In Algeria, taboos and law deter organ donors

By donating one of his kidneys, Aisha's son gave her a new lease on life after she had unfergone years of dialysis. (AFP)
Updated 17 September 2017
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In Algeria, taboos and law deter organ donors

BATNA, Algeria: By donating one of her kidneys, Nawel gave her husband Boubaker Ziani a new lease on life after he had undergone 16 years of dialysis.
But in Algeria and across the entire Maghreb in North Africa, many people continue to suffer or die because of the lack of donors.
Part of the problem lies with laws restricting the harvesting of human organs, coupled with cultural or religious reticence, despite Muslim theologians’ approval of organ donations.
Ziani’s wife offered him a kidney after she saw that he had become too weak to play with or even to hold his children.
He had long rejected her willingness to help, but in the end as no other donor was available, he finally relented.
He had the operation at one of Algeria’s two main centers for kidney transplants, the University Hospital in Batna, 435 kilometers (270 miles) east of Algiers.
“I’m like a newborn,” Ziani told AFP, tears in his eyes.
In a consultation room, 47-year-old Abderahmane said he hoped an end to 24 years of dialysis was in sight thanks to a kidney from his mother.
“Dialysis has dominated my life. I want to take a break from this machine and live,” he said.
He suffers from a hereditary condition that also affects two of his brothers. Lacking access to transplants, one of them has died and the other has now been on dialysis for two years.
More than 22,000 people in Algeria suffer from renal conditions and are forced to undergo dialysis, according to the ministry of health. A third are waiting for a transplant.
Many others require liver donations, which can also be offered by live donors.
But under Algerian law, a living person can donate an organ only to a parent, child, sibling or spouse.
In the absence of a national database, the overall number of people awaiting transplants in Algeria is unknown.
Many patients are critically ill as they wait for organs such as a heart which can only be taken from deceased donors.
But the law says organs may only be removed from a dead person if their family agrees.
The overwhelming majority refuse, for lack of information, fear of violating religious laws or mistrust of doctors.
Some also suspect that transplants benefit only the privileged.
“Some families had never heard of donations from corpses before the death of a relative,” said Dr. Ahmed Bougroura, head of the Batna hospital’s kidney health department and coordinator of the transplant team.
Theologian Kamel Chekkat, a member of Algeria’s association of Islamic scholars, stressed that the practice was not religiously outlawed.
“From a religious point of view, there is nothing to oppose organ donation and the taking of organs from corpses,” he said.
He and other Muslim theologians have argued that organ donation after death is “ongoing charity” — a pious act in Islam that outlives the person who performs it.
The gift of an organ fulfils “one of the major objectives of Islamic law, which is the preservation of life,” Chekkat said.
As for the recipient, “whatever the religion of the patient... the law of God instructs us to preserve his life.”
In 2015, just two patients in Algeria — which has a population of more than 40 million — received donor kidneys, according to the Global Observatory on Donation and Transplantation (GODT).
The figures for Morocco and Tunisia were only marginally better, with fewer than 10 patients in each country receiving kidneys from the deceased.
“Organ donation... is struggling to gain a foothold in Morocco, even though there are no prohibitions: not medical, legal or religious,” Moroccan organ registrar Said Sabri told AFP.
Dr. Rafika Bardi, head of the Tunisian Center for the Promotion of Organ Transplantation, said that “as in all the countries of the Maghreb... organ donations by the deceased are minimal.”
She said the region lacked a “culture of donating organs” and that many people confuse organ donation with organ trafficking.
Algeria is considering changing the law to allow citizens to indicate in writing that they accept to have their organs removed in the event of their death, overriding refusals by their families.
However, specialists say that is not enough.
Campaigners in Algeria and Tunisia want to create registers of people who refuse to have their organs taken after their death — and anyone not on the list would be considered a potential donor by default.
Farid Sekouf, 41, who is finally preparing to receive his wife’s kidney after six years on dialysis, believes the public needs more information on the issue.
“When it comes to going to vote, the state does all it can so that even a person in a tent in the Sahara is informed,” he said.


Babel La Mer: Dining aboard the fisherman’s deck

Updated 10 August 2018
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Babel La Mer: Dining aboard the fisherman’s deck

  • Mezze is already a full-on feast of its own, and Babel knows how to put an ocean-twist on the traditional champions of Lebanon’s “tapas”
  • “Arabic restaurants depend on how good their hummus is”

Standing tall at the southern entrance of Dubai’s trendy, seaside open-air strip La Mer, Lebanese restaurant Babel welcomes diners to enjoy a Mediterranean seafood experience.

Upon entering the high-ceilinged restaurant, diners are met with a faux-night sky that hovers above the wide selection of fresh fish tidily nestled on a bed of ice chips that stretches across the hall. Charbel, an experienced fish connoisseur, stands behind the assortment, detailing the different types of fish and crustaceans and how they would be best enjoyed — grilled, fried or raw. He’s also there to make sure you don’t over-order, as the mezze selection is “extremely rich and worth every bite,” as he put it.

He was right. After taking our seats, we were served a delightful salty algae, a tangy chili sauce and the typical Lebanese mixed nuts and sunflower seeds you’d find at any Lebanese restaurant. Be sure to only take a bit of each though — there’s plenty more to come. 

Mezze is already a full-on feast of its own, and Babel knows how to put an ocean-twist on the traditional champions of Lebanon’s “tapas.” Among the winners — and highly recommended dishes that are must-orders for any first-time (and surely second- or third-) visitors — were the shrimps fatteh (a bed of shrimps sautéed with garlic, lemon and parsley topped with yoghurt, eggplants and fried pita bread) and Tabboulet El Bahar (Arabic for Sailor’s Tabbouleh) which features shrimps mixed with wheat sprouts, tomatoes, onions and parsley. It’s refreshing when experimentation with classic staples yields mouthwatering results.

My father always told me, “Arabic restaurants depend on how good their hummus is.” And as he’s a heavy-set, stubborn Lebanese man who refuses to have a below-par bite, you can take his word for it. He would, I believe, have ordered three plates of the Hummus Beiruti for the table. It’s a pleasantly tangy dish mixed with radishes, parsley and mint. This, accompanied by the well-dressed shrimps and octopus à la Provençale (read: sautéed with garlic, lemon and parsley) and small, crispy cubes of batata harra (spicy potatoes) are the deserving opening acts to the much-awaited main show.

Charbel recommended we go with the ultimate trifecta of the ocean — the prongs of Poseidon’s trident: Grilled jumbo shrimps, fried Sultan Ibrahim (threadfin bream) and charcoal-grilled sea bass. Seafood is all about freshness and too much seasoning can overpower the natural flavors and ruin the whole experience. But Babel makes sure it’s the fish flavor that takes center stage. Small bits of burnt charcoal on the butterfly-opened sea bass complemented the tender fish flesh, as they did on the jumbo shrimps. The Sultan Ibrahim was lightly fried — not so much as to have Greenpeace protest an oil spill, but enough to make the outer skin crunchy with every bite and keep the inner flesh soft and succulent. 

After all that, it’s safe to say that we weren’t just stuffed... we were primed to explode. 

After clearing the table, our server brought us the desert menu, only for us to rapidly wave him away — “Please, no more...” — while patting our bloated bellies. However, he insisted we try the Ghazlieh, the Arabic version of cotton candy, topped with lotus-cookie chunks and caramel sauce. Our resolve already defeated by the mere description of this — and, honestly, what’s an Arabic feast without desert? — we gracefully acquiesced.

I woke up the next morning wishing I had had more of it. The featherlight cotton candy hairs melted into sugar crystals on the tip of our tongues while swing dancing with the cookie bits and caramel sauce, only to be lit up by the vanilla ice-cream hidden at the bottom.

Stop salivating and book a table.