Organ donation can save 500,000 lives in India each year. But many Indians are saving them up for their next lives.

Axar.az reports citing foreign media that nearly 20% of Indians fear they will be reborn without a donated organ, according to a recent survey by the Mumbai-based Edelweiss Tokio Life Insurance. Another 21% are unsure if that will happen or not.

This, along with other factors like fear of disapproval from family, lack of faith in medical practitioners, and low transparency results in dismal levels of commitment to the cause, according to Edelweiss Tokio, which surveyed 1,565 respondents across 12 cities in the country.

Many respondents said organ harvesting is a scam. There is also mistrust in India’s healthcare system and hospitals’ ability to carry out organ donations efficiently. The country has only 412 hospitals that are equipped to perform organ transplants and retrievals, said the survey.

“The belief that harvesting of the organs would mutilate the body, or that the family would lose all rights to the body of their loved ones perpetuates fear regarding the organ donation process,” said Sumit Rai, managing director, and chief executive officer at Edelweiss Tokio Life Insurance.