"If I didn't have my birds, I wouldn't be as well as I am," she said. "Sometimes when I wake up, I feel like I don't want to do anything that day - even get up - but I know I have to look after my birds. And, once I get out there with the birds, I forget about my other problems."

The Oak Flats woman's husband, Alan, their six children and 14 grandchildren also keep her spirits up, and entertain her, while she spends hours every other day undergoing dialysis.

OPINION: Patients deserve opportunity to live

POLL: Are you an organ donor?

Reflux from childhood caused irreparable damage to her kidneys and, while she always knew she would end up on dialysis, it's still tough going.

"It's terrible. I've spent months and months in hospital because I haven't been able to get a new kidney," she said.

"When you die, you don't need your organs any more; you could give people like me my health back, and, finally, a decent life again.

"Although I suppose I'm lucky to still be alive really."

Last year 1009 Australians received organ transplants thanks to the generosity of 337 donors and their families.

But there are thousands more, like Ms Thomas, awaiting transplants and, despite a federal government campaign costing $151 million to boost organ donation over the past four years, the nation is still lagging behind many other developed countries.

New figures released by not-for-profit group ShareLife Australia last month show that Australia ranks 22nd in the world for organ donation rates, behind the UK (17), the US (6) and world leader Spain.

However, a spokeswoman for the Organ and Tissue Authority, which was set up by the federal government in 2008 to oversee the multimillion-dollar reform package, said some progress was being made.

"In 2011, Australia achieved its highest donation and transplantation outcomes since national records began, with 1009 transplant recipients from 337 deceased organ donors," she said.

"This represents a 36 per cent increase on the 2009 outcome of 247 donors and a 9 per cent increase on the 2010 outcome of 309 organ donors.

". . . Based on our projections, Australia should be able to achieve 628 donors by 2018."

The spokeswoman said the national reform agenda included a clinical network of dedicated specialist organ and tissue donation staff in 74 hospitals across Australia, as well as DonateLife agencies in each state and territory.

These staff were working to improve organ and tissue donation rates and outcomes, to provide specialised family support services and raise awareness in their clinical communities.

She said other countries which had introduced similar reforms had taken years to achieve firm results. "Both Spain and Croatia in particular took 10 years to fully realise their national reform agendas."

The Organ and Tissue Authority is also implementing a national community awareness and education program, educating Australians about the need for families to ask and know each other's donation wishes. This is important as the family will always be asked to confirm the donation wishes of the deceased before it can proceed.

"Another achievement under the national reform agenda to date has been the significant increase in family discussion about organ and tissue donation wishes, with 77 per cent of Australians now having had a family discussion, of which 58 per cent discussed their donation wishes with family members in the past 12 months."

The initial funding package for the national reforms expired at the end of June. However, the spokeswoman said ongoing funding had been allocated.

At a state level the situation is particularly dire, as NSW's organ donation rates are the lowest in the country. NSW Health Minister Jillian Skinner said the state government had launched a strategy in August, aimed at doubling those rates.

"The NSW government is on a mission to see NSW organ-donation rates match, and ultimately exceed, those achieved by other Australian states and territories," Ms Skinner said.

"Last year NSW hospitals identified 215 potential organ donors, who were medically suitable to donate. Of those, only 77 actually donated organs - a rate of just 36 per cent.

"Our goal is to see this rate increase to meet the national target of 70 per cent. One organ donor can help as many as 10 people, with many more assisted when tissue is also donated."

Ms Skinner said the government was also moving to a single national organ-donor register, which would bring NSW into line with other states and make it easier for people to make their wishes known.

She said the amendments to the Human Tissue Act would place patients first, by considering their wishes. A key part of the strategy was expanding specialist training for clinicians in conducting donor family conversations.

"If a person has expressed a wish to be a donor but their family refuses, the requesting doctor is now required to document the reasons why the family do not support their loved one's wishes," she said. "If a patient has registered a decision not to be a donor but later changed their mind and discussed this with their family, this can be taken into account in a decision with the family to proceed with donation."

Unfortunately, one in six people who could have been saved by an organ donation in NSW, currently dies waiting for a suitable donor.

Ms Thomas said it was "disappointing and frustrating" that Australia was still not in the top 20 countries for organ donation rates.

"You would want to think that no organs were being wasted in Australia, but that's not the case," she said.

"Hundreds of people are waiting and continuing to die because of not getting a transplant.

"I just want to be happy and healthy, like I could be with a donated kidney."

As it stands, plans for a trip around Australia by Ms Thomas and her husband in their new van have been shelved while they concentrate on her health - although she's not putting her life completely on hold.

"I get pretty tired but I'm pretty stubborn too," she said.

"My grandchildren bought me a miniature foxy for my 70th birthday and nothing's going to stop me from taking her for walks.

"My doctor tells me I'm very healthy, apart from my kidney problems, so, while it'd be lovely if I did get a kidney, I'm still living my life.

"It's not a sickness, it's a condition."

DONATE LIFE

A key strategy of the NSW government’s plan to increase organ donation in the state is to move to a single national organ-donor register. Using the national register will bring NSW into line with other states of Australia and make it easier for people in NSW to make known their wishes about donation.

To register to be an organ donor visit: www.donorregister.gov.au or www.medicare.gov.au, call 1800777203 or visit a Medicare Australia office.