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Hitches to establish BD/DNC protocols to declare death in Africa

Calixto Machado

Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

DOI: 10.15761/FDCCR.1000154

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Abstract

The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis. The World Brain Death Project published an outstanding paper formulating a consensus statement of recommendations on the determination of brain death/death by neurologic criteria (BD/DNC). Now, Lewis et al particularized analysis of brain death/death by neurologic criteria (BD/DNC) protocols in Africa and found that the percentage of countries with BD/DNC protocols is much lower in Africa than in other developing regions. This is the largest assessment up to the present time about the prevalence of BD/DNC protocols in that continent. The authors also affirmed that, compared with Africa, the proportion of countries with BD/DNC protocols in Latin America/the Caribbean and Asia/the Pacific is similar to that of the world in general. In Africa, hundreds of religions are recognized. In Cuba, the Yoruba religion is very common [1]. Santería, was developed in Cuba and then spread throughout Latin America and the United States. Santería was brought to Cuba by people of the Yoruban nations of West Africa (mainly from the actual territory of Nigeria), who were enslaved in great numbers in the first decades of the 19th century. It arose through a process of syncretism between the traditional Yoruba religion of West Africa, the Roman Catholic form of Christianity, and Spiritism. Curiously, although in Cuba, Santeria, and Christian religions are common, contrary to Africa, most people accept BD/DNC and organ donation. It is also important to consider many African countries are lacking primary and essential medical services, which makes more difficult the establishment of BD/DNC and organ donation protocols.

The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis. [2,3,4-16].

Now, Lewis et al particularized analysis of brain death/death by neurologic criteria (BD/DNC) protocols in Africa and found that the percentage of countries with BD/DNC protocols is much lower in Africa than in other developing regions. [1].

An interesting finding was that the few African countries that have BD/DNC protocols are dissimilar compared with other developing countries. The authors also affirmed that, compared with Africa, the proportion of countries with BD/DNC protocols in Latin America/the Caribbean and Asia/the Pacific is similar to that of the world in general [1,2,5-16].

It is important to consider that economical resources in Africa are scarce, limiting the global access to intensive care units (ICUs) not allowing support by mechanical ventilation for brain-injured patients, who can progress to BD/DNC. Additionally, specialists and nurses trained in intensive care are infrequent [1,2,17-21].

Social and religious views on death can impact how death is declared and accepted by the population. In Africa, hundreds of religions are recognized. In Cuba, the Yoruba religion is very common [1]. Santería, (Spanish: “The Way of the Saints”), also called La Regla de Ocha (Spanish: “The Order of the Orishas”) or La Religión Lucumí (Spanish: “The Order of Lucumí”), the most common name given to a religious tradition of African origin that was developed in Cuba and then spread throughout Latin America and the United States. Santería was brought to Cuba by people of the Yoruban nations of West Africa (mainly from the actual territory of Nigeria), who were enslaved in great numbers in the first decades of the 19th century. The name “Santería” derives from the correspondences made by some devotees between the Yoruba deities called orishas and the saints (“santos”) of Roman Catholic piety. Many contemporary practitioners refer to the tradition as “the religion of the orishas” or the “Lukumi religion,” after the name by which the Yoruba were known in Cuba. It arose through a process of syncretism between the traditional Yoruba religion of West Africa, the Roman Catholic form of Christianity, and Spiritism. Curiously, although in Cuba, Santeria, and Christian religions are common, contrary to Africa, most people accept BD/DNC and organ donation [21-31].

I agree with Lewis et al. [1,17,26] that identifying the reasons to explain the lack of national BD/DNC protocols in individual nations in Africa are multifactorial and subtlety, and differ from country to country, and specialists and nurses trained in intensive care are infrequent [4].

References

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Editorial Information

Editor-in-Chief

A.A. Altintas
University Essen, Germany

Ozgur KARCIOGLU
University of Health Sciences, Turkey

Article Type

Mini review Article

Publication history

Received date: May 10, 2021
Accepted date: May 20, 2021
Published date: May 29, 2021

Copyright

©2021 Calixto Machado. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation

Calixto Machado (2021) Hitches to establish BD/DNC protocols to declare death in Africa. Frontiers Drug Chemistry Clinical Res. 4: DOI: 10.15761/FDCCR.1000154

Corresponding author

Calixto Machado, MD, Ph.D

FAAN, Institute of Neurology and Neurosurgery Department of Clinical Neurophysiology 29 y D, Vedado, La Habana 10400, Cuba

E-mail : bhuvaneswari.bibleraaj@uhsm.nhs.uk

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