UNIVERSITI TEKNOLOGI MALAYSIA

UHB 2422 : ADVANCED ENGLISH ACADEMIC COMMUNICATION

Title : A study of a shortage of organ donors in Malaysia

Group Members:
NAME FATIN HAMIMAH BINTI MOHAMED SALLEH SITI SURIYAH BINTI MAT LAZIM MOHD SHAHRIZAL ABDUL RAHIM ZAITON BT BAKAR UMA A/P BUN KING MATRIX NO. SX090583EEJ03 SX090632EEJ03 SX090603EEJ03

LECTURER: PN SALWA BT ABD WAHID

CHAPTER 1

INTRODUCTION

1.0

Introduction

Malaysia is faced with a serious problem of organ supply which leads increasing number of patients in waiting list as well as the subsidies money by government for dialysis. Even though there are a lot of affords have been taken to increase the number of donor, the result is still same. Questions may comes to mind about our community awareness of the needs and the moment we want to figured out the answer, thousands of lives in need of organs is at stake as these patients condition become worse day by day. Sadly to think that some of them are counting to the end of their days as the expected donor does not appear as expected. This patient comes from various categories of races, ages and gender, who suffer while waiting for generous donors to come forward to donate suitable organ for them. However, donating organ is not easy like donating money where there is some test need to do to obtain suitable donor for the patient. According to the World Health Organisation, the organ donor rate in Malaysia is only 1.4 per one million people. This is in sharp contrast to developed countries, such as Spain, which is at the top with 34.4 per one million. Although 194,001 people have pledged their organs so far, there have been only 370 actual donors since 1976 which is below 500. Based on the statistic from National Transplant Resource Centre, there are 15395 patients is currently in waiting list for a kidney transplant till 31st May 2012. There are two patients are still waiting for heart and lung transplant while another two patients waiting for lung transplant. It is not exaggerated to say that a shortage of organ donors gives suffers to the patients. The patient is not only suffering from their illness but may also lose their hope to survive. Thus, a study is conducted for the purpose to identify the factors of why a person finds it difficult to register as organ donors, especially among

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people in Malaysia and finding suggestion for this matter. In the first chapter, brief discussion on background information, statement of problems, research objectives and research questions, significance of study, scope, limitation and methodology will be given.

1.1

Background of the Study Organ transplantation is an operation, which involves the replacement of diseased

and defective organs and tissues with healthy ones from donors. In other words, it is a process of removing an organ from the body of one individual and transferring it to others. Generally, organ that can be transplant are the heart, kidneys, livers, lungs, pancreas, small bowel and the skin. Also bones, tendons, cornea, heart valves, vein and arm for tissues. Organ transplant has been in Malaysia since 1970. However, the procedure was only actively performed since 1997, when the National Transplant Centre was set up at Hospital Kuala Lumpur. Among the successful transplant reported are kindly transplant, cornea transplant and bone marrow transplant. Thus the increasing success rate of organ transplant procedures is one reason that organ transplant waiting lists have risen so dramatically since the late 1997s.Currently, the need for organ transplant in Malaysia more exceeds the supply that was donated. In Malaysia, more than 14,000 people are on the waiting list for organ transplant, with the great majority of patients diagnosed with end stage kidney failure. According to World Health Organisation (WHO) report placed Malaysia among the lowest in terms of organ donation. As of April 2012, only 194,846 from the Malaysian population of 28 million signed up as organ donors, there are only 0.66 donors per million. This figure is positively miniscule, when compared with that of Spain, which has a rate of 35 donors per million, the highest in the world. There are some factors causes lack of people contribute in organ donation in Malaysia. Lack of awareness about organ donation is one of the causes for the fewer organ donations. This is due to difference level of awareness of people and lack of iii

understanding by the people about organ donation. Another factor behind the organ shortage is obligation from family. Family members not support and even oppose the donor.

1.2

Statement of Problems

Recently, issued regarding about organ donation become crucial when there are a lots of patients waiting for an organ transplant from a donor. Many patients or their family comes forward through a media asking a helps from people to safe life. Although there are a lot of efforts taking by the National Transplant Centre in order to increase the number of donors through mass media and others, there are still lacks of people to register as organ donors. This can be seen through the statistics of organ donor and pledges from the National Transplant Centre where only 373 organ donations have been recorded till 31st May 2012, while 195921 have been registered as organ donor pledges. However, the number of patients is still in waiting list for kidneys transplant is 15395. Its cannot be denied that the donation from living or deceased person can help the patient, but still not enough to cater the needs of organ donation. In order to survive, the patient need to go abroad to get an organ transplant that cost a lot of money for them. For certain patient with wealthy family, they can afford the cost but for the poor family they cannot afford it. In fact, they will suffer to death if there are no financial supports from the public. Meanwhile, the patient with kidney problem also need more cost for dialysis. It would also be beneficial to determine the factors that influence the shortage of organ donors and levels of awareness people towards organ donation. For this purpose, a study related to the issue of a shortage of organ donors was conducted on a people from various backgrounds in Kedah and Pulau Pinang.

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1.3

Research Objectives

The objectives of the research are:

1. To identify the causes of a shortage of organ donors in Malaysia. 2. To identify the effects of a shortage of organ donors in Malaysia. 3. To suggest solution of a shortage of organ donors in Malaysia.

1.4

Research Questions

The research questions are: 1. What are the causes of a shortage of organ donors in Malaysia? 2. What are the effects of a shortage of organ donors in Malaysia? 3. What is the suggestion of solution towards a shortage of organ donors in Malaysia?

1.5

Significance of Study

The findings of this report are to create awareness among people in Malaysia regarding the shortage of organ donors. Apart from that, people will also gain knowledge about the caused of shortage of organ donor, the effect of the shortage to the patient and how to cater this problem in future. This report may also be crucial because it contribute to the improvement of public attitude towards organ donation which will then increase the number of organ donors in Malaysia. Consequently, it will also reduce the number of patients in waiting list. By able to have organ donor, it will give new hope for the patient as well as the cost.

1.6

Scope

This research is focused on a shortage of organ donor in Malaysia. The respondents include 47 people with different background (students, private sector, government sector & others) who are being chosen randomly. The venue of collecting data will be set at Kedah and Pulau Pinang states.

1.7

Limitation

This study is limited to 47 respondents with various backgrounds, who are students, government sector, private sector and others as Malaysian people due to the time constrains. Therefore, the resource as references is limited as well as guidance from the lecturer.

1.8

Methodology

This research will be conducted in Kedah and Pulau Pinang as represent Malaysian people within a week. The total population of Malaysia is 29,428,625 people at the time this research is undergoing. In this research, quantitative way (questionnaires) will be considered in obtaining data instead of and qualitative way (interviews). The survey questions will be created after being discussed and innovated according to the statements gained from the literature review in Chapter 2. Relatively, more than 10 questions will be included in the questionnaire. The questionnaires will then be distributed randomly to about 47 people who are chosen randomly in Kedah and Pulau Pinang since there is nearest states for the researcher. Practically, Respondents will answer the questionnaire anonymously and confidentially to avoid any other inconveniences and problems will be brought to the answerer after completing it. The result will be recorded and analysed. Primary data will be gained from methods stated

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above; in contrast, secondary data will be obtained from reading materials, such as books, journals and online resources.

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CHAPTER 2

LITERATURE REVIEW

2.0

Introduction

According to Longman Dictionary of Contemporary English (2005), organ is defined as a part of the body such as the heart or lungs, which has a particular purpose. While the term transplant based on The New Oxford Dictionary of English (2001), refers to move or transfer something to another place or situation, with some effort or upheaval. Abdi O. Shuriye (2006) stated from the previous research that the specific usage of transplant refers to moving living tissue or an organ and implant them in another part of the body or in another body as it indicates the operation in which an organ or tissues is transplanted, or a person or a thing which has been moved to a new place or situation. Based on the previous research, Abdi O. Suriye (2011) claim that the combination of the two terms organ and transplantation, or organogenesis as it is also known, gives the meaning of moving part of the biological organism from certain place in the body to another place or from another person or animal to another. In other word, organ transplant is the replacement of diseased and damaged organs. It is established treatment for end stage organ failure. Organs for transplantation can be obtained from living or deceased donors. A person can only donate part of their liver or one of their kidneys while still alive compared to deceased donors where there are no risks to the donors.

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Statistics obtained (Table 1) from the National Transplant Resource Centre, Kuala Lumpur (2012), found that only 373 donors were recorded from 1997 till 31st May 2012. This been support by the statement of Dr Lela Yasmin, chief clinical manager of National Transplant Resource Centre (The Malay Mail, March 21, 2012) said that there had only been 364 organ donations in Malaysia between 1976 and Feb 29 this year because most of those who pledged were still alive. Besides, from the previous studies Nazmi Nordin. et. al (August 1, 2012) revealed that 6.36% of the donors contribute by the Malay community while Chinese and Indian contribute 61.86% and 31.78% respectively. These figures raise a question mark that leads us to initiate a study to identify the main factors that contribute to these scenarios. The literature review will be delivered in this chapter regarding on shortage of organ donors, factors, effects and suggestion for the improvement of organ donation based on various journal, books and online resources.

Table 1: Statistics of organ donors since 1997 till May 2012 provided by National Transplant Resource Centre (20120 ix

2.1

Factors that caused the shortage of organ donors

There are several factors that caused the willingness of people to be an organ donor in Malaysia. It is important to identify why people unwilling to donate their organ in order to help the patients. A significant number of researches obtained statistical results about the factor that influenced the willingness of people to donate their organ which is religious belief, the awareness and perception towards organ donation. In our report, some of the common factors that caused a shortage of organ donors will be concerned and discussed in texts.

2.1.1 Religious Belief

Religion is an important factor that affects an individuals decision to become an organ donor, although religion itself is never forbid them to do so (Bilgin, 1999). This can be seen through previous studies Nazni Nordin. et. al (August 1, 2012) mentioned that the shortage of organ donors is associated with the Malay religious factors as the value of r=0.485 and p>0.5(p=0.000). Moreover, certain people in Malaysia are not clear about the fact that their religion allows them to perform organ transplants in order to save other human lives. In other word, lacks of religious knowledge regarding organ donation caused people unwilling to donate their organ even though all of religious support organ donation. As reviewed by H. Khalaf, M.I.M. Al Sebayel (2004), organ transplants are generally accepted as a method or solution to the final stage of organ failure in the human body.

2.1.2 The Awareness toward organ donation

The awareness towards organ donation is the second factor that influenced a shortage of organ donor among people in Malaysia. Awareness raises an individuals desire to do something including donating their organ. However, it will only be essentially available if they have little knowledge of something that is to be done. According to Gupta, A., Jain, S., T., & Gupta K., (2009) states that knowledge is a major step in raising awareness among the society. It also been mentioned in by Nazni Nordin. et. al (August 1, 2012) where awareness contributed the most to the lack of organ donation. Loch et. al (2010) also stated in his studies that 88.3% of their respondents aware of organ transplant in general.

2.1.3 Perception towards organ donation

Perception towards organ donation is closely related to attitude in which they influenced the people around them especially close family members. The decision to participate as organ donors can be overshadowed by the insistence of family members based on factors leading to the interest of their fellow family members. It includes numerous assumptions that affect the donors themselves and also the immediately family members. Nevertheless, it is unhealthy to be negative without thinking of the sacrifice and the virtue in the effort in helping people who really need organ donations. Educational factors play an important role in countering this. According to H. Bilgel, G. Sadikoglu and N. Bilgel (2006), stated that many factors can influence the attitudes of

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people on the organ donation such as age, religion and education. This been supported by Nazni Nordin. et. al (August 1, 2012) in their studied revealed that the shortage of organ donors Malay is influenced by perception as r=0.441 and p< 0.05 (p=0.000). Furthermore, Loch et. al (2010) stated that only 43.6% would donate their organ, 10.6% would definitely not donate their organ and 45.8% were not sure in their previous studies.

2.2

Effects of a shortage of organ donors Organ transplant is a medical procedure for the treatment of patients with end-

stage organ failure. It is proven to save lives and significantly improves quality of life. Unfortunately, due to the shortage of organ donor, there are a lot of consequences affect the patient as well as to their family. Below this are the effects of the shortage of organ donors towards patients.

2.2.1 Waiting list

According to National Transplant Resource Centre (2012), stated that 15,395 patients currently in the waiting list for a kidneys transplant. Furthermore, there are 2 patients still waiting for heart and lungs transplant while another 2 patients for lung transplant. Meanwhile, the number of organ donor in Malaysia is below 500 to meet the demands. Sadly, the number of patients in waiting list is rising year by year. As

mentioned in The Star (July 12, 2012), an estimated 7,000 potential cadaveric organ donors die in Malaysia every year yet there is an acute shortage of organs for transplant here. It shows how critical this issues for us where patient who are waiting for organ

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donation suffer till death. To avoid death, some of the patient goes for illegal transplant in other country even though our countries have all the facilities to do the organ transplant.

2.2.2 Financial

Due to the shortage of organ supply, certain patient needs to spend a lot of money for the treatment especially to those who have kidneys failure where they need to spend money for monthly dialysis. Deputy Prime Minister Tan Sri Muhyiddin Yassin (The Star Online, 2012) mentioned that the Government had allocated RM171.1 million to nongovernmental organisations between 2001 till 2010 to provide subsidised dialysis treatment for 23,390 individuals. Besides, there is RM20.1 million in capital grants also provided to NGOs to buy dialysis machines over the last decade. Moreover, some of the patient spends a lot of money for organ transplant in another country to saved life. This been mentioned by Dr Ghazali (The Star, 2012), stated that the National Renal Registry indicates that in 2010, 35 Malaysians had undergone kidney transplants in China and one had his transplant done in India.

2.2.3 Mechanical Organs

Mechanical organ is an alternatives method used by medical as a way to helps patients who had organ failure. This mechanical organ is built likely as human organ to cater the crisis of shortage organ supply. Unfortunately, these mechanical organs have their lifespan where a person who used it needs to change the part for a certain period.

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Besides, not every patient can suite this mechanical organ compared to human organ. According Bernama (2005), Tee Hui Yi who used mechanical heart has undergone a heart transplant at National Heart Institute (IJN) after receiving a donor heart. This shows that the mechanical organs used to helps the patient to survive until received an organ from a donor.

2.3

Ways to increased the number of organ donors

To handle the shortage of organ donor problem in Malaysia, it is important to diagnose the problem at the first hand and then try to find a best solution to overcome it. Based on the previous studies, they suggested several ways to increase the number of organ donors in Malaysia as stated below.

2.3.1 Promotion and campaign

Promotion regarding organ donation through mass media regarding organ transplant is the best way to get attention from the public. This been support by Wong L P (2010) from previous studies, mentioned that featuring the stories of potential organ recipients and family members of cadaveric organ donors was the most effective way to draw public attention to the issue. More campaign also needed to promote organ donation among people in Malaysia.

2.3.2 Involvement religious leaders

Religious leaders play important role in multi-ethnic country like Malaysia regarding religion. It is important to makes sure that all religious leaders participate in

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promoting organ donation among public. As mentioned by Wong L P (2010) in his previous studies, the involvement of community and religious authorities in education and in the dissemination of information is required to eliminate sociocultural misconception and perceived religious objections to organ donation.

2.3.3 Place for easy registration as organ donor

To gain the number of registered organ donor, a suitable place for easy registration as organ donor must be set up by the authorities. This mentioned by Wong L P (2010) in his studies that suggested having registration kiosks at workplace, in public places like shopping centres or in busy areas such as bus and train station to increase opportunities to sign up for organ donation. Furthermore, implementation an online registration system also been suggested by Wong L P (2010) for easy registration.

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CHAPTER 3

RESEARCH METHODOLOGY

3.0

Introduction

The objective of the research is to find out the causes of a shortage of organ donors in Malaysia thus make great efforts to amend the discovered problems. In the interest of investigation to the shortage of organ donors, the people from various backgrounds will be selected randomly in Kedah and Pulau Pinang. Data of the study will be collected through questionnaires. Questionnaires will consist of 11 questions but Interview sessions are avoided.

3.1

Research Instruments

This research is built by using idea of quantitative and qualitative research methodology. The questionnaire and interview session are the common way to conduct study in each research. However, interview session will not be included in this research. Questionnaires questions are constructed by closed-ended questions (scale, listing, yes/no, ranking and category). The different sections of the questionnaires are divided to different sections as below:I. II. III. Demographic information The causes of a shortage of organ donors The effects of a shortage of organ donors Pilot studies are conducted to 20 undergraduate students of UTMSPACE before actual study is being carried out to confirm the questionnaire is proper and straight to the point.

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3.2

Respondents of the study

The respondents of the study will only involve in people who are chosen randomly from various background in Kedah and Pulau Pinang. A total of 47 questionnaires will be given out to the respondents of this study. Each questionnaire consist of 11 questions which do help us to make research about the problem from their impersonally opinions. The 47 respondents will be divided into male and female randomly. Besides, the respondents will not be only involved in one particular races or religions.

3.3

Research Procedure

A pilot study will be done before the real questionnaires are prepared to ensure that the study questions are not biased and satisfied to the research. Other than that, executors could also gain experience in it and they will be well prepared for distributing actual study questionnaires next time. During the actual study, questionnaires will be distributed to respondents at Kedah and Pulau Pinang states to represent the people of Malaysia. The people of Kedah and Pulau Pinang states are chosen randomly from various backgrounds by executors before questionnaires are spread to them.

3.4

Data Analysis

A few variables will be considered, namely causes, effects and suggestions regarding the shortage of organ donors in Malaysia in order to analyse the data collected from the questionnaire. The data from the questionnaire will be keyed into computer using Microsoft Excel 2010. After that, the results will be presented through frequency counts and other descriptive statistics. xvii

CHAPTER 4

FINDINGS AND DISCUSSION

4.0

Introduction This chapter discusses the result of the research on A study of a shortage of

organ donors in Malaysia. The findings will be divided into important topics found from a survey of 47 people selected randomly from Kedah and Pulau Pinang. The objective of this research is to find out causes of shortage of organ donor, effects to the patients and also suggestion to increase the number of organ donor. All the data that have been collected is analyzed and presented in the tables, charts, and graphs.

4.1

Demographic

Demographic Infomation of Respondents

25 Number of respondents (%) 20 15 10 5 0

Below 20 years old 2 0

20 to 30 years old Age 11 11

31 to 40 years old 8 6

41 years Malay Chinese Indian old and above Race 6 3 21 14 3 1 3 3

Others Muslim

Christia Buddha Hindu n Religion

Others Student

Govern Private ment Others Sector Sector Occupation

Male Female

0 2

21 14

0 0

3 2

3 3

0 1

9 1

5 7

13 11

0 1

Figure 1 : Demographic Information of Respondents xviii

Figure 1 shows the demographic information of respondents that answer our questionnaire regarding a shortage of organ donors among people in Malaysia. These data obtained from section A (refer to Appendix). There are 47 respondents selected randomly from various backgrounds where 27 people of the total respondents are male and 20 respondents are female. We can see that 22 person of the total respondents are within the age of 20 to 30. Another 14 respondents are within the age of 31 to 40. While others 9 respondents are above the age of 41. The ages below 20 are the lowest that was just 2 respondents. Among all races, the Malay respondents are the highest respondents that answer our questionnaire which means that majority of the respondents are Muslim and there are 35 respondents. Meanwhile, Hindu and Buddha are 5 and 6 respondents respectively. None of the respondents are Christian. The chart also shows the proportion of respondents occupation where we can see that 24 of the respondents are working in private sector. Another 12 respondents are government servant whereas 10 respondents come from students. The number of others occupations are the lowest rate that was just 1 respondent

4.2

The causes of a shortage of organ donors in Malaysia

RQ1: What are the causes of a shortage of organ donors in Malaysia? Causes of a shortage of organ donors
Religious beliefs

13% 30%

13%
I dont believe I am healthy enough I dont care My family didnt support it

44%

0%

Others

Figure 2: The causes of a shortage of organ donors xix

The data for this section is obtained from section B question 4 (refer to Appendix). Figure 2 shows the proportion of the causes of the shortage of organ donors. The causes of the shortage of organ donors are religious beliefs, I dont believe I am healthy enough , I dont care, My family didnt support it, and others. The proportion of I dont believe I am healthy enough is the highest rate and there are 44%. The second higher rate causes of the shortage of organ donors is 30% due to the respondents family didnt support it. Another 13% is because of religious beliefs and others 13% also due to others causes. None of the respondents select I dont care. From our survey, it show that people nowadays are alert about organ donation but the factor influence the shortage of organ donors is caused by the concern of health of people who want to be a donor compared to religious belief and family obligation. The condition of health of people makes people refused to donate their organ regarding family obligation. These findings give new information regarding causes of a shortage of organ donor compared to the previous finding. However, the findings of the current study do not support the study conducted by H. Bilgel, G. Sadikoglu and N. Bilgel (2006), Nazmi Nordin. et. al (August 1, 2012) and Loch et. al (2010). According to H. Bilgel, G. Sadikoglu and N. Bilgel (2006), stated that many factors can influence the attitudes of people on the organ donation such as age, religion and education. This been supported by Nazmi Nordin. et. al (August 1, 2012) in their studied revealed that the shortage of organ donors Malay is influenced by perception as r=0.441 and p< 0.05 (p=0.000). Furthermore, Loch et. al (2010) stated that only 43.6% would donate their organ, 10.6% would definitely not donate their organ and 45.8% were not sure in their previous studies. These results of this study seemed to confirm the findings of a study by them in this field. This may because of many respondents is lacks of knowledge regarding organ donation that lead the misconception. People nowadays are having unsafe lifestyle so that they are worried about their health and decide not to be an organ donor. Some people we survey have own disease such as heart disease, and diabetic because of smoking, drinking, and others. According to Malaysian Transplantation Article, said that very few medical conditions automatically disqualify somebodys from donating organs. The decision to use an organ is based on strict medical criteria. It may turn out that certain organs are not suitable for xx

transplantation, but other organs and tissues may be fine. We cant disqualify our self prematurely. Only medical professionals at the time of our death can determine whether our organs are suitable for transplantation. Actually, all religion has gives their permission regarding organ donation in order to saves other people life. The concern of their health has relationship with the family obligation due to people who are willing to donate their organ may have bad lifestyle that their family refuse their willingness.

4.3

The effects of a shortage of organ donors in Malaysia

RQ2: What are the effects of a shortage of organ donors in Malaysia?

The Knowlegde of Respondents Regarding Organ Donation

20 18 16 14 12 10 8 6 4 2 0 yes no knowlegde regarding organ donation Options

number of respondents

Male Female

Figure 3: The knowledge of respondents regarding organ donation

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Others They suffer the illness before get the donor

Effects

They still wait until end of life They use animal organ They use mechanical organ 0 0.5 1 1.5 2 2.5 3 3.5 4

Female Male

Figure 4: The effects of a shortage of organ donor

The effect if using donor from overseas

Number of respondents 12 10 8 6 4 2 0

Patient need to pay higher costing of that place because is far away 11 6

Patient need to pay higher costing to do the transplant

Patient do nothing

Others

Male Female

The effects if using donor from overseas 10 4 11 0

2 3

Figure 5: The effects of using donor from overseas

The data for this section are from section C question 7 till 9 (refer to Appendix). In Figure 3, shows the porportion of male and female in their knowledge regarding organ donation. There are similarity selection between the two genders where majority of them xxii

select no knowledge regarding organ donation, in which male and female contributed 22 and 15 respondents respectively. Meanwhile, Figure 4 shows the proportion of male and female in the selection of patient alternatively if they didnt meet suitable organ or nobody donor organ, according to the selection of they suffer the illness before get donor, they still wait until end of the life, they use animal organ, they use mechanical organ and others. There are similarity selection between two genders in selection of they use mechanical organ. Both of the genders contributed 4 repondents respectively in this selection which is the highest rate. In the selection of they still wait until end of life, male made up 2 respondents, where as female made up 3 respondents. None of the respondents select they use animal organ and others. Moreover, in Figure 5 shows us the proportion of male and female in the selection of the effect if using donor from overseas, according to the delection of patient need to pay higher costing of that place because is far away, patient need to pay higher costing to do the transplant, patient do nothing and others. From Figure 5, it is obvious that almost similar number of respondents from two genders select patient need to pay higher costing to do the transplant, where that was 11 respondents of female comparison to 10 respondents of male. Also from the Figure 5, 11 repondents of male comparison to 6 respondents of female perceived the effect if using donor from overseas is need to pay higher costing of that place because is far away. Based on our study, effects of a shortage of organ donors is obviously to the patients where the patients will be in waiting list, death, high costing for monthly treatment or use optional option. From the survey, most of the respondents (78% from two genders) lack of knowledge of organ donation. Also majority of the respondents (79% from two genders) respond that the main effect if using donors from overseas are patient and family needs to pay higher costing. This is due to lack of awareness of the issue organ donation in our multicultural communities and cause lack of organ donors in Malaysia. This is why education is important. Thus the Government and Non Profit Organizations should have an intensive public awareness campaign periodically. The result obtained by the current study seemly agree with the previous study where the effects of a shortage of organ donor influenced the patients in several aspects.

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The effects that influenced the patients are they need to be in waiting list to received new organ from a donor. This been support by National Transplant Resource Centre (2012), stated that 15,395 patients currently in the waiting list for a kidneys transplant. Furthermore, there are 2 patients still waiting for heart and lungs transplant while another 2 patients for lung transplant. On the other hand, they need to wait until they found a suitable donor for them. Moreover, financial aspects also influenced the patients where they need to spend a lot of money for their treatment. According to Deputy Prime Minister Tan Sri Muhyiddin Yassin (The Star Online, 2012), mentioned that the Government had allocated RM171.1 million to non-governmental organisations between 2001 till 2010 to provide subsidised dialysis treatment for 23,390 individuals. Besides, there is RM20.1 million in capital grants also provided to NGOs to buy dialysis machines over the last decade. Besides, to get organ transplant in other country seem to use a lot of money in order to get better. This mean, a lot of money need to spend by the patients and family for their treatment until they found a donor. Using mechanical organ is an option for the patient while waiting for organ donor. Meaning that, this is the aspect that effects of a shortage of organ donor where patients need to use mechanical organ to reduces their suffer. In fact, this mechanical organ has their lifespan where it need a replacement for a certain period. According Bernama (2005), Tee Hui Yi who used mechanical heart has undergone a heart transplant at National Heart Institute (IJN) after receiving a donor heart. This shows that the mechanical organs used to helps the patient to survive until received an organ from a donor. The results obtained by this study are unsatisfactory because only 15 of 47 respondents answer this question. It cannot show exactly all of the respondents agreed

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with effects of a shortage of organ donor. This may happen because of people did not care about other people needs. The effect that they suffer the illness before get the donor is least by using mechanical organ or waiting until end of life among the respondents. This was expected as the patients or their family will find other solution rather than suffer the illness. Apart from that, using mechanical organ is the best option they got until they found suitable donor.

4.4

The suggestion of solution towards a shortage of organ donors in Malaysia

RQ3: What is the suggestion of solution towards a shortage of organ donors in Malaysia?

Suggestions of solution towards a shortage of organ donors

Others Suggestions Mass Media (documentary regarding sucessful Government (More campaign and Educational at school/ college/ university 0 Suggestions Educational at school/ college/ university Male Female 14 9 Government (More campaign and advertisement) 13 12 Mass Media (documentary regarding sucessful of organ transplant 17 14 Others 4 0 10 20 30 40

Figure 6: The suggestion of solution towards a shortage of organ donors xxv

The data for this section are from section C question 10(refer to Appendix). Figure 6 shows the proportion of male and female in the selection of the suggestions of a shortage of organ donors, according to the selection of educational at school / college / university, government (more campaign and advertisement), mass media (documentary regarding successful of organ transplant) and others. From Figure 6, it is obviously show that the respondents from two genders select the most effective way to educating about organ donation is through mass media, where there are 17 respondents of male comparison to 14 respondents of female. There are almost similar selection from two genders to suggest government play a main role in educating about organ donation, where male and female contributed 13 and 12 respondents respectively. In the selection of education at school / college / university, male make up 14 respondents and female make up 9 respondents. Based on our findings, the suggestions of a shortage of organ donors are educational at school / college / university, government (more campaign and advertisement), mass media (documentary regarding successful of organ transplant and others. From Figure 6, majority of respondents (38% from two genders) suggested that mass media played an important role to educated awareness of organ donation to public. Mass media are influences of different sources of information such as television, the press and radio, magazines, hoardings and posters, campaign about donation, information given by health professionals etc. towards organ donation and are the most effective way to educated awareness of organ donation to public communities. However, the currents finding similarly with the previous study by Wong L P (2010) for a certain suggestions. In his previous studies stated that suggestion to increase the number of organ donors are by promotion and campaign through mass media, involvement of religious leaders and place for easy registration such as a kiosk. According to Wong L P (2010) in his previous studies, the involvement of community and religious authorities in education and in the dissemination of information is required to eliminate sociocultural misconception and perceived religious objections to organ donation. Wong L P (2010) also suggested in his studies to have registration kiosks at workplace, in public places like shopping centres or in busy areas such as bus and train xxvi

station to increase opportunities to sign up for organ donation. Furthermore, implementation an online registration system also been suggested by Wong L P (2010) for easy registration. Compared to our findings, it shows that the suggestion to increased the number of organ donors are by giving educational at school/college/ university, more campaign and advertisement through mass media and shows a documentary of successful of organ transplants to the public. This may shows that currently all religious leaders taking action to makes effort of increasing the number of organ donor as well as the National Transplant Resource Centre. The results obtained from the findings, have turned out to be successfully because it gives new suggestion to us in order to increase the number of organ donors in Malaysia. These findings suggested shows a documentary of successful of organ transplant to the public to get their attention towards organ donation. Besides, it will gain the confidents level of people to be an organ donor. It is possible that with a lot of effort in showing documentary of successful transplant, giving educational, more campaign and advertisement will increased the number of organ donor among people in Malaysia.

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Chapter 5

Conclusion

This research investigated the shortage of organ donor in Malaysia. Primary data were collected randomly by distributing questionnaires to 47 people from various backgrounds. As mentioned in the earlier introduction, the purpose of this study is to identify the factors of why a person finds it difficult to register as organ donors, especially among people in Malaysia, effects of shortage of organ donor towards patients and finding suggestion for this matter. It is necessary a right information about organ donation. The great majority of those polled indicated that they would agree to be an organ donor. The majority of the hospital staff had information about organ donation, however a high percentage needs more information and considered the information disseminated on the subject insufficient. The following conclusions can be drawn based on the findings of the study: 1. This study has shown that most people in Malaysia are aware regarding organ donation through mass media and others source. 2. The condition of health of people influences their willingness to be an organ donor compared to religious belief and family obligation. 3. Lastly, show a documentary of a successfully transplant to attract people towards organ donation in Malaysia. This study may pave the way for improvements by the Government to act more actively in creating awareness to all Malaysians on the importance of organ donation in creating a society that is mutually helpful, and share their joy and sorrow that is based on the "1Malaysia" concept. It involves an emphasis on awareness programs, but also to a level that is more significant by creation of certain policies in order to increase the number of donors, such as introducing certain benefits and incentive to organ donors. As for Non-governmental organizations, related campaigns should be intensified to support the government along with sponsorships of organizations.

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Chapter 6

Recommendations

6.0

Recommendation

According to previous survey, public didnt get information or education about organ donation. They said can't be a donor because of their religion belief. But, based on our previous finding, by Wong L P, Singapore Med J (2010), all organized religions support organ donation as it is typically considered a generous act. For those unsure of or uncomfortable with your faith's position on donation, they need to ask a member of clergy. To overcome the aforementioned difficulties, suggestion to support organ donation are make organ transplant easy which is avoid delay in funeral, public awareness of benefit of transplant to society, introduce an education system and legal definition of organ transplantation. Public society also can give awards to donor's family. All of these recommendations hopefully can avoid unsupported issue by family and religious objection transplant.

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REFERENCES

Bilgin N. (1999). The Dilemma Of Cadaver Organ Donation. Transplant Proc, 31, 3265. http://dx.doi.org/10.1016/S0041-1345(99)00719-8

Gupta, A., Jain, S., Jain, T., & Gupta K. (2009). Awareness and Perception Regarding Eye Donation in Students of a Nursing College in Bangalore. Indian Journal of Community Medicine, 34(2), 122-125. http://dx.doi.org/10.4103/0970-0218.51235

H., Bilgel, G. Sadikoglu, & N. Bilgel. (2006). Transplantationsmedizin, 18. Jahrg., S. 91. H. Khalaf, & M.I.M. Al Sebayel. (2004). Knowledge and Attitude of Intensivists Toward Organ Donation in Riyadh, Saudi Arabia. Transplantation Proceeding, 36, 1883-1884. http://dx.doi.org/10.1016/j.transproceed.2004.08.147

Nazni Nordin. et. al (2012). Organ Donation Among Malaysian: The Malay Dilemma toward Social Development.Vol 8, No. 10; August 2012 http://dx.doi.org/10.5539/ass.v8n10p8

Wong L P (2010). Information needs, preferred educational messages and chanel of delivery, and opinion on strategies to promote organ donation: a multicultural perspective. Singapore Med J 2010;51(10): 790

Loch et al (2010). Differences in attitude towards cadaveric organ donation: observations in a multiracial Malaysian society. Hong Kong j.emerg.med Vol.17(3)

Longman Dictionary of Contemporary English (2005), definition of organ noun from the Longman Dictionary of Contemporary English Pearson Education Limited , 1978, 2003.

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The New Oxford Dictionary of English (2001), definition of transplant noun from the New Oxford Dictionary of English Oxfords University Press. http://www.mmail.com.my/story/more-make-organ-donation-pledges

http://www.thestaronline.com.my

http://www.agiftoflife.gov.my/eng/statistics2.html

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APPENDIX

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QUESTIONNAIRE A SURVEY REGARDING A SHORTAGE OF ORGAN DONORS AMONG PEOPLE IN MALAYSIA Sir/Madam: This research is to identify a shortage of organ donors among people in Malaysia. questionnaire contains 3 sections which are: Part A: Demographic Part B: Causes of a shortage of organ donors Part C: Effect of a shortage of organ donors Please answer the question using your own experience. Your answer will be only conducted in educational usage. Details are kept confidential. Thank you for your time and cooperation. The

Part A: Demographic
Gender Male Female

Age Below 20 years old 20 to 30 years old 31 to 40 years old 41 years old and above

Race Malay Chinese Indian Others

Religion Muslim Christian Buddha Hindu Others

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Occupation Student Government Sector Private Sector Others

Part B: Causes of a shortage organ donors

1. Do you know about organ donation? Yes No

If Yes, please state where do you know about organ donation?

2.

Do you support organ donation? Yes No

If Yes, give your reason:

3.

Do you want to be an organ donor? Yes If No, please answer question 4. Why you dont want to donate your organ? Religious beliefs I dont believe I am healthy enough I dont care My family didnt support it Others: _____________________________________ No

4.

5.

If you or your family member need an organ, would you or your family accept an organ from other people? Yes No

If No, give your reason: ...

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Part C: Effect of a shortage of organ donors

6. Do you know how many patients waiting for an organ donation? Yes No

7.

Do you know any alternative, patient do if they didnt meet suitable organ or nobody donor his/her organ? Yes No

8.

If yes, what do you think? They use mechanical organ They use animal organ They still wait until end of life They suffer the illness before get the donor Others: _____________________________________

9.

How about if the donor is from overseas. What will happen? Patient need to pay higher costing of that place because is far way Patient need to pay higher costing to do the transplant Patient do nothing Others: _____________________________________

10.

Who do you think is responsible for educating about this organ transplant? Educational at school/ college/ university Government (More campaign and advertisement) Mass Media (documentary regarding sucessful of organ transplant Others: _____________________________________

11.

After you already answer this questionnaire, are you willing to be an organ donor? Yes No

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