The Fatwa and HOTA Forum

06 Apr 2004

By Dr Mohamad Maliki Bin Osman, Parliamentary Secretary For Health

Venue: MUIS Auditorium

Opening Remarks By Dr Mohamad Maliki Osman, Parliamentary Secretary For Health And Community Development, Youth and Sports At The Fatwa and HOTA Forum At the MUIS Auditorium On 11 Dec At 10.30 am

Assalamualaikum wr wb

Mr Ameerali Abdeali, President of MKAC Association

Mr Ameerjan Hj Sheriff, President of PKMIS

Ladies and Gentlemen,

First of all, I would like to commend both The Muslim Social Welfare Association of Sembawang (PKMIS) and The Muslim Kidney Action Association (MKAC) for organising this dialogue session. I hope that at the end of this event, all of you will leave with a better understanding of organ donation from both the medical and religious perspectives, and how organ transplant can help those suffering from organ failure improve their quality of life and in some instances, even save lives.

Over the last few months, MKAC, together with the support of its partners such as the National Kidney Foundation (NKF) and PKMIS, have been active in its community outreach efforts to encourage more Muslims to pledge their organs. You would have seen, heard and read the advertisements on Suria, Warna and Berita Harian. Some of you might even have attended the events organised by the association and its partners.

HOTA and MTERA

HOTA is an opt-out scheme which involves all non-Muslim Singapore Citizens and Permanent Residents between the ages of 21 and 60 years. This means that they are automatically included under HOTA unless they choose to opt-out. Under the revised HOTA which took effect on 1 July 2004, kidney, liver, heart and cornea can be removed from a person who has died in a hospital, usually from causes such as accidents, bleeding in the brain or brain tumours. So far, 19 additional people have benefited from the revised HOTA.

While Muslims are not included under HOTA, we can also help organ failure patients by pledging to donate our organs under the Medical (Therapy, Education and Research) Act or MTERA [pronounced as M-Te-Ra]. Unlike HOTA, MTERA is an opt-in scheme in which we can pledge to donate any organs or tissues for the purpose of transplant. The Fatwa Committee has ruled that besides kidney, the donation of liver, heart and cornea is permissible. With the recent ruling (fatwa) released by MUIS in August this year, it is easier for Muslims to pledge their organs under MTERA. Now, you will only need to obtain the signatures of two witnesses, both of whom must be male Muslim adults.

The gift of life will not only benefit the many patients with organ failure. By pledging to donate your organs, you will have the same priority as other Singaporeans who have not opted out of HOTA in receiving cadaveric organs, if one is needed. For patients with liver failure or severe heart failure, organ transplant is often the only way to save their lives.

Need to increase donor pool

Diabetes and hypertension are the leading causes of kidney failure in Singapore. Based on the last National Health Survey in 1998, about one third of the Malay community has hypertension and one in ten is a diabetic. With an ageing population and increasing number of Singaporeans with hypertension and diabetes, the number of patients with kidney failure is likely to increase. This makes the demand for cadaveric organs even more urgent.

For these reasons, we must encourage more Muslims to pledge their organs so that with an expanded donor pool, more organ failure patients will benefit from organ donation. Donated organs are assigned to patients on the transplant waiting list based on the medical criteria, such as how well the tissues of the donor and patient match, and the urgency of the patient's condition. So far, only 15,000 Muslims have pledged their kidneys under MTERA. This is about 5 per cent of the Muslim population. In Singapore, there are almost 700 people currently waiting for an organ transplant and about 20 per cent of them are Malays. On average, they have waited for about seven years. Hence, there is still very much more that the community can do.

Collaborations with other Malay/Muslim groups

I therefore applaud the efforts of MKAC, NKF and their partners in promoting organ donation. My Ministry will support their efforts for further collaboration and partnership to create a ground swell or movement. MKAC needs the support from various Malay/Muslim organisations from both the religious and social sectors. I would strongly encourage the association to reach out to as many organisations as possible, including even the Unions.

Malay/Muslim organisations must believe and embrace the same cause of saving lives through organ donation. They play a critical role in reaching out to their members to spread the same message and encourage them to pledge to come into MTERA.

I would also like to appeal to the unions to see this as means to assist their members whose livelihood will be severely affected if they come down with a particular organ failure. We have heard heart wrenching stories of families suffering when the income earner comes down with organ failure. We have more than 60,000 Muslim workers who are members of the Unions and who make up about 14 per cent of the total membership. They must be made aware of the important role they must play in this movement.

Indeed, an inclusive approach for this movement is crucial in order for it to succeed. We must arrive at a state where a Muslim feels left out if he is not an organ pledger.

Changing mindsets is a long-drawn process and support from many partners is critical. There is a need to reach out to the community directly, besides increasing awareness on the need for organ donation through the mass media. It also calls for regular monitoring of the progress of community outreach efforts and programmes to see how we can better achieve our desired outcomes. Sessions like today is crucial in ensuring that all doubts with regard to organ pledging and donation are answered. These sessions must be made accessible to all members of the community.

I am glad to see so many of you today. Your presence is indicative of the support towards organ pledging and donation in the community. I hope that you will help to spread the message of organ pledging and how organ donation could give a new lease of life to organ failure patients. Please be our ambassadors and send the message loud and clear to members of our community. Quoting a Malay proverb, "Together we climb the hills, together we go down into the valley".

Thank you.