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HEALTH-PAKISTAN: Poor Worse Off After Selling Kidneys

Zofeen Ebrahim

LAHORE, Oct 1 2007 (IPS) - “The only time I’ve been to Rawalpindi was in 2004 when I was taken by an ‘agent’ (middleman in the human organ trade) to a hospital there to sell my kidney,” says Faqir Masih, 23. He never wants to visit the city, again.

Coming from Youhanabad, a poor Christian settlement on the fringes of Lahore, capital of Punjab province, Faqir, a labourer, makes Rs 250 (four US dollars) for a day’s toil -– when he can find work. “I was enticed into selling a kidney by the thought of marriage,” he said. “The agent promised me Rs 100,000 (1,666 dollars) for the kidney, which was transplanted to an Arab.”

But Faqir was duped. The agent fled, literally throwing him out on the road with not even enough money to board a bus back to Lahore. “When I came around, after the operation, I found myself on the highway. My wound was raw and it hurt.” Luckily for him, some passersby took him to a nearby hospital where he was treated and then put on a bus bound for Lahore. Three years later, he remains single and as impoverished as ever.

Faqir’s is not the only such case. The narrow, unpaved alleys of Youhanabad are littered with such shameful tales of deceit.

Shahzad Rizwan works as a ticket collector for a bus company. His kidney “only fetched Rs 50,000 (833 dollars) because of my (less in demand) A-positive blood group.” Riaz Masih, 24, is angry at having been deceived. “They accuse me and my mother of cheating them into giving their daughter’s hand in marriage to a man with one kidney.”

“Corruption almost always creeps in when organ transplants changed from being made on altruistic considerations to commerical transactions,”explains Dr Anwar Naqvi at the Sindh Institute of Urology and Transplantation (SIUT), Karachi. He is a campaigner against commercial dealings in human organs.

There are many in Masih’s neighbourhood who have either not been paid at all or given a small fraction of the promised amount. Additionally, many of them are living with sense of guilt at having sold away a part of themselves. “As if it were a spare part,” was how Bilal Masih described it.

For Bilal, 43, a bus driver, the money did “buy momentary relief when I paid off my debt back in 2003.” But the happiness was short-lived. Four years down the road, he is resigned that “it is our fate to remain poor”.

None of his five children goes to school. He is still in debt and always fighting with his wife. “I’ve become irritable either because I feel tired all the time or it’s this burden of having sold a part of me that weighs me down.”

Much to his discomfiture, his wife Gulshan discloses: “He has become incontinent and passes urine in his sleep.” She is sure the aftereffects are catching up. “The wrath of God has fallen upon us,” she says, rocking her youngest child vigorously.

A few minutes’ drive out of Lahore are hamlets that agents see as well-stocked warehouses for kidneys in the form of willing, poverty-ridden, unlettered adults living in abysmal conditions. They scour the area, enticing the villagers with sweet talk.

Many agents have usually sold away a kidney themselves and have a surgical scar to prove it. They are well-dressed and carry expensive looking accessories like a mobile phone to convince potential donors that their lives would be better minus a kidney.

For years ‘transplant tourists’ have flocked, from as far away as Europe, the United States and the Middle East, to private hospitals in Pakistani cities like Lahore and Rawalpindi to get a renal transplant, paying a fraction of what it would cost in their home countries.

According to the World Health Organisation, approximately 1,500 transplant tourists receive organs for a fee in Pakistan annually, earning the country the reputation of being a ‘kidney bazaar’ in the world.

However, after the promulgation of a Transplantation of Human Organs and Tissues Ordinance 2007, on Sep. 3, there is hope that this will slow down if not put a stop to the gruesome trade. It will definitely stop transplant tourism.

Lahore’s Masood Hospital, till the beginning of the year, was a major centre for the trade. Today the hospital is not even a shadow of its former glory, hidden from public glare, housed in a small decrepit bungalow with not even a nameplate.

In May, the Punjab police raided three hospitals in Lahore, one of which was Masood Hospital. Seventy-year-old Dr Masood Nasir, the owner, was among those arrested and sent to prison.

While admitting that “nobody gives it (a kidney) for free”, Dr Ahsan M. Khan, executive director at Masood, is defensive. ‘’We only charged the surgeons’ and hospital fees. We even stopped performing such operations from January this year when the legislation was being put together.”

Young Ghulam Farid (name changed on request) was working as an operation theatre assistant (OTA) at Masood for over five years. He left five months back. “I find it hard to believe that the hospital management didn’t know what was going on,’’ he told IPS.

“There was a receptionist by the name of Nawazish who later became a middleman,’’ Farid said explaining how the racket worked. ‘’He had scores of people working for him, usually former kidney donors, who would scour the villages looking for poor laborers and entice them with talk of big money. The anesthetists would ask the donors before putting them out for the operation if they had consented to ‘selling’. The word ‘donate’ was never used.’’

According to Farid, donating a part of oneself is alright, but “when money is exchanged it becomes a business and I know that everyone was a party to this. We all knew what was happening. And it is always the rich benefiting from the transplant’’. Farid saw over 300 operations done during his time at Masood and a majority of the recipients, he says, were Arabs.

Farid has no sympathy for those who sell off kidneys. “We are also poor; it does not mean we start selling our body parts, these people just saw an easy way to get rich quickly.”

He continued: “Even when they do get the money, they just don’t know how to invest it wisely, it just vanishes in a few months. It does not alleviate their poverty but leaves them even more impoverished and vulnerable. The cycle of poverty catches up with them again. ”

There is some truth is what Farid says.

With the Rs 60,000 (1,000 dollars) Aqeel Masih received from his agent, he bought a television set, a CD-player and a gold chain for his wife. Then he decided to buy a three-wheeler rickshaw for which he paid Rs17,000 (283 dollars), which he sold away for a lesser price. “There was still about Rs15,000 (250 dollars) left in cash but a few days later our house was burgled.’’

“I never even got a whiff of the money,” laments his wife. She has left him and gone to her parents’ home, angered that she had no idea that her husband had sold away a kidney.

(*Reporting for this story was supported by the United Nations Development Programme through a UNDP Asia Pacific Human Development Media Fellowship.)