Angry Doctor

Saturday, November 19, 2005

Maybe a campaign will make you change your mind?

"The workgroup has identified inadequate patient education as a key obstacle to live donor kidney transplant... Families of patients with kidney failure often do not come forward to donate a kidney for transplant, even to someone they care for, out of fear that donating a kidney may be dangerous."

- Dr Balaji Sadasivan, Senior Minister of State for Information, Communications and the Arts and Health at the launch of National Transplant Awareness Campaign and Donor Appreciation Ceremony 12 Nov 2005

I am sure the intentions are good but I really wonder about the relevance of a campaign to 'raise awareness that living donor kidney transplant is safe for both the donor and recipient'.

You'd imagine that when a patient needs a transplant, the family members are informed about it and educated by the transplant team regarding the benefits and risks. A small, personal, thing. Doctors, transplant co-ordinator and medical social worker sit down together with the immediate family and they discuss the patient's care, the costs, details of the surgery, prognosis, etc. Misconceptions are dispelled, fears are allayed.

Or are our transplant teams doing such a bad job communicating with them on a face-to-face level that we need a publicity campaign to let them know all that?

I just can't imagine someone who has refused to donate a kidney to his brother after seeing him suffer and being educated and counseled at length by the doctors will suddenly change his mind after seeing a poster about how safe the procedure is.

Or a TV ad.

Or a show on which TV personalities perform stunts to persuade people not to opt out of the HOTA.

Nor can I imagine people rushing down to the 'Kidney Bank' after this campaign to donate one of their kidneys, since we only need one (or one-fifth of one, to be precise), even though I am sure that is not the intention of the campaign.

I think it's sad that something as personal as donating a kidney to your family should become the subject of a nation-wide awareness campaign, as if Singaporeans cannot be trusted to make such a decision of sacrifice for their loved one unless it is 'de-personalised' into a media event.

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  • As you know, Singaporeans by and large are very ignorant about medical matters. Ask them about food and they can tell you where to find the best at the cheapest! Working in a public hospital, you should know how difficult it is sometimes to dispel away the taboos and superstition of our local population. Distinguished mediocrity on his site mentioned that Singaporeans are really blur even about drawing blood for a test. They think that losing too much blood will make one shrivel, dry up and die!

    I think it is quite harmless to mount a campaign to raise awareness amongst the local population that donating one fifth of their kidney (you say?) is not going to be a great loss to them but an immense help to someone who will need it just to live and not be incapacitated by the dreary prospect of life long dialysis.

    Next to fines, Singapore is famous for mounting all sorts of campaigns. I do not object to campaigns per se but it should be done in a tastful manner and result orientated.

    By Blogger uglybaldie, At November 19, 2005 10:09 pm  

  • By and large they are ignorant, but when a patient needs a transplant, family members are called down and 'family conferences' are had where they are given info on the transplant.

    Currently, people who need the info get the info.

    This is not the same as say screening for high cholesterol, where you may not know you have high cholesterol. You KNOW when your brother needs a transplant!

    "Yo, bro, just calling to see how you're doing. I just saw the ad on TV; any chance you need my kidney?"

    With the number of patients requiring transplant, I cannot imagine how this campaign has direct relevance to anything more than maybe 10,000 Singaporeans? This campaign seems to call for giving info to a lot of people who don't need it, which is fine except it is not the aim of the campaign, which is to raise transplant rates.

    I doubt whether it will make anyone change his mind about donating his kidney. Unless its:

    "Eh, Ah Seng, why you never donate kidney to your brother? The TV say very safe one leh."


    "Doctor, I know I refused to donate my kidney even after all the times you've talked to me, but now I will do it since the TV says it's safe."

    Either way, it doesn't make you feel better about this country...

    And to clarify, they take a whole kidney because it's not feasible to take bits. What I meant was you theoretically need only 20% of one kidney to function normally.

    By Blogger angry doc, At November 19, 2005 10:24 pm  

  • Reading the speech again, I can't help but to notice the subtexts, capitalised here for emphasis...

    1. "Donors in our PUBLIC hospitals have developed complications and have died."

    Go ahead, uglybaldie. :)

    2. "I understand that in Norway... more than 4000 renal transplantation surgery procedures. We need to learn from countries like Norway... We must constantly review all our procedures to ensure that the highest standards are always maintained. THEN, I am sure more people will come forward and donate their kidney."

    C'mon! If you guys don't volunteer, how are our surgeons going to improve their skills?

    By Blogger angry doc, At November 19, 2005 11:26 pm  

  • Uglybaldie: I am sure wat you say is true. But the point is, Singaporeans are still very traditional and superstitious even in this present age. They avoid hospitals, any mention of sickness and misfortune like plague. The campaign is just a waste of money if you wish to educate the adults. They will go "CHOI", or just let the information drift across their brain with no registration at all.
    A closely knit familywill still donate their kidneys if required to their own family members even without campaign. So I do not see the point of the ads.

    By Anonymous Anonymous, At November 20, 2005 8:47 am  

  • Good Morning Doc. Sorry, I went to bed early after watching such a boring video that it's better than any sedative.

    I have not read his speech but from the truncated quotes made by you, I get the impression that:

    1. It is dangerous to donate one's kidney in a PUBLIC hospital. Sorry again.

    2. Overall, Singapore still lags behind a mediocre country like Norway in transplantation skills and its successful outcome thereof. And here, we are saying we have arrived as a first world country.

    So, can you blame the honourable minister for thinking up a campaign to start making it hip to donate and transplant and raise the country's awareness of organ donation in general?

    Which brings me to the topic of trades in human organs. It is no secret that lots of Singaporeans who can afford it have gone to China or India to get the needed "spare parts". Perhaps, the campaign will also seek to address the pitfalls and dangers of "transplant tourism" forcefully.

    Volunteer? Not me! Too dangerous! see?

    By Blogger uglybaldie, At November 20, 2005 8:48 am  

  • Seems like he has a Catch-22 situation.

    1. People won't donate because it's still unsafe.

    2. It won't get safer until more people donate.

    If the campaign does succeed in raising transplant rates, what does that say about Singaporeans?

    By Blogger angry doc, At November 20, 2005 11:51 am  

  • It says we are a compliant population, easily governed, media hype unsavvy, without a mind of our own and wholely dependant on the nanny state even to educate us on a subject as fundamental as saving our fellow citizens.

    Hey doc, I am just wondering, other than the computer and your work, don't you go loosen up like some of your peers?

    By Blogger uglybaldie, At November 20, 2005 12:40 pm  

  • angry doc does stuff... he just doesn't talk about them on this blog. :)

    By Blogger angry doc, At November 20, 2005 1:08 pm  

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