NCRHA blocks Venezuelan woman from donating kidney to Trini husband

A FORMER MARKET vendor has sent a pre-action protocol letter to the Minister of Health and the chairman of the North Central Regional Health Authority (NCRHA) over the authority's refusal to allow his Venezuelan wife to be his kidney donor.

Vijay Nanan, 53, of Rousillac, is seeking a declaration that his 29-year-old Venezuelan wife can donate a kidney to him, as he suffers from kidney failure. His letter was also addressed to the Solicitor General.

Nanan is being represented by attorneys Anand Ramlogan, SC, Jayanti Lutchmedial, Ganesh Saroop and Gary Ramkissoon.

In the letter sent by e-mail, Nanan's attorneys say he fell ill in August 2018.

He visited a private hospital for treatment, where he had a heart attack while being examined.

Nanan was taken to the San Fernando General Hospital where it was confirmed he had a heart attack. He was also diagnosed with kidney failure.

"He was rushed to various departments where he was given treatment and two (2) days after arriving there he was warded. He was warded for approximately four (4) months. While warded he was monitored due to the two (2) major medical issues he suffered, those being the heart attack and kidney failure," the letter states.

Nanan was discharged in mid-December 2018 and advised to attend the hospital's renal clinic every two weeks.

However, Nanan had issues accessing the clinic during the covid19 pandemic and started attending the Mt Hope Renal Clinic at the Eric Williams Medical Sciences Complex.

"He receives 'Mircera' injections to help 'build his blood,' because his kidney no longer produces a normal amount of blood," the letter states.

In November 2022, Nanan was told by a doctor from the renal clinic that he was a candidate for a kidney transplant. He spent the next several months doing blood tests at another private hospital before submitting his results to the transplant unit in May, 2023.

During that period, the letter states, Nanan was involved in "a stable and loving relationship" with Yolanda Maria Garcia Rodriguez. The letter states their relationship began in 2019.

"They met at a mutual friend’s home, who is a pastor in New Grant. They eventually married on 1st March 2023 at the Hindu temple, Lime Head Road, Chase Village," the letter states.

Nanan's lawyers say Rodriguez was born in Venezuela.

Sometime in May Nanan visited the transplant unit to submit his application for a transplant. He met with a senior representative of the unit.

"(The representative) consulted with a doctor, then informed our client that his wife’s medical records would not be considered or reviewed," the letter stated.

Nanan said he explained the donor was his "legally married wife" but was told this did not make a difference.

"Our client expressed his confusion and profound disappointment, because it was his understanding that any healthy adult could be a donor, once they were compatible.

"Notwithstanding this, our client left updated copies of his medical records with her, which were consolidated with the records that they previously had from his clinic visits."

Nanan claims he was told if he could find a donor who was a citizen of TT, he could return and his entry into the transplant programme would be facilitated.

"On or about the beginning of June 2023, (the representative) called our client to inquire as to whether he had found a 'local' donor, to which our client replied that he had not."

According to documents submitted with the letter, plasma and urine samples were taken from Rodriguez on March 28.

The letter pointed out the ministry's policy on organ donation, which states, "A potential recipient must be referred to the National Organ Transplant Unit by a consultant nephrologist in order to receive a kidney transplant. At the present time this can be best expedited if the recipient has identified a donor.

"A donor is any person over the age of 18, who has a compatible blood group with the recipient, who has who has been medically, psychologically and socially cleared to do this altruistic act. The donor as well needs to bring a referral from his/her general practitioner. To become an organ donor call the National Organ Transplant Unit. Any person over the age of 18 can choose to become a donor."

Nanan contends that the decision to bar his wife from donating her kidney to him is contrary to the published requirements for a donor.

"It is clear that the policy makes no provision for nationality or residence of a potential donor. The only applicable criterion are having a compatible blood group with the recipient and having

been medically cleared to be a donor.

"In contrast to the prescriptions of the policy, you have applied improper considerations and discriminated, by refusing to properly consider our client’s wife and/or deeming her an invalid donor candidate due to her nationality and residency status," the letter stated.

Nanan said this decision deprived him of accessing lifesaving treatment without justification.

"You have failed to even consider the donor he provided (his wife) due to improper considerations."

The letter alleges a breach of the principles of natural justice, a breach of Nanan's Constitutional right to the protection of law and his right to life.

It said the decision to reject Rodriquez as a donor was a contravention of the usual practice where applications are considered once the donor is an adult.

"The decision is also discriminatory because it unjustifiably discriminates against overseas donors and persons who have married non-citizens."

Both organisations have been given five days to respond. If there is no response by 4 pm on July 25, the letter states an application will be made for judicial review relief, including a declaration that the policy which prohibits an overseas donor who is not a citizen from donating an organ to a citizen is irrational, unfair and illegal.

Nanan will also seek a declaration that the policy prohibiting a wife from donating an organ to her lawfully married husband on the basis that she is not a citizen is irrational; an order of certiorari to quash those policies; a declaration that refusing to allow his wife from donating a kidney to him is irrational, unfair and illegal; and an order to compelling the Minister of Health and chairman of the NCRHA to consider the suitability of the donor candidate.

Nanan will also seek, among other things, a declaration that the failure to consider his wife as a candidate was "an exercise of power in a manner that is so unreasonable that no reasonable person could have so exercise the power."

If he files for judicial review, Nanan will also seek a declaration that his constitutional rights under Sections 4 (a), (b) and (d) have been breached; compensatory damages; vindicatory damages, interest; costs; and any further orders, directions or writs the court considers just.

The letter underlined the urgency of Nanan's condition, saying, "The impugned decision and/or policy has serious adverse implications for the intended claimant’s constitutional rights to life, equality of treatment and the protection of the law."

It also stated this issue can affect other citizens who are married to Venezuelan nationals.

"The deleterious and devastating impact is accentuated by the fact that there is a significant number of Venezuelan citizens who have settled and now reside in this jurisdiction, many of whom have formed lasting social and emotional bonds with citizens of Trinidad and Tobago, that have resulted in lawful marriages."

It also notes the difficulty in finding donors and ensuring those donors are compatible with the person needing a transplant.

"The impugned decision and/or policy is therefore xenophobic, irrational and narrow-minded because it unfairly restricts the pool of potential donors to citizens of this country. This is absurd given the size of our population and the international trend towards securing organs from a compatible and willing source in the global village."

The letter said the situation required immediate judicial intervention.

"Our client is currently receiving dialysis treatment and is in excruciating pain due to his condition. He is in urgent need of a kidney transplant and his wife is willing to donate this precious organ to ease his pain and suffering and save his life. Unfortunately, she has been unable to do so because of this irrational and unfair policy."

The attorneys also note concerns about "illegal donor harvesting" but said, "there is no basis for such concerns here as the donor is the lawful wife of our client."

Newsday tried contacting NCRHA chairman, Steve De Las; and CEO Davlin Thomas but both their offices said they were unavailable. There were no responses up till press time to messages left for both men. Calls to the National Organ Transplant Unit went unanswered. Contacted for comment via WhatsApp, Minister of Health Terrence Deyalsingh said questions should be sent to his ministry's corporate communications unit.