To meet the need of organs by the public, China used to extract organs from executed prisoners for transplant procedures, a practice that has been long condemned by international human rights groups and medical ethicists.

As such, 90% of transplants in China used organs from executed inmates, until last year when the government finally ended the horror by enforcing a ban on the usage of organs from executed inmates unless the inmate has previously agreed to it.

Previously, before the government banned transplants from living donors - except for spouses, blood relatives and step-or adopted family members - in 2007, people living in poverty often sold their organs in exchange for bread on the table. But the black market in organ trafficking has not been halted.

Recently, China has vowed to reform the organ donation system, battling corruption by cracking down on the black market and spreading public awareness to increase public donor rates. However, how it will manage to meet the growing need of organs, is now the biggest question.

Only 1.4% of Malaysians are willing to donate organs

Organ trafficking exists worldwide, even in Malaysia - this is because the need for organs is too high. As of August, there are 20,774 Malaysians on the waiting lists for various organ transplants, with the majority of patients needing kidneys (20,751), while others need livers (6); lungs (6); heart (1); lungs and hearts (6).

The National Organ Donation Public Awareness Action Committee chairman Tan Sri Lee Lam Thye said that only 362,667 people have pledged themselves as organ donors. Dr. Lela Yasmin Mansor, head of National Transplant Resource Centre said that this could most likely be the result of cultural taboos and fear of what happens after death.

"There has been an increase in the number of pledgers over the years, but the ratio to the population is still low," Lee said. Only 1.4% of Malaysians are willing to donate their organs to save the lives of others.

The organ donation rates for both tissue and organ transplants in Malaysia are also among the lowest in the world, says Negri Sembilan health director Dr. Abdul Rahim Abdullah.

The current rate of 0.6 donors per one million population is not enough to meet the demand as not all donors have viable organs or tissues for transplant.

Selayang hospital liver transplant surgeon Dr. Krishnan Raman, said that only one liver transplant could be performed in 2016 because of the poor quality of donor livers.

"This year, we received eight calls on brain dead patients who had pledged to donate their organs. However, only one of the livers was healthy, while the rest were fatty livers which were the result of poor diets and lack of exercise, among others," he said.

"According to racial breakdown, the Chinese top the list with 152,113 people registered (42%), followed by 104,450 Malays (29.02%), Indians (83,648 or 23.24%) and others (19,707 or 5.46%)," he said, adding that 56.84% were women.

Even the law cannot help

Perhaps all countries should learn from Singapore, whereby the law requires donations by all after death, unless they decide to opt out - which 2-3% do. However, the number of viable organs remains low as they may be damaged or diseased. Some grieving family members are also unaware that the deceased wanted to donate, objecting to organ donation.

On average, about five people lose the use of their kidneys each day and Singapore has one of the highest kidney failure rates in the world. Many potential donors are worried about the surgical risk, poor health after donation and the cost, causing low transplant rates. Many surgeons also say that the lack of "buy-in" by other doctors to harvest organs upon death is also a factor.

As such, Singapore hopes for more living donor transplants, which are also much better for the recipients - especially for kidney and liver transplants.

"We hope that more people will come forward to donate because there is still a long way to go, with the kidney failure population continuing to increase at an alarming rate," said a NKF spokesman. MIMS

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