Thousands Registered for Donating Organs in Hong Kong, But It Is Far From Enough

As of today, there is a total of 281,579 people registered to be organ donors in Hong Kong. At first glance, this number may appear to be significant on the surface. However, it accounts for only 2 percent of the city’s local population.

Hong Kong’s rate of organ donation is among the lowest in the world, according to the statistics from the Department of Health. For 2017, the number of organ donors remained the same from 2016, and slightly decreased from the year of 2015. Given the number of donors in 2017, the rate of donors in Hong Kong is only 6 per million. Despite continuous government promotional activities to encourage people to donate their organs, there hasn’t been any significant improvement in numbers of organ donors.

Number of organ and tissue donation v.s. the number of patients waiting for transplantation.

Hong Kong’s donation rate is only a seventh of other comparable countries’ donation rate, such as Spain. A country with 46 million people, Spain had a total of 2,018 registered organ donors in 2016. The figure shows that Spain has 43 donors per million people – 7 times that of Hong Kong.

Currently, there are more than 2,000 patients waiting for vital organs in Hong Kong. Kidneys remained the most in-demand organ, with 2,153 patients on the waiting list in 2017. According to the Hospital Authority, patients had to wait an average of 51 months to get a new kidney, and an average of 43 months to get a liver.

Hong Kong adopts an opt-in system for organ donation based on an individual’s voluntary decision. In the case of an individual’s death, a family member’s consent to donation also applies to this system. People who want to sign up register through the Department of Health’s website. After registration, they need to carry an organ donation card at all times. However, this existing system of donating organs isn’t conducive to increasing the organ donation rate in Hong Kong.

Furthermore, for Hong Kong specifically, social and cultural reasons also affect people’s decisions to donate. In 2016, the Department of Health conducted a poll to examine the rationale behind Hong Kong’s low donation rate. The results showed that traditional beliefs and other misconceptions about organ donation procedures were one of the main reasons why Hong Kongers refused to donate organs. These cultural concepts were based on a taboo about death in Chinese culture.

Sickbeds in Queen Elizabeth Hospital. (Photo: Skylar Lee)

Many people do not want to donate organs because they want their bodies to remain intact after death and want to be buried as a full corpse. This practice is seen as an embodiment of a “dignified” funeral. Some people consider the decision of making a donation may be opposed by older family members, going as far as enraging them. Others commonly misunderstand that their health might be affected after the donation procedure.

Mrs. Chan, a secondary school teacher of Liberal Studies, said, “I hope that the public will be more supportive of organ transplantation.”

She also hopes to increase public knowledge and reduce common misconceptions about organ donation. “It would not hurt donors, and for rehabilitees, as long as they have gradual exercise, their physical ability can be better than an average person,” she said.

Live Life then Give Life. (Photo: Skylar Lee)

Successful systemic implementation of increasing organ donations can be identified from other countries like Spain and Australia. Both countries experienced a marked increase in their organ donation rate after the implementation of reform measures in 1989 and 2009, respectively.

These measures included establishing a dedicated authority charged with the overarching responsibility for organ donation and transplantation activities, providing funding support to donation and transplant hospitals, and setting up a dedicated team within each hospital for early identification of potential donors.

Australia has also implemented theme-based organ donation promotion measures, which target young people and promote family discussions about donation wishes to ensure that every potential donor’s decision is upheld.

The government also plans to conduct a study to find out public views on a presumptive consent scheme or an opt-out system – meaning, everyone is considered a donor unless they specifically say they are not.

Spain’s donation rate increased significantly, supported by a system that automatically considers adult citizens as donors unless they register an objection. Certainly, in society, some people don’t care if they donate their organs; others are lazy, or do not know how to act. Hong Kong’s government can try to promote the opt-out policy by referring to the Dutch’s approach: to allow young people to enter the name of organ donation when they reach adulthood. If they do not reject, they become a donor in the future.

Organ donation promotion at Queen Elizabeth Hospital. (Photo: Skylar Lee)

The Food and Health Bureau has launched a series of campaigns to promote awareness of organ donation by setting up a promotion committee. Meanwhile, local secondary schools have recently been encouraging discussions of organ donations in Liberal Studies classes developed by the Hong Kong Organ Transplant Foundation to establish more comprehensive life and death education.

The government is also developing a Facebook app through which organ donors will be able to register and spread awareness of the life-saving initiative to friends. Secretary for Food and Health Dr. Ko Wing-man stated that he hoped better education about life and death issues would help boost registrations.

These rudimentary steps are certainly heading towards a direction of increasing organ donation in Hong Kong. In order to solve this problem, as shown in Spain’s and Australia’s successful initiatives, it requires extensive community and local awareness with the implementation of an administrative system that supports these endeavors.


Reporter: Skylar Lee

Editor: Wilson Wong

Copy Editor: Jasmine Hong

Content Manager: Christy Yeung

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