As throngs of people head to Qatar's malls at the end of the Muslim holy month of Ramadan, it is Yassir Yosri's job to ask shoppers to make a more thoughtful choice besides what Eid gifts to buy.

The Egyptian web designer is one of the hundreds of employees at the state-owned Hamad Medical Corporation (HMC), which is stationed at attractions around Doha and tasked with increasing the Gulf state's organ donor registration rate. 

Before Ramadan, which began on June 18 this year, the country had around 45,000 people on its donor registration list, or five percent of eligible residents, according to HMC. Since the start of the campaign during the Muslim holy month, 13,000 people have been added to the register.

However, even the higher figure represents a lower proportion of the population than in countries like the US.

Like Qatar, the US adopts an 'opt-in' method but has a designated donor registry that includes 48 percent of eligible adults.


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Within Qatar's smaller pool of donors, the number is lower still among Qatari citizens and Arab expatriate workers. In late 2012, the head of HMC's Organ Transplant Committee, Dr. Yousuf al-Masalamani, told the local Al Arab newspaper that expatriates made up 99 percent of people on Qatar's donor registry.

A report by Doha News last year said that of 20,000 new donor registrants that summer, less than 1,000 were Arab, including Qatari nationals.

Yosri said that superstitions and misunderstandings about religious opinions on the matter were behind low sign-up rates among those of Arab origin or Muslim faith.

"Some people believe that by signing up to give their organs after death, they are tempting fate and they will die … That's silly, obviously nobody is going to die before their time," Yosri told Al Jazeera, adding many were unaware of religious edicts encouraging the practise.

"I give most Muslims, who are unsure, a leaflet containing a fatwa by Yusuf al-Qaradawi, and the next day they've made their mind up and they're telling me they want to donate," Yosri said, referring to a religious decree by the Qatar-based Egyptian religious scholar, widely followed in Muslim-majority countries.

Based at Doha's City Centre shopping mall, one of the largest in the country, Yosri and his team say attitudes are changing, with 1,400 people signing up in the first three weeks of Ramadan at their stall alone.

But Al Jazeera spoke to some passersby that were not convinced enough of the religious arguments in favour of organ donation.

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Sharif, an Egyptian construction executive, said for many Arabs, the Islamic imperative to bury the body quickly after death was a strong counterpoint. "The cultural taboos are related to the recommendation to bury the body as soon as possible. For many, following this will override benefit to others of their organs," Sharif said.

Yet HMC nurse Dhana Shankar said the removal of organs from a donor was normally a fast procedure.

"After we have the consent of the family we take the (dead) person to surgery within six to seven hours … The process is done within a day," she told Al Jazeera.

Ibrahim, a Palestinian businessman in Doha, said he was open to the idea of donating his organs but only after studying the Islamic perspective on the issue further.

"I might [donate], but not before doing some deeper research on it … People donate their organs alive to their loved ones, especially kidneys, so why not if you're dead?" he said.


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While opposition to organ donation is rare among Muslim scholars, there remains some disagreement on its validity within Islamic law.

The UK-based Muslim scholar, Mufti Muhammad ibn Adam supports organ donation under most circumstances, but has collated arguments used by others against the practise.

Most counter-arguments are derived from injunctions against mutilating dead bodies and protecting the sanctity of the human body.

The Quran says, 'Whoever has saved one life, it's as if he's saved the whole of mankind.'

Dr Riadh Fadil, director of Qatar Organ Donation Centre

Adam cites a hadith, or a saying of the Prophet Muhammad, prohibiting the harming of corpses. "Breaking the bone of a dead person is similar [in sin] to breaking the bone of a living person," according to the hadith.

The opinion popular among Adam and others who back organ transplants is that the sanctity of human life supersedes nearly all other considerations.

A fatwa, or religious edict, by Qaradawi that is distributed by HMC calls organ donation the "highest form of charity".

"Islam promotes relief for the needy, comfort and aid for the injured, treatment for the patient and saving any person in danger ... A Muslim should be committed to saving any individual or group of people in need and exert maximum effort to alleviating their suffering," the fatwa states.

Beyond religious arguments, the Qatari government offers a series of incentives for those who donate their organs. Living donors, who give parts of their liver or a kidney, benefit from comprehensive medical insurance for life, discounted plane tickets and compensation for loss of income during medical procedures.

Families of deceased donors are given social care and support, as well as financial help to cover the cost of transferring the body to their home country.

Patients on waiting lists are not given preference based on whether they are citizens of the state or not, and all procedures are free irrespective of nationality, according to HMC.

Beyond such incentives, it is the focus of HMC's campaign that appeals to the better nature of Qatar's residents, according to Dr Riadh Fadil, the director of the Qatar Organ Donation Centre. He explained that Ramadan was the ideal time to highlight the religious and humanitarian virtues of signing up to the organ donor's register. "We want the spirit of Ramadan to prevail, [but] there is a cultural taboo," Fadhil told Al Jazeera.

The country currently has 80 people cleared for kidney transplants, and another 10 awaiting surgery to replace their livers. Last year, 38 donor organs were successfully transplanted to patients, but 36 new patients were also added to the waiting list.

Fadhil said the country was on track to reach its target of having 10 percent of the population on the donor's register by the end of the year. Clearing up religious misconceptions, he said, will help Qatar reach that goal.

"The Quran says, 'Whoever has saved one life, it's as if he's saved the whole of mankind,'" said Fadhil. "It's clear and straight forward."

Follow Shafik Mandhai on Twitter: @ShafikFM

Source: Al Jazeera