Organ Donation among Malaysian Muslims: The Role of Mosques

ORIGINAL PAPER ISSN 1425-9524 © Ann Transplant, 2015; 20: 206-210 DOI: 10.12659/AOT.892707

Organ Donation among Malaysian Muslims: The Role of Mosques

Received: 2014.10.10 Accepted: 2014.11.12 Published: 2015.04.13

Authors’ Contribution: Study Design A Data Collection B Analysis C Statistical Data Interpretation D Manuscript Preparation E Literature Search F Collection G Funds

ABDEFG 1 ADE 1 CDE 2 ACD 1 ADE 3 ABD 4 ABD 1

Corresponding Author: Source of support:

Background:

Material/Methods:

Results:

Conclusions:

MeSH Keywords:

Makmor Tumin Raja Noriza Raja Ariffin NurulHuda Mohd Satar Nawi Abdullah Wan Ahmad Hafiz Wan Md Adnan Ahmad Zuhdi Ismail Mazlan Che Soh

1 Department of Administrative Studies and Politics, Faculty of Economics and Administration, University of Malaya, Kuala Lumpur, Malaysia 2 Department of Economics, University of Malaya, Kuala Lumpur, Malaysia 3 Department of Medicine, Faculty of Medicine Building, University of Malaya, Kuala Lumpur, Malaysia 4 Department of Akidah and Islamic Thought, Academy of Islamic Studies, University of Malaya, Kuala Lumpur, Malaysia

Makmor Tumin, e-mail: [email protected] This research was funded by the University of Malaya Research Grant Scheme 2013 (Project Number: RG490-13HTM)

Malaysia, a country of Muslim majority, is suffering from a severe organ shortage due to the lack of donors. Mosques are the main gateways into the Muslim community. Hence, it is imperative to explore their role in facilitating organ donation. A self-administered survey was conducted between October and December 2013. We distributed 700 pilottested questionnaires to 82 mosques in Kuala Lumpur and its suburbs. The respondents were stratified into 2 groups: the mosque committees and the Muslim Jama’ah (individuals who come regularly to mosque for prayer). Data collected from a survey on 653 Malaysian Muslims reveals that the main factors that hamper organ donation-related activities at the mosques in Malaysia are the lack of experts and financial resources. The level of autonomy of the mosque is also another main issue. The respondents believe that talks and dialogues are the best methods for organ donation campaigns at the mosques. We argue that if the mosques are to play a role in imparting knowledge on organ donation, there should be ample opportunity for the mosque committee to choose the content of religious talks held in their community. The mosques in Malaysia are not sufficiently facilitated to channel the information on organ donation to the Muslim community. Providing financial support and expert campaigners are expected to increase organ donation-related activities at the mosques and subsequently could increase awareness regarding organ donations among Malaysian Muslims. Living Donors • Malaysia • Tissue and Organ Procurement

Full-text PDF: http://www.annalsoftransplantation.com/abstract/index/idArt/892707

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Tumin M. et al: The role of mosques in organ donation © Ann Transplant, 2015; 20: 206-210

ORIGINAL PAPER

Background Organ shortage is a common issue in many countries worldwide. The problem is chronic in some countries, including Malaysia, where organ donation has been recording very low rates in the last few decades that does not match the demand for organs, which is rapidly increasing. For instance, in 2012 the number of dialysis patients was 28 590 and about half of them were on the waiting list for transplants, while only 94 kidney transplantations were performed during the same year [1]. Data on new dialysis patients and dialysis deaths in Malaysia from 1993 to 2012 shows an exponential increase, in which the recorded number of dialysis patients was 358 in 1993 and 5830 in 2012, while there were 102 dialysis-related deaths in 1993 and 3075 in 2012. The Global Observatory on Donation and Transplantation (2010) reported that the rate of deceased donation in Malaysia was only 0.48 per million population (pmp), deceased kidney transplant activities stood at 0.81 pmp, and living kidney donation at 0.98 pmp, [2] suggesting there is no way to meet the organ demand without drastic measures taken by the government and other institutions such as religion. Many studies have identified factors affecting willingness to donate organs in order to understand the motivation behind an individual’s decision to be an organ donor. Lack of knowledge on organ donation, family influence [3–6], and religious beliefs [7–11] were among the most-cited determinants. These studies suggest that awareness of the importance of organ donation could be increased directly by educating the potential donors, and indirectly by educating their families and religious leaders in the community. This study focuses on the role of religious centre – the mosque – in imparting information on organ donation. In Islam the mosque is not only a sacred place to worship Allah but should also be a centre for social, economic, and educational activities. The mosque is an important educational institution for Muslims and the widest point at which to access the Muslim community. Many Muslims visit mosques at least 5 times a day to perform prayers. On Friday afternoons, Muslims have to gather to perform Friday prayers and to listen to Friday sermons. Furthermore, many talks are conducted between prayers and many religious classes are taught there as well. Mosques are also used for conducting campaigns on important issues in the lives of Muslims. In other words, mosque activities are not only relevant for educating Muslims on spiritual beliefs, but also with regards to the Muslims’ daily life matters, including organ donation. The fact that about 61.3% of Malaysians are Muslims adds to the huge importance of mosques in the lives of Muslims. This motivated us to explore and evaluate the role of mosques in Malaysia in organ donation. This study aimed to investigate

the Malaysian Muslims’ views on mosque activities related to organ donation. In particular, we explored: 1. Whether there was any organ donation-related activities held at local mosques in the past 12 months; 2. The appropriate organ donation activities that should be conducted at the mosques; and 3. The Muslims’ views on factors that might hinder the mosques from carrying out any organ donation-related activities.

Material and Methods Data were collected through a self-administered survey conducted between October and December 2013. We distributed 700 pilot-tested questionnaires to 82 mosques in Kuala Lumpur and its suburbs, and we managed to collect 653 completed questionnaires (93.2% response rate). We stratified the respondents into 2 groups: the mosque committees (MC) and the Muslim Jama’ah (individuals who come regularly to mosque for prayer) (MJ). Because the committee members are usually involved in the organization of events at the mosques, it eliminates the possibility of lack of communication in terms of mosque activities if the responses from the public are similar to those from the committee. First, respondents were asked to indicate whether the mosque has embedded any information on organ donation in the Friday prayers’ sermons or religious talks and whether there were any organ donation-related activities held at the mosque in the past 12 months. Next, we explored their preferred method of delivering the message regarding organ donation by asking them to choose the level of suitability for 5 suggested methods for organ donation activities to be organized at the mosques – talks, exhibitions, pamphlet distribution, posters, and forums/dialogues. Finally, respondents were given 4 possible barriers to having organ donation activities in mosques, and they were asked to indicate to what extent these barriers seriously hinder organ donation-related activities. We considered 4 constraints: financial constraints, lack of experienced staff, lack of autonomy in choosing the content of the talks, and logistic barriers. The study were conducted in accordance with University of Malaya ethics guidelines, and we obtained approval (No: UM.TNC2/RC/H&E/UMREC-21) from the University of Malaya Ethics Committee (UMREC).

Results Of our respondents, 245 (37.5%) were MC and 408 (62.5%) were MJ. The results from Table 1 indicate that 50% of respondents

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Table 1. Respondents’ views on organ donation activities during the past 12 months before the survey.

Mosque activities Information on organ donation was available in sermons Information on organ donation was available in talks Organ donation campaigns were organized alone in mosques Organ donation campaigns were organized with another events Total

Yes

No

Unsure

MC

MJ

Total

MC

MJ

Total

MC

MJ

Total

43

81

124

133

157

290

69

170

239

(17.6%)

(19.9%)

(19.0%)

(54.3%)

(38.5%)

(44.4%)

(28.2%)

(41.7%)

(36.6%)

52

106

158

136

155

291

57

147

204

(21.2%)

(26.0%)

(24.2%)

(55.5%)

(38.0%)

(44.6%)

(23.3%)

(36.0%)

(31.2%)

60

107

167

153

200

353

32

101

133

(24.5%)

(26.2%)

(25.6%)

(62.4%)

(49.0%)

(54.1%)

(13.1%)

(24.8%)

(20.4%)

46

60

106

157

215

372

42

133

175

(18.8%)

(14.7%)

(16.2%)

(64.1%)

(52.7%)

(57.0%)

(17.1%)

(32.6%)

(26.8%)

555 (21.2%)

stated that they did not observe any organ donation-related activities at the mosques in the past 12 months, 28.7% of respondents were unsure, and 21.3% had witnessed organ donation activities in their mosques. The results show that the majority of MC confirmed that they had not been exposed to any information on organ donation in the past 12 months. Between 54.3% and 64.1% of the MC answered ‘no’ for all items pertaining to the existence of organ donation information and campaigns in their mosques. However, between 17.6% and 24.5% of MC stated that they had witnessed organ donation activities in mosques, while between 13.1% and 28.2% of them were unsure. For MJ, the results showed that the biggest portion of them (between 38.5% and 52.7%) confirmed that there had been no activities on organ donation in their mosques in the 12 months before the survey. Nevertheless, more than one-third of MJ appeared uncertain about the existence of organ donation activities in their mosques. The remaining portion of MJ (between 14.7% and 26.2%) stated that they had been exposed to organ donation information or campaigns during in the 12 months before the survey.

1306 (50%)

751 (28.7%)

staff and financial constraints are the most serious reasons. For instance, 67.8% of MC and 66.7% of MJ stated that lack of experienced staff is a serious or a very serious barrier against organ donation campaigns. On the other hand, lack of freedom in choosing topics was the least cited reason by MC (59.9%) and MJ (34.9%) (see Table 3 for detailed results).

Discussion Islam plays an enormous role in guiding attitudes among Muslims, and mosques are leading institutions within the Islamic communities. As such, mosques are expected to be portals for delivering information about the organ shortage and creating higher awareness; therefore, leading to higher donation rates among Muslims. There are many studies in Malaysia indicating that Muslims are willing to become donors [12–15], in which the percentage ranged from 20.7% to 35.9%. These potential donors should be persuaded to register their wishes.

Table 2 illustrates respondents’ choices of the best methods for organ donation campaigns at mosques. In general, all the suggested methods had good acceptance. However, talks and forums received the highest approval from respondents. In other words, 92.2% and 91.2% of MJ believe that talks and forums, respectively, are very suitable or suitable methods for organ donation campaigns at mosques, and for the same items the ratios were 90.6% and 86.9% for MC.

The results of our study reveal that mosques in Malaysia are not playing their anticipated roles in organ donation. This urges the responsible parties to redirect the role of mosques in organ donation in the right direction. In other words, mosques should host effective organ donation campaigns, and mosque activities such as sermons, talks, and lectures must be facilitated to spreading awareness among Malaysian Muslims about the issue of organ donation.

The results show that most of the presented reasons were of high importance in impeding organ donation campaigns at mosques. However, respondents stated that lack of experienced

These goals could be achieved by providing the necessary financial resources, logistic support, and expert campaigners for launching efficient campaigns. Enhancing the role of mosques

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Table 2. Respondents’ views on suitable activities that could be organized at mosques. Very suitable

Campaigns

Talks

Suitable

Not suitable

MC

MJ

Total

MC

MJ

Total

MC

MJ

Total

MC

MJ

Total

117

158

275

105

218

323

7

9

16

16

23

39

(2.9%)

(2.2%)

(2.5%)

(6.5%)

(5.6%)

(6.0%)

6

15

21

30

31

61

(2.4%)

(3.7%)

(3.2%)

(12.2%)

(7.6%)

(9.3%)

5

8

13

33

32

65

(2.0%)

(2.0%)

(2.0%)

(13.5%)

(7.8%)

(10.0%)

4

6

10

31

37

68

(1.6%)

(1.5%)

(1.5%)

(12.7%)

(9.1%)

(10.4%)

4

7

11

28

29

57

(1.6%)

(1.7%)

(1.7%)

(11.4%)

(7.1%)

(8.7%)

(47.8%) (38.7%) (42.1%) (42.9%) (53.4%) (49.5%) 81

Exhibitions

107

188

128

255

383

(33.1%) (26.2%) (28.8%) (52.2%) (62.5%) (58.7%) 83

Pamphlet distributions

116

199

124

252

376

(33.9%) (28.4%) (30.5%) (50.6%) (61.8%) (57.6%) 91

Posters

128

219

119

237

356

(37.1%) (31.4%) (33.5%) (48.6%) (58.1%) (54.5%)

Forums/dialogs

Unsure

111

157

268

102

215

317

(45.3%) (38.5%) (41.0%) (41.6%) (52.7%) (48.5%)

Table 3. Respondents’ views on factors that hinder the activities of organ donation at mosques.

Factor

Financial constrains Lack of experienced staff Lack of freedom in choosing topics Logistics

Very serious

Serious

Not serious

Unsure

MC

MJ

Total

MC

MJ

Total

MC

MJ

Total

MC

MJ

Total

52

44

96

110

169

279

36

76

112

47

119

166

(21.2%) (10.8%) (14.7%) (44.9%) (41.4%) (42.7%) (14.7%) (18.6%) (17.2%) (19.2%) (29.2%) (25.4%) 44

92

136

122

180

302

(18.0%) (22.5%) (20.8%) (49.8%) (44.1%) (46.2%) 35

37

(14.3%)

(9.1%)

43

38

(17.6%)

(9.3%)

72

111

167

278

15

24

39

(6.1%)

(5.9%)

(6.0%)

38

72

110

64

112

176

(26.1%) (27.5%) (27.0%) 61

132

193

(11.0%) (45.3%) (40.9%) (42.6%) (15.5%) (17.6%) (16.8%) (24.9%) (32.4%) (29.6%) 81

113

171

284

37

81

118

52

118

170

(12.4%) (46.1%) (41.9%) (43.5%) (15.1%) (19.9%) (18.1%) (21.2%) (28.9%) (26.0%)

in organ donation requires mosque committees to be free to choose topics related to organ donation to be discussed during mosques activities. These activities, according to our results, should be primarily based on talks and dialogues.

organ donation. By providing Malaysian Muslims with proper information on organ donation and raising awareness about the organ shortage, organ donation rates could be improved. Acknowledgements

Conclusions Mosques in Malaysia are not effectively promoting organ donation; therefore, organ donation activities at mosques should be enhanced to provide accurate information to the Malaysian Muslim community. Appropriate financial support and expert campaigners should be provided to facilitate the campaigns at mosques. Moreover, organ donation campaigns in mosques should use talks and dialogues in delivering the information on

The authors wish to thank the University of Malaya for funding this research. We would also like to thank Mr. Khaled Tafran for his help during the preparation of the manuscript. Declaration of conflicting interests The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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