AUDIE CORNISH, HOST:
More than 120,000 people are waiting for organ transplants in the United States. The shortage of available organs is a problem that governments, doctors and public health workers all over the world struggle with. Chana Joffe-Walt of our Planet Money team has the story of one woman who believes she is close to a solution.
CHANA JOFFE-WALT, BYLINE: When Kim Zaza became the volunteer coordinator for a nonprofit called Gift of Life Michigan only 11 percent of Michigan's population was on the organ donor registry. Her job was to increase that number. Kim Zaza is an energetic person. People like people, is a thing she says a lot, and a thing that's easy for Kim to believe because people like her. So Kim was naturally optimistic about her ability to sell organ donation to the people of Michigan just by talking to them.
KIM ZAZA VOLUNTEER COORDINATOR, GIFT OF LIFE MICHIGAN: We just went out and, like, signed up for every art fair, church event, yeah, every little podunk little thing we could possibly think of just to try to get our information out there.
JOFFE-WALT: The Romeo Peachfest, the Alpinefest Parade. Most Americans support organ donation according to polls. Kim would just have to explain how important it was to actually sign up as a donor. Even better, she'd get someone like Marge Delgreco, a woman who has received not one but two donated livers, to make the pitch.
MARGE DELGRECO: I would drive there, set up my table, have little snicky(ph) snacks for the people to get them to come to the table. And six hours later I could walk out of there and sign up two people. So, OK, is that really worth my time to do that?
JOFFE-WALT: The answer seemed to be no. Kim and her army of 800 volunteers were talking to as many people as they could. And still they'd see a small bump in the numbers but not a big one. So they launched a Donate Life Day at the state capitol. They tried radio and TV ads, celebrities, billboards with an endless cycle of new campaign slogans and still the Michigan registry numbers were poor when compared with other states.
Every time Kim would go to the National Donate Life conference with all the other state organizations that managed donor registries, Kim would sit in the back of the room.
MICHIGAN: It was kind of embarrassing for us to sit in some of those meetings. Yeah, we'd be like, oh look, we're in the bottom of the barrel again.
JOFFE-WALT: Kim noticed that the states that were successful had outsourced a lot of the work she herself was doing. They had enlisted the help of an enormous workforce, a workforce that was already coming into contact with a population much larger than the one at the Romeo Peachfest.
AUDREA AGEE: I think I see at least - I'd say I see about 80 or 90 people a day.
JANINE SHEPHERD: I mean, she sees more than I do because she move faster than me.
JOFFE-WALT: Audrea Agee and Janine Shepherd are eating their lunch in the back of the Ann Arbor DMV. They're DMV clerks. In 2011 Kim and her colleagues convinced the State of Michigan to allow DMV clerks to ask every person if they wanted to become an organ donor. More than half the U.S. states do this. Most states ask on paper, but in Michigan the verbal ask made a huge difference. Kim's boss Tim started getting in the new donor registration numbers.
TIM: And it was almost like, well that can't be right. I don't know how we could've had that many.
MICHIGAN: And then he calls me in and I'm like, you must've done it wrong. I'm like, do it again, boss.
JOFFE-WALT: In 2010 Michigan had 320,000 new organ donors. In 2012 the first full year the clerks were asking, there were 520,000 new organ donors in Michigan. Most of those people signed up because a DMV clerk asked them to. The conversation in the break room at the Ann Arbor DMV is about a new GEICO ad.
AGEE: The commercial where you see that pig...
JOFFE-WALT: In it a pig with a GEICO insurance card is getting his picture taken by a surly, dismissive DMV clerk.
AGEE: And then the lady yells, next.
JOFFE-WALT: Audrea and Janine, DMV clerks, do not like this depiction. Janine says, screaming next like that, you have to do that because customers get angry with you if you don't. When she first started, Janine used to sit behind her counter and whisper, number 22, 22.
SHEPHERD: I was afraid to even call a number because you have to call a number really loud, you know.
AGEE: But, you know, if...
JOFFE-WALT: You were afraid to call a number?
SHEPHERD: I mean, I was shy. I just did not - and then when people come up and, you know, some people can be intimidating the way they come up.
JOFFE-WALT: It took years of practice for Janine to get comfortable doing this...
JOFFE-WALT: Similarly, asking a person if they'd like to donate body parts when they die, that took some practice too.
SHEPHERD: Would you like to be on our organ donor registry today?
UNIDENTIFIED MAN #1: What's that for?
SHEPHERD: If something happens to you, your organs go to help someone else live.
UNIDENTIFIED MAN #1: Yeah.
SHEPHERD: You would?
UNIDENTIFIED MAN #1: Yeah.
SHEPHERD: And how will you be paying today? It's going to be cash, check that we...
JOFFE-WALT: Most interactions go this way. People don't say, absolutely. Most people just say, uh, what? Yeah, sure. Can I pay with a credit card for this? And there are some people who say no.
SHEPHERD: Did you want to be an organ donor?
UNIDENTIFIED MAN #2: Uh, no, that's all right. I don't think anybody wants my organs.
SHEPHERD: Well, that's not true. No.
UNIDENTIFIED MAN #2: Well, I'm a heavy smoker and drinker. Nobody wants my organs.
JOFFE-WALT: Kim Zaza would want me to jump in here and say that smoking and drinking do not disqualify you from organ donation. Michigan now has more than 3 million people on the organ donor registry. It took 16 years to register 2 million of those people. The DMV clerks did the rest in just the last few years.
It turns out getting people to be organ donors is a lot like getting people to exercise more or save for retirement. If you put a gym in the building, they're more likely to exercise. Automatic 401K contributions help. And with organs, if you bury the question of mortality and body parts in a bureaucratic routine, it makes it easy to say yes. At last year's Donate Life conference instead of sitting in the back of the room, Kim Zaza was actually asked to present.
MICHIGAN: It was like, wow, people actually showed up. And then, you know, I had people call me afterwards and say, oh how'd you do that and, you know, how did it work? And suddenly it felt like, oh we're on the map. And we didn't feel like the laughing stock of the whole nation, yeah, because we kind of were for a while.
JOFFE-WALT: Kim no longer spends lots of time driving to the Romeo Peachfest or sending hundreds of organ recipient volunteers to distant churches. In fact, she spends most of her time now traveling to the state's 131 DMV offices. She comes with chocolates for the clerks. These are her soldiers now. She wants them to be pampered. Chana Joffe-Walt, NPR News.
NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.