SINGAPORE: No parent should ever have to mourn the death of their child. But 83-year-old Madam Tan Sock Lian has had to grieve twice.
In 1991, her youngest son, Tony Chua Yam Chek died of a brain haemorrhage at age 27. His heart was successfully transplanted into 30-year-old Mdm Tan Chwee Suan - the first woman in Singapore to receive a heart transplant.
Mdm Tan first met Chwee Suan in 2011, 20 years after her son’s heart was donated to the latter.
Chwee Suan, who lost a leg to bone cancer when she was 18, led a frugal life. She earned a monthly salary of S$700 as a bookbinder at local charity organization SPD, previously known as the Society for the Physically Disabled.
Home was a sparsely-furnished rental one-room HDB flat in Mei Ling Street, and her meals were bought from the hawker centres near her home, as dining in restaurants were beyond her means.
But she was happy and felt blessed to be able to wake up the following morning, still breathing, she once told a friend.
But on Mar 28, 26 years after the transplant, Chwee Suan’s heart stopped beating. She was found dead at home by a nurse who was close to her, her colleagues told Channel NewsAsia.
“She was close to my heart. She was like my child. My son’s heart was inside her, so she was like my child too,” said Mdm Tan who broke down and cried when told of Chwee Suan's death.
“She called me during Chinese New Year and said she wanted to visit me and I told her to come. But she didn’t come…”
"HE NEVER WOKE UP"
Mdm Tan’s tears started flowing as she recalled how her son died. He had returned home from a dinner outing and complained of a headache. She gave him two Panadol pills before he went to bed.
“He never woke up,” said Mdm Tan. “The doctor told me he couldn’t save my son who was already brain dead."
"But his organs were good and there were four people who needed them. The heart of one of them couldn’t function, another needed a liver, two needed kidneys," she said.
"He asked me to save others. Initially I refused. My son was already in that state and you still wanted to operate on him to remove his organs … I raised my son since young, I couldn’t bear to. But the doctor kept pleading with me, so I signed and gave my consent to save others.”
LOW NUMBER OF VIABLE DONORS
This was before the Human Organ Tranplant Act (HOTA) was amended in 2004 to allow for the automatic removal of the liver, the heart and the corneas, in addition to the kidneys for transplants.
Under the amended HOTA, non-Muslim Singapore citizens and permanent residents of sound mind are automatically included for organ donation once they reach 21 years, unless they opt out with the Ministry of Health.
In 2009, the HOTA was amended again so that more people could benefit from it.
Currently, the act covers all Singapore Citizens, including Muslims, Permanent Residents who are 21 years old and above and are not mentally disordered, unless they have opted out. The upper age limit of 60 for donors has also been removed.
Since the first heart transplant was performed in 1990, Singapore has had a total of 73 heart transplants. There are currently 23 patients on the waiting list for a new heart.
According to the National Heart Centre Singapore, numbers have gone up to about three to six heart transplants a year. Despite the increase, the figure is still considered low compared to other parts of the world.
Factors like Singapore’s population size as well as a lack of violence and better road safety practices have reduced the number of accidental deaths but the number of viable donors are also low.
“The donors that we face here in Singapore nowadays are over 40 years old, often coming in with stroke, so they have risk factors for heart diseases, so again that limits the number of donors we can procure from the community,” said Dr C Sivathasan, Director of the Heart Transplant programme at the National Heart Centre.
“We used to lose about 30 per cent of patients (on the waiting list) because generally once they receive that stage of heart failure they don’t survive long, about an average of six months," he added.
Family refusal remains one of the biggest obstacle to donation, said Dr Sivathasan.
For 20 years, Mdm Tan wasn’t sure if she had made the right decision to donate her son’s organs. But when she eventually saw how Chwee Suan worked hard to keep her heart pumping and how she cherished her life, she told Channel NewsAsia she had no regrets.