Between 1988 and 30 June 2004,
there was a total of 674 cadaveric kidney transplants or an
average of 40.8 cadaveric kidney transplants per annum
(Fig. 1). Of these, 13.5 cadaveric kidney transplants per
annum were obtained through HOTA during this period.
Necessity for Amendments to HOTA
When HOTA was first introduced, a conservative
approach was taken as Singaporeans were unfamiliar with
the concept of organ donation and there was cultural
reluctance to donate organs. HOTA was thus restricted to
only kidneys and death due to accidents. In addition, the
other types of organ transplant were not yet well developed
in Singapore.
However, with an increasing number of patients requiring
transplants, there was a need to review and revise HOTA
to alleviate the demand for more organs, including kidneys
as well as other vital organs such as the heart and liver. At
the same time, there was also a need to put in place an
effective regulatory framework for living donor organ
transplants, which till then had not been subject to any
legislative purview, even though the first living donor
kidney transplant in Singapore was carried out in 1976.
Although the Ministry of Health had established professional
guidelines stipulating that the social, psychological and
emotional profile of the donor had to be assessed, a full
medical examination carried out, and informed consent
taken, there was no legislation supporting these
requirements.
Demand for More Organs
Whilst the introduction of HOTA in 1987 had made more
cadaveric kidneys available for transplantation, this effect
was far outstripped by the growth in demand for kidneys,
as evidenced by the continued growth of the kidney
transplant waiting list. In 1988, there were 208 end-stage renal failure patients on the kidney transplant waiting list.
By end 2003, the waiting list had increased to 673 end-
stage renal failure patients (Fig. 2).
Likewise, there was also a shortage of livers and hearts
available for transplant. The first liver transplant and the
first heart transplant were only carried out in Singapore in
1990,
4,5
and hence liver and heart had not been included in
HOTA when it was first introduced in 1987. The organ
shortage resulted in a small number of liver and heart
transplants being carried out in Singapore. Between 1998
and 2003, there was only an average of 7.3 liver transplants
per annum and 1.8 heart transplants per annum. Due to the
shortage of organs, an average of 14.7 patients per
annum died while waiting for a liver transplant, and 2.7
patients per annum died while waiting for a heart transplant
(Table 1).
With regard to cornea transplants, Singapore relied heavily
on imported corneas, mainly from the United States of
America. Between 1998 and 2002, there were 861 cornea
transplants carried out in Singapore, of which 363 (42%)
transplants involved imported corneas. As imported corneas
might not be of optimal quality because of the long transit
time between the country of origin and Singapore, there
was a need to increase the local supply of corneas.
Amendments to HOTA
Following extensive public consultations spanning
January to September 2003, the HOTA Amendment Bill
was debated over 2 days in Parliament and passed
unanimously on 6 January 2004. The amendments to
HOTA were:
a. to extend HOTA beyond kidneys to include the liver,
heart and cornea;
b. to extend HOTA beyond death due to accidents to all
causes of death; and
c. to extend HOTA beyond cadaveric organ donation to
include living donor organ transplants.
The regulation of living donor organ transplants was
achieved through the addition of Sections 15A to 15D to
HOTA. These provided for the appointments and functions
of hospital Transplant Ethics Committees (TECs), and
required all living (both related and unrelated) donor organ
transplants to have prior written authorisation from the
TEC. The considerations of the TEC, in deciding whether
to approve an application of a living donor organ transplant
were to include whether there was (a) informed consent
from the donor, (b) presence of any form of organ trading,
or (c) presence of any “fraud, duress or undue influence”
when the informed consent was obtained from the donor.
In addition, the TEC was to “have regard to the
considerations of public interest and community values”,
to allow the TEC the breadth to take into account the
dynamic nature of societal expectations in a rapidly changing
medical arena.
Amendments to the Interpretation (Certification and
Determination of Death) Regulations
The Interpretation (Determination and Certification of
Death) Regulations were also amended to allow for the use
of supplementary tests in the determination of brain death.
The supplementary tests provided for were: (a) cerebral
angiography to confirm that there was no intracranial blood
flow; and (b) radionuclide scan to confirm that there was no
intracranial perfusion.
Impact of the Amended Human Organ Transplant Act
The revised HOTA came into effect on 1 July 2004.
Between 1 July 2004 and 30 June 2005, there was a total of
24 cadaveric organ donors, making available for
transplantation a total of 47 kidneys, 5 livers, 3 hearts and
33 corneas. Twenty-one donors (87.5%) came under HOTA,
while the other 3 donors came under MTERA. Among the
21 HOTA donors, 5 donors (23.8%) had deaths due to
accidents, while 16 donors (76.2%) had non-accidental
causes of death (Table 2). Supplementary tests were used
during brain death certification for 6 cadaveric organ
donors. Thus, the number of HOTA kidneys since the
amendment of HOTA has risen to 41 over the preceding
year. This compares to 13.5 cadaveric kidney transplants
per annum obtained through HOTA prior to the
amendments.
Discussion
The introduction of HOTA in 1988 led to an increase in
the number of cadaveric kidneys available for transplant.

This was similar to the experience in other countries with
presumed consent legislation.
6,7
However, despite the
increase in availability of organs, demand continued to
outstrip supply, with the waiting list for cadaveric kidneys
more than tripling between 1998 and 2003.
In the first year that it was implemented, the revised
HOTA resulted in an increase in the number of cadaveric
organs for transplant. Of the 21 cadaveric organ donors
who came under HOTA, 16 donors died from non-accidental
causes of death. Prior to the extension of HOTA beyond
deaths due to accidents to include all causes of death, those
who died from non-accidental causes of death would not
have been included under HOTA. Instead, organ donation
would have come under MTERA and would have required
consent from the donor’s family. Based on Sheehy et al’s
estimation of a consent rate of 54% for organ donation
8
and
NOTU’s estimate of a consent rate of 30% to 35% in
Singapore (personal communication with Ms Sally Kong,
Senior Manager, NOTU), it can be estimated that the
amended HOTA resulted in an additional 8 to 11 cadaveric
donors in its first year of operation.
The provision for supplementary tests under the
Interpretation (Determination and Certification of Death)
Regulations is likely to have also contributed to the increased
number of organ donors. If supplementary tests were not
available, the 6 donors where supplementary tests were
used might not have actualised as it might not have been
possible to perform some of the tests for brain death
certification, or the potential donor’s condition might have
deteriorated while waiting for the drug titres of depressant
drugs to go down.
Various factors have been suggested as possible
determinants of the organ donation rate in a country.
9,10
In
carrying out our policy review, we considered the possible
impact of these factors on the yield of organs. As HOTA
was originally limited to deaths due to accidents, we
examined the relationship between the number of deaths
due to accidents among Singaporeans and permanent
residents between the ages of 21 years and 60 years, and the
number of cadaveric kidneys obtained through HOTA. We
found no correlation between the number of accidents and
the number of cadaveric kidney transplants (Fig. 3).
Nonetheless, the lower yield of actualised donors over the
years could have been due to more accident victims either
dying at the site of the accident, or surviving due to better
management in the intensive care units at the hospitals.
With regard to the low organ donor rate in 2002, of the 8
potential HOTA donors identified, 5 potential donors
could not be actualised because they were found to be
medically unsuitable. The absence of any HOTA donors in
2003 is likely to be due to the impact of SARS and the
related policies implemented for infection control purposes.
200
180
160
140
120
No. of cadaveric kidney transplants
No. of deaths due to accidents
0
5
10
15
20
25
2002
2003
2000
1998
1993
1995
1996
1997
1991
1989
1994
2004
2001
1999
1992
1990
Fig. 3. Scatterplot of number of deaths due to accidents among Singaporeans
and permanent residents aged 21 to 60 years, and the number of cadaveric
kidney transplants obtained through HOTA, 1988-2004.
Source: Ministry of Health, Registry of Birth & Death and NOTU
There was extensive public consultation before we
proceeded with the amendments to HOTA. There are many
ethical and societal concerns with regard to presumed
consent legislation for organ donation
11-14
and it was
extremely important to take into consideration societal
views on organ donation and presumed consent legislation.
The public consultation on the proposed amendments to
HOTA spanned 9 months and the views of all major
religious groups, as well as various community and
professional groups were sought before the HOTA
amendment bill was presented and debated in Parliament.
There were also extensive public education campaigns
before and after the passage of the HOTA amendment bill
to inform the public of the amendments to HOTA as well
as organ donation.
In conclusion, based on the first-year experience, the
amended HOTA has helped to increase the yield of cadaveric
organs for transplantation. The kidney transplant waiting
list has also begun to shorten. Nonetheless, the organ
donation rates in Singapore still lag behind those in many
countries such as Spain, the United States and the United
Kingdom. The transplant community in Singapore will
need to identify further avenues to enhance the organ
transplant programme. In particular, we will need to explore
how the number of living donor organ transplants can be
enhanced to increase the supply of organs. The
implementation of a robust regulatory framework for living
donor organ transplants will thus allow us to move forward
with greater confidence in promoting living organ
transplants, thereby saving the lives of more patients.
Acknowledgement
We are indebted to Ms Sally Kong and Ms Ang Siang Eng, National Organ
Transplant Unit, for their assistance with the transplant data

REFERENCES
1. Rauff A. Renal transplantation in Singapore – a brief historical perspective.
Ann Acad Med Singapore 1991;20:556-8.
2. Soh P, Lim SM, Tan EC. Organ procurement in Singapore. Ann Acad
Med Singapore 1991;20:439-42.
3. Lim SM, Soh P, Woo KT, Rauff A. Organ donation in Singapore.
Transplant Proc 1990;22:2179-80.
4. Wai CT, Lo SK, Lee KH, Tan CK, Aw MM, Quak SH, et al. Ten years
of experience of liver transplantation in Singapore. Transplant Proc
2000;32:2139.
5. Sivathasan C. Experience with cyclosporine in heart transplantation.
Transplant Proc 2004;36:346S-348S.
6. Roels L, Coosemans W, Christiaens MR, Waer M, Vanrenterghem Y.
The relative impact of legislative incentives on multi-organ donation
rates in Europe. Transplant Proc 1995;27:795-6.
7. Michielsen P. Presumed consent to organ donation: 10 years’ experience
in Belgium. J R Soc Med 1996;89:663-6.
8. Sheehy E, Conrad SL, Brigham LE, Luskin R, Weber R, Eakin M, et al.
Estimating the number of potential organ donors in the United States. N
Engl J Med 2003;349:667-74.
9. Gridelli B, Remuzzi G. Strategies for making more organs available for
transplantation. N Engl J Med 2000;343:404-10.
10. Matesanz R. Factors that influence the development of an organ donation
program. Transplant Proc 2004;36:739-41.
11. Kennedy I, Sells RA, Daar AS, Guttmann RD, Hoffenberg R, Lock M,
et al. The case for “presumed consent” in organ donation. International
Forum for Transplant Ethics. Lancet 1998;351:1650-2.
12. Kluge EH. Improving organ retrieval rates: various proposals and their
ethical validity. Health Care Anal 2000;8:279-95.
13. Loewy EH. Presuming consent, presuming refusal: organ donation and
communal structure. Health Care Anal 2000;8:297-308.
14. Siminoff LA, Mercer MB. Public policy, public opinion, and consent for
organ donation. Camb Q Healthc Ethics 2001;10:377-

1994, TOHO, Transplantation, Transplantation_of_Human Organs Act_TOHO_Act_1994

TRANSPLANTATION OF HUMAN ORGANS ACT, 1994 Chapter I

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Bill No.LIXF- of 1992

 

THE TRANSPLANTATION OF HUMAN ORGANS BILL, 1994
(AS PASSED BY THE HOUSES OF PARLIAMENT)

A BILL

 

 

to provide for the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs and for matters connected therewith or incidental thereto.
Whereas it is expedient to provide for the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs;
And Whereas Parliament has no power to make laws for the states with respect to any of thematters aforesaid except as provided in articles 249 and 250 of the constitution,Any whereas in pursuance of clause (1) of article 252 of the constitution, resolutions have been passed by all the Houses to the Legislatures of the States of Goa, Himachal Pradesh and Maharashtra to the effect that the matter aforesaid should be regulated in those states by Parliament by law;Be it enacted by parliament in the Forty fifth Year of the Republic of India as follows:-

 

CHAPTER – I

PRELIMINARY

1. (1) This Act may be called the Transplantation of Human Organs Act, 1994
(2) It applies in the first instance, to the whole of the States of Goa, Himachal Pradesh and Maharashtra and to all the Union territories and it shall also apply to such other State which adopts this Act by resolution passed in that behalf under clause (1) of article 252 of the Constitution.
(3) It shall come into force in the States of Goa, Himachal Pradesh and Maharashtra and in all the Union territories on such date as the Central Government may, by notification, appoint and in any other State which adopts this Act under clause (1) of article 252 of the constitution on the date of such adoption; and any reference in this Act shall, in relation to any State or Union Territory, means the date on which this Actcomes into force in such State or Union Territory.

2. In this Act, unless the context otherwise requires –

(a) ‘advertisement’ includes any form of advertising whether to the public generally or to any section of the public or individually to selected persons;
(b) “Appropriate Authority” means the Appropriate Authority appointed under section 13;
(c) “Authorisation Committee” means the committee constituted under clause (a) or clause (b) of sub-section (4) of section 9;
(d) “brain-stem death” means the stage at which all functions of the brain stem have permanently and irreversibly ceased and is so certified under sub-section (6) of section 3;
(e) ” deceased person” means a person in whom permanent disappearance of all evidence of life occurs, by reason of brain stem death or in a cardio pulmonary sense at any time after live birth has taken place;
(f) “donor” means any person, not less than eighteen years of age, who voluntarily authorises the removal of any of his human organs for therapeutic purposes under sub-section (1) or sub-section (2) of section 3;
(g) “hospital” includes a nursing home, clinic, medical centre, medical or teaching institution for therapeutic purposes and other like institution;
(h) “human organ” means any part of a human body consisting of a structural arrangement or tissues which, if wholly removed, cannot be replicated by the body;
(i) “near relative” means spouse, son, daughter, father, mother, brother or sister;
(j) “notification” means a notification published in the Official Gazette.
(k) “payment” means payment in money or money’s worth but does not include any payment for defraying or reimbursing –
(i) the cost of removing transporting or preserving the human organ to be supplied; or
(ii) any expenses or loss of earnings incurred by a person so far as reasonably and directly attributable to his supplying any human organ from his body;
(l) “prescribed” means prescribed by rules made under this Act
(m) “recipient” means a person into whom any human organ is, or is proposed to be, transplanted
(n) “registered medical practitioner” means a medical practitioner who possesses any recognised medical qualification as defined in clause (h) of section 2 of the Indian Medical Council Act, 1956, and who is enrolled on a State Medical Register as defined in clause(k) of that section.
(o) “therapeutic purposes” means systematic treatment of any disease or the measures to improve health according to any particular method or modality; and
(p) “transplantation” means the grafting of any human organs from any living person or deceased person to some other living person for therapeutic purposes.

 

1994, TOHO, Transplantation, Transplantation_of_Human Organs Act_TOHO_Act_1994

THE TRANSPLANTATION OF HUMAN ORGANS ACT, 1994

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THE TRANSPLANTATION OF HUMAN ORGANS ACT, 1994

(Central Act 42 0f 1994)

 

 

Bill No. LIX-F of 1992
THE TRANSPLANTATION OF HUMAN ORGANS BILL, 1994

 

(As Passed by the Houses of Parliament
Rajya Sabha on 5th May, 1993)
 Lok Sabha on 14th June 1994
Amendments made by the Lok Sabha
 Agreed to by the Rajya Sabha on
15th June 1994)

 

Assented to on 8-7-1994
Act No. 42 of 1994

 

Bill No. LIX-F of 1992

 

 

 

THE TRANSPLANTATION OF HUMAN ORGANS BILL, 1994
————
ARRANGEMENT OF CLAUSES
————

 

 

 

CHAPTER I
PRELIMINARY

 

CLAUSES
1. Short title, application and commencement
2. Definitions.

 

CHAPTER II

 

 

AUTHORITY FOR THE REMOVAL OF HUMAN ORGANS

3. Authority for removal of human organs.
4. Removal of human organs not to be authorised in certain cases
5. Authority for removal of human organs in case of unclaimed bodies in hospital or prison.
6. Authority for removal of human organs from bodies sent for postmortem examination
for medico-legal or pathological purposes.
7. Preservation of human organs
8. Savings
9. Restrictions on removal and transplantation of human organs

 

 

CHAPTER III

REGULATION OF HOSPITALS

10. Regulation of hospitals conducting the removal, storage or transplantation of human organs
11. Prohibition of removal or transplantation of human organs for any purpose other than
therapeutic purposes.
12. Explaining effects, etc, to donor and recipient.

CHAPTER IV
APPROPRIATE AUTHORITY

13. Appropriate Authority

CHAPTER V

14. Registration of hospitals engaged in removal, storage or transplantation

of human organs.
15. Certificate of registration.
16. Suspension or cancellation of registration
17. Appeals

 

CHAPTER VI

OFFENCES AND PENALTIES

 

18. Punishment for removal of human organ without authority
19. Punishment for commercial dealings in human organs
20. Punishment for contravention of any other provision of this Act
21. Offences by Companies
22. Cognizance of offences

 

CHAPTER VII

 

MISCELLANEOUS

 

23.Protection of action taken in good faith
24. Power to make rules
25. Repeal and savings.

 

Kidney

Ethical Incentives — Not Payment — For Organ Donation

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Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

The therapeutic promise of transplanting organs from cadavericdonors, as envisioned by the pioneers of transplantation,1 hasnever been realized because the demand for cadaveric organshas far exceeded the supply. The waiting list for organ transplantscontinues to grow, and in 2000, nearly 5000 patients were removedfrom the list because of death.2 Consequently, many patientswith end-stage organ failure are no longer relying solely onthe waiting list. Instead, they are turning to spouses, friends,or strangers as possible donors — a medically acceptablealternative because advances in immunosuppression have eliminatedthe requirement of a genetic match for . . .

The Market for Transplantable Tissues and Organs

New Congressional Legislation

Ethical Incentives to Increase Organ Donation

Donor Medal of Honor

Reimbursement for Funeral Expenses

Organ Exchanges

Medical Leave for Organ Donation

Ensuring Access to Organs for Previous Donors

Donor Insurance

A Regulated Market System

Incentives versus Payment

References

Related Letters:

Ethical Incentives — Not Payment — for Organ Donation
Mosimann F., Matas A. J., Spital A., Delmonico F. L., Arnold R., Youngner S. J.
Extract | Full Text | PDF
N Engl J Med 2002; 347:1382-1384, Oct 24, 2002. Correspondence

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  • Matas, A. J. (2006). Why We Should Develop a Regulated System of Kidney Sales: A Call for Action!. CJASN 1: 1129-1132 [Full Text]
  • Ghods, A. J., Savaj, S. (2006). Iranian Model of Paid and Regulated Living-Unrelated Kidney Donation. CJASN 1: 1136-1145 [Abstract] [Full Text]
  • Siegal, G., Bonnie, R. J. (2006). Closing the Organ Gap: A Reciprocity-Based Social Contract Approach. J Law Med Ethics 34: 415-423
  • Kunin, J D (2005). The search for organs: halachic perspectives on altruistic giving and the selling of organs. J. Med. Ethics 31: 269-272 [Abstract] [Full Text]
  • Giles, S (2005). An antidote to the emerging two tier organ donation policy in Canada: the Public Cadaveric Organ Donation Program. J. Med. Ethics 31: 188-191 [Abstract] [Full Text]
  • Scheper-Hughes, N. (2004). Parts unknown: Undercover ethnography of the organs-trafficking underworld. Ethnography 5: 29-73 [Abstract]
  • Wendler, D., Emanuel, E. (2004). Assessing the Ethical and Practical Wisdom of Surrogate Consent for Living Organ Donation. JAMA 291: 732-735 [Full Text]
  • Beauchamp, T L (2003). Methods and principles in biomedical ethics. J. Med. Ethics 29: 269-274 [Abstract] [Full Text]
  • Douglas, D. D. (2003). Rebuttal by Dr Douglas. Arch Intern Med 163: 1885-1886 [Full Text]
  • Mosimann, F., Matas, A. J., Spital, A., Delmonico, F. L., Arnold, R., Youngner, S. J. (2002). Ethical Incentives — Not Payment — for Organ Donation. NEJM 347: 1382-1384 [Full Text]
  • Goyal, M., Mehta, R. L., Schneiderman, L. J., Sehgal, A. R. (2002). Economic and Health Consequences of Selling a Kidney in India. JAMA 288: 1589-1593 [Abstract] [Full Text]
  • Rothman, D. J. (2002). Ethical and Social Consequences of Selling a Kidney. JAMA 288: 1640-1641 [Full Text]
  • Ramos, E., Aoun, S., Harmon, W. E. (2002). Expanding the Donor Pool: Effect on Graft Outcome. J. Am. Soc. Nephrol. 13: 2590-2599 [Full Text]

Apollo

Medical Insurance Companies in India

1 Comment

There are many Medical insurance companies which have a tie up with Apollo and provide insurance for covering cost of various treatments like Surgery, Cardiology, Dentistry, Orthopedics and so on. The list of some of these International Medical Insurance Companies are given below:

BUPA International
Russell Mews
Brighton
Sussex
BN1 2NR
United Kingdom
Tel No: 44(0) 1273 323 563
Fax: 00441273 820517 /1273 866 301
Contact Person: Eileen Burfitt
BUPA International Customer Service Advisor
Tel: 00 44 1273 323 563
Fax: 00 44 1273 820 517
E Mail: info@bupa-intl.com
PREAUTH@bupa-intl.com

Vanbreda International
P.O Box 15
B-2018 ANTWERP 19 +
Belgium
Contact Person:
Véronique Billiau
Customer Service Representative
Tel +32 3 217 68 17
Fax +32 3 235 83 51
E Mail Id: mcc213@vanbreda.be
MCC5@vanbreda.be

GMC Services
Country Offices
Address: GMC International Administration UG74
10 rue Henner
75459 Paris Cedex 09
France
For Europe Middle East, Africa
Tel +33 1 40 82 42 05
Fax +33 1 40 82 45 21
E-mail: mip.paris@henner.com

For South America
Address: Rutherford international
UNDP department
5500 Cherokee Avenue
Suite 300
Alexandria, VA 22312
USA
Tel: +11703 354 8637
Fax: + 1703 354 0370
E-mail: mip.Washington@henner.com

For Asia
Tel: + 65 6887 2488
Fax: +65 6887 0328
E-Mail: mip.Singapore@henner.com

CIGNA International
Attn: GHCMS
590 Naamans Road
Claymont, DE 19703
USA
Tel No – 001 302 797 3043
AT & T direct -+800 339 6922

GHCMS Contacts
Markus Zettner – Ph -001 302 797 3494
(Director) Fax – 001 302 797 3055

Cynthia Gatanis – Ph – 001 302 797 3422
(Provider Relations Coordinator) Fax – 001 302 797 3055
E Mail: ciebprovider@cigna.com

World Access – Blue Cross Blue Shield
2805 North Parham Road
Richmond, VA 23294
USA
Contact Person: Director: Ms. Sharon Leicester
Provider Network Development
Director: Ms. Sharon Leicester
Email: providernetwork@worldaccess.com
Tel: +1 804 673 7179
Fax: +1 804 673 1587
E-mail: assistancegroup@worldaccess.com
Kim Boynton: kboynton@worldaccess.com

Davidshield, Israel
8a Haztoran St. Second Floor
Poleg Business Park
South Industrial Zone
Netanya, Israel
Contact Person:
Asaf Sobol
E Mail: asafso@davidshield.com

Prestige International Singapore
Prestige International (S) Pvt. Ltd.
Sales & Marketing Department
Htut Khaung Lwin
Office: (+65)- 6738-1533
Fax: (+65)-6734-1850
390 Orchard Road #07-01/02
Palais Renaissance
Singapore 238871
URL: http://www.prestigein.com
Contact Person: Michael.
E Mail: lwin@prestigein.com

Aetna Global Benefits, West Pachia
Pachia West, Network Representative
Aetna Global Provider Services
813/775-0031
Fax 860/975-0610
Tampa, FL
USA
E-mail: westpm@aetna.com

International Third Party Administrators (TPA’s) (For International Medical Insurance)

ARMS, Calcutta
42B, Park Mansions, Ground Floor
57, Park Street, CALCUTTA-700016
INDIA
Email: arms@vsnl.com
Tel: +91-33-22292922/30907146
Fax: +91-33-2229 1329/24743344
Mobile No.: +91-9831005000/9831008900(Dr. Anraj Singh)
Website: www.armsindia.com

Amar Tours & Travels
SCO- 83 Sector 22 Palam Vihar Road Gurgaon – 122 00
Phone Number: 951245016901
E Mail: amartours@touchtelindia.net or amartours@vsnl.com
Contact Person: Arjun Ghoshal
Manager Tours
9810036054

East West Rescue, New Delhi
24698865/24623738/24699229/24690429
Fax: 24690428/24632382/26431068
Dr. Chawla 9811029283
Email: ewr@vsnl.com
airambulance@eastwestrescue.com

Exotic Tours, Delhi
26850823/26858361/26858376/26854851
Fax No: 26859055
Vinita Sinha
Manager, Exotic Tours, New
Customer Care Officer:
Geetanjali
Kavita Bhatt
E Mail: exotictr@del2.vsnl.net.in

International SOS, New Delhi
2nd floor, Lotus tower,
New friends Colony,
Community Center
New Delhi-110065
Tel No: 51898800
Fax: 51898801
Contact Person: Sameer Roy/Naveen Sharma
Customer Care Officer: Anuradha Agarwal/ Devika /Shipra
Email Id: 1DELOPS@internationalsos.com
Sameer.Roy@internationalsos.com
Naveen.Sharma@internationalsos.com

Thomas Cook (India) Ltd.
Rishya Mook Building
85-A, Panchkuin Road,
New Delhi 110001
Contact Person: Natesh Rajagopalan
Manager – Assistance Services
Thomas Cook (India) Limited
TEL: 91-22-22048556 – 8: Extension: 1172
FAX: 91-22-22046769 / 22871069
Mobile: 98203 72512
Email: nateshan.rajagopalan@in.thomascook.com
Mr.. Puneet Shah: + 91 98208 09107
Mr. Natesh Rajagopalan: + 91 098203 72512
Office Contacts:
Telephone Numbers+ 91 22 2204 8556/ 7 /8
Extension numbers: Puneet 1181
Natesh 1172
Daisy 1165

Out of office Telefax
Residential Telefax + 91 22 2415 3554
Thomas Cook (Delhi Contact Details)
Email Id: nitin.budhaulia@in.thomascook.com
Mobile no.: 9810712498
Fax No: 234-11244
Mr. Sunil Kumar Singh
Mobile No. 9818189995
sunil.singh@in.thomascook.com

Meera Rescue
24693508/24653170
Harpreet/Dr.Berry/Mrs. Berry

Uncategorized

Luxury Spas in India

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Spa is derived from the Latin phrase, Salus per Aquam which means health by water. This technique is still used in modern times for rejuvenation, relaxation and rest.

Luxury Spas in India offers essential healthcare therapies and beauty treatments. There are many luxury spas in India which provide specialized treatments and therapies like Ayurveda, Yoga, Meditation and other relaxing massages to heal the mind and body.

The luxury spas in India are located at beautiful locales like the Udai Vilas in Udaipur, Rajvilas in Jaipur, Wildflower Hall in Shimla, Park Hyatt Sereno Spa in Goa, Oberoi Amar Vilas, Agra and many more.

Cardiac, Heart

Medical VISA to India

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With India emerging as a preferred destination for medical tourists across the world, the demand for medical visas is on the rise. Medicalindiatourism.com now offers you complete information on the conditions and requirements for obtaining a medical visa to India. The conditions can be summed up in the following points:

  • Indian Missions and Posts abroad may scrutinize all medical documents to make sure that the request for a medical treatment visa is a valid one.
  • The Missions may also seek details to satisfy themselves that the applicant has sought preliminary medical advice at his / her country of origin / residence and has been advised to go for specialized treatment. In case, the person desires to undergo treatment under the Indian System of Medicine, he / she can also present his / her case for consideration.
  • A Medical Visa to India should be granted only for medical treatment in reputed / recognized centers. Though there are many treatments that can be considered for a medical visa to India, some of the following treatments are always given primary importance: Neuro-Surgery, ophthalmic disorders, heart treatments, renal disorders, organ transplants, congenital disorders, gene therapy, plastic surgery, radio therapy and so on.

Validity of Indian Medical Visas and extension

The initial period for medical visas to India can be up to a period of 1 year or the period of treatment (whichever is less). The visa can also be extended to up to 1 year by the State Governments / FRRO’s on production of medical certificate from reputed / recognized hospitals in the country. Further extensions will be validated by the Ministry of Home Affairs only on recommendations of the State Government / FRRO’s ably supported by valid medical documents. Such visas will be valid for a maximum of three entries during 1 year. State Governments / FRRO’s can also permit an additional entry in urgent situations.

Visas to attendants / family members

Attendants or family members of medical patients traveling to India will be given miscellaneous visas co-terminus with the ‘M Visa’ of the patient. Such visas can be granted to the spouse / children or blood relations of the patient. It must also be noted that not more than two attendants will be considered for miscellaneous visas at a given time. Such visas will be called ‘MX visas’. These persons also need to get themselves registered with the local FRRO’s / FRO’s within 14 days from the date of arrival.

Registration

Foreign nationals traveling on ‘M visas’ will have to get themselves registered with the concerned FRRO’s / FRO’s within 14 days of arrival in India.

Registration for Pakistani and Bangladeshi Nationals

Medical Visas to India are available to all foreign nationals including China, Pakistan, Bangladesh and Sri Lanka. Though it must be mentioned that the registration formalities for Pakistani and Bangladeshi nationals will have to conform to the provisions stated in para 106 (for Bangladeshi nationals) and para 118 (for Pakistani nationals) of the Visa Manual. Nationals from these countries will need to conform to the entry and departure procedures as per the existing policy for their countries.

1994, Liver

‘The organ transplant act is seriously flawed’

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27 Sep, 2002 l 2334 hrs IST
http://timesofindia.indiatimes.com/articleshow/23498564.cms

ANJALI SINGH JAISWAL
President of the Indian Society of Organ Transplantation Padamshree Dr KS Chugh was in town on Friday. In a candid conversation with Anjali Singh Jaiswal, he speaks on the controversal issue of cadaver donation
Why is cadaver dononation a better option?
Following the use of a drug called cycloscronin, success rates in transplants became phenomenal in the West. This prompted more and more people to come forward and donate their organs. The success of the transplants, however, became it’s own victim. Before long, rich people and foreigners started coming to India to buy organs. It was a flourishing buiness, until the Human Transplant Act was introduced in 1994. Some middlemen and touts however still exploit the loopholes in the Act and the business of organ transplant continues unabated.
What are these loopholes in the Human Transplantation Act?
The organ transplant was big buinsess before the act was formulated. But it has not made the difference it set out to after its formulation. The clauess in the act are being exploited openly. A case in point is the the clause which allows,”unrelated donors offering organ on emotional grounds,” and the inclusion of the wife as a prospective donor.
Only an affidavit has to submitted to the Authorisation Committee for clearance. Sure enough, the committee has been flooded with affidavits prepared by middlemen in conivance with the hospital staff, police and at times, even committee members.
What is the solution?
The Act has to been amended. The clause relating to emotional donors should be struck off. In the West, 20,000 transplants take place annualy, all from cadaver patients. But in India the figure stands at a dismal 4000-5000 transplants per year. Secondly, the wife should be excluded from the clause. Instead, cousins, neices, nephews, uncles, aunts should be included. A HLA Tissue typing should be made mandatory to ascertain the relationship of the donor with the patient.
Do you think amending the law will solve the problem?
Yes, to some extent. But a government initiative should also be encouraged. They have not been addressing the problem properly. The programme to make cadaver donors has been deliberately sabotaged by vested interests. As far as the cost of sustaining the cadaver donor once he is brain dead is concerned, it should be borne by the family of the recepeint issues like these should be addressed.
The recent case of an Indian doctor actually procurring organs from live Indian donors for British patients is an eye opener. What has discouraged cadaver donations is the absence of any registartion of the patients suffering from diseases requiring organ transplantion. As a result the deals are done unofficial without any database to give the actual figure. When it happens with kidneys, it is bearable as it is a paired organ, but what with liver transplants showing a success rate of 60-70% possibilities of tout involvement increases manifold.

Apollo

Ayurveda in India

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Ayurveda is a traditional branch of science that originated in India thousands of years ago. The study of Ayurveda is divided into eight parts, Kaya, Bal, Graha, Urdhwa, Shalya, Dhanstra, Jara and Vrishan. It is believed that every human is composed of Doshas which regulate and guide the structures and substances of the body. The understanding of the Doshas provides the base for the study of Ayurveda in India.

Often considered as an alternative medicine, Ayurveda in India is more than a medical system, it is a science of life. It helps human beings to maintain equilibrium with ones mind and body.

Ayurvedic medicines are made of herbs, minerals, metals and ingredients of animal origin.

India offers many Ayurveda Resorts which provide specialized therapy and treatment. Kerala houses some of the best Ayurveda Resorts in India.

Apollo Hospitals have a specialized Department of Alternative and Complementary Medicine which offers an Ayurveda Centre. The in-house pharmacy offers a range of Ayurvedic medicines.

1994, Cardiac, Heart, Kidney, Liver, Lung, Pancreas, Skin, Small_Bowel

Indian Govt. Laws for Human Organ Transplant

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The transplantation of an organ from one body to another is known as the organ transplant. The person who gives the organ is called the donor while the one who receives is called the recipient. Organ transplant is done to replace the recipient’s damaged organ with the working organ of the donor so that the recipient could function normally. The person who is donating the organ (donor) could either be a living or a deceased.

Organ Transplantation is a boon to medical industry as it has helped in saving the lives of those who would have died otherwise. There are various laws that are to be followed while conducting the organ transplant. Medical India Tourism offers to give you online information on Human Organ Transplant Laws in India, India.

Kidney, Liver, heart, lung, pancreas, small bowel and sometimes skin etc. are some of the organs that can be donated for an organ transplant.

Due to inefficient and corrupt healthcare system, illegal trafficking of organ is really high in India. To stop illegal organ transplant, Indian Government has come up with a 1994 law that criminalizes organ sales. The Human Organs Transplant Act, 1994 has laid down certain rules and regulations that are to be followed while conducting organ transplant.

Organ transplant law does not allow exchange of money between the donor and the recipient. According to the Act, the unrelated donor has to file an affidavit in the court of a magistrate stating that the organ is being donated out of affection. After which the donor has to undergo number of tests before the actual transplant takes place. The Authorization Committee set up for the purpose ensures that all the documents required under the act have been supplied.

If it is found that the money has been exchanged in the process then both the recipient as well as the donor are considered as prime offenders under the law.

According to the Indian law, organ sales are banned and therefore no foreigner can get a local donor. Human organ transplant laws are very strict in India and the penalty incurred for organ trade is also very high.

According to the Indian Law, close relatives of recipient like parents, children, brothers, sisters, spouse can donate the organ without government clearance. But all other relatives who wish to donate the organ need to appear before the authorization committee for clearance and only after its approval and clearance can get the organ transplanted. (This has been now amended)