Despite thousands on Malaysia’s transplant waitlist, organ donation rates remain among the lowest in the world.
In Malaysia, over 10,000 people are currently on the waitlist for organ donations. Yet since 1976, the nation has only seen 3,106 organ donations.
A health crisis has been looming over Malaysia as a result of the rising rates of non-communicable diseases (NCDs). Based on findings from the 2023 National Health and Morbidity Survey, about 33% of the population have high cholesterol, 15.6% suffer from diabetes, and 29.2% have developed hypertension.
Furthermore, a study by Malaysia’s Institute for Public Health revealed that the probability of dying from NCDs, including diabetes, cancers, and cardiovascular and chronic respiratory diseases, is set at roughly 19.4% this year, and is projected to increase to 20% by 2030.
As such, organ donations play a critical role in saving lives and providing hope to patients in need. From kidney transplants for renal failure to heart transplants for cardiovascular ailments, organ donations offer a second chance at life for many people battling NCDs.
A large majority of those on the waitlist for organ donations consist of kidney transplant patients (10,266 individuals), followed by patients for heart transplants (nine), liver transplants (nine), heart and lung transplants (six), and an individual anticipating a lung transplant.
And yet, organ donation rates have been abysmal in the country. Despite the fact that almost 400,000 people had pledged to donate their organs after death since 1976, not all have fulfilled this pledge. Having seen a mere 986 deceased donors, Malaysia actually records one of the lowest deceased organ donation rates globally.
Given that this country boasts citizens who are known for offering kindness and generosity, why do Malaysians hesitate to pledge the gift of life?
Why Aren’t Malaysians Donating?
The low rate of organ donations in Malaysia can be credited to a critical factor – a lack of awareness.
The country utilises an opt-in donation system, and those who wish to become organ donors after death can easily and quickly make their pledge through the MySejahtera app.
However, one would be hard-pressed to find a citizen who actually knows how to even register as a prospective donor.
One reason why most are uninformed about this process could originate from how the necessity of organ donation gets very little exposure online and on mainstream media in the first place.
And for those who have made their pledge, even after completing their registration, consent from their next of kin is needed for their donation to go through. When a donor dies, their next of kin must still give the green light for the organs to be used. Often, that consent never comes.
“It is not uncommon that in the emotionally charged moments after a death, one relative’s objection can halt a potential donation, and hospitals have no legal means to proceed without unanimous family agreement,” explained Dr Mohamad Zaimi Abdul Wahab, President of the Malaysian Society of Transplantation, in CNA.
Cultural and Religious Concerns
This refusal—in addition to why not more people choose to become donors to begin with—can also be attributed to existing misconceptions over the idea of donating organs.
“There’s a strong cultural belief among some families that removing organs compromises the body’s integrity needed for the afterlife,” Dr Zaimi highlighted.
In religious and conservative Malaysia, the concept of organ donation is riddled with superstition and fear that a pledge to donate could bring bad luck, or that the process of removing the organs could even engender painful sensations for the deceased.
A System Under Pressure
Further compounding the problem is Malaysia’s restricted transplant capacity.
Only two public hospitals in Malaysia are able to perform these transplants, both of which are located in Kuala Lumpur. Furthermore, there are only two dedicated transplant surgeons under the Ministry of Health in the entire country.
Even if donation rates increases dramatically, the nation simply doesn’t have the resources currently to proceed with more operations. Perhaps with more dedicated funding and training programmes to update the transplantation structure, the medical industry can work towards extending services and improving patient outcomes.
As Dr Zaimi puts it: “The effectiveness of a transplant programme is only as good as the healthcare infrastructure supporting it.”
Without investment in infrastructure, training, and access across the country, increased donations won’t translate into saved lives.
What Needs To Change?
This massive gap between the number of actual organ donors and patients in need of transplants can cost countless lives.
The government might thus need to pivot their strategies in efforts to boost donations.
For one, Malaysia could look into expanding the donor pool. Malaysia currently accepts organs only from donors who meet brain death criteria. But other countries have expanded their donor pool by accepting organs from patients who die from cardiac arrest—known as uncontrolled donation after circulatory death (u-DCD).
Another suggestion is to establish an opt-out system for organ donations instead, which can offset the inaction in an opt-in system that explains why some fail to contribute, despite planning to. As it is, opt-out systems have been shown to result in an increase in the total number of deceased organs donated.
But before any new tactics can even be effective, most importantly, Malaysia needs a national conversation on organ donation. It is important to resolve the lack of public awareness, and overcome prevailing sociocultural beliefs that hinder greater progress.
Caption: Raising awareness on the importance of organ donation is crucial for gaining ground in this vital area.
Original Image Source: Shutterstock
Increasing awareness is crucial for encouraging more Malaysians to become organ donors. This can look like sustained public education campaigns. This can also includes working jointly with religious leaders and minority communities to address superstitions and clarify religious guidance on this issue.
Behind each number on that waitlist is a person: a parent, a child, a sibling, a friend. By shedding light on the importance of organ donation and addressing concerns, we can bridge the gap and renew hope for those in need.
Read more
- Everything You Need to Know About Organ Donation in Singapore
- 380 Donors Pledge to Brain Bank Singapore, 9 Brains Harvested
- Can the Sugar Tax Sweeten the Outcome of Malaysia’s Battle Against Diabetes?
References
- Raynaud’s Disease and Raynaud’s Syndrome. WebMD. Updated: 7 May 2024. https://www.webmd.com/arthritis/raynauds-phenomenon
- Raynaud’s Disease. Mayo Clinic. Updated: 16 November 2024. https://www.mayoclinic.org/diseases-conditions/raynauds-disease/symptoms-causes/syc-20363571
- Raynaud’s Phenomenon. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Updated: July 2024. https://www.niams.nih.gov/health-topics/raynauds-phenomenon
- Lupus: The Intricate Dance of the Immune System. Medical Channel Asia. Updated: 17 October 2023. https://medicalchannelasia.com/lupus-the-intricate-dance-of-the-immune-system/
- Scleroderma: Systemic Sclerosis. Medical Channel Asia. Updated: 7 October 2022. https://medicalchannelasia.com/scleroderma-systemic-sclerosis/
- Raynaud’s Syndrome. Cleveland. Updated: 29 August 2022. https://my.clevelandclinic.org/health/diseases/9849-raynauds-phenomenon
- Vanessa Smith, Claudia Ickinger, Elvis Hysa, Marcus Snow, Tracy Frech, Alberto Sulli, Maurizio Cutolo. Nailfold capillaroscopy. Best Practice & Research Clinical Rheumatology. Volume 37, Issue 1. 2023 (1521-6942). https://www.sciencedirect.com/science/article/pii/S1521694223000359
