The illegal organ trade is targeting the desperately poor from within India and countries like Myanmar and Nepal. Driven to desperation by their circumstances, they are willing to sell their organs to those who can pay for them in India. A vast network of agents, corrupt officials and hospitals ensures that the affluent jump the queue for organs in defiance of the law. The vast gap between demand and supply of organs is equally to blame. Please listen to the latest episode of All Indians Matter.
Learn more about your ad choices. Visit megaphone.fm/adchoices
[00:00:01] Hello and welcome to All Indians Matter, I am Ashraf Engineer.
[00:00:05] A recent CNN investigation showed that desperately poor people in Myanmar have been selling
[00:00:09] the organs in India. The initial matching of seller to buy are done through Facebook
[00:00:14] groups and then taken forward by agents. The sellers make their way to India often on
[00:00:18] the pretext of tourism where the illegal transplants happen. This isn't unique to Myanmar,
[00:00:23] such donors and often they don't even know their organs are being harvested,
[00:00:27] are increasingly coming from Nepal too. Other media reports have highlighted that the poor
[00:00:32] there are targeted by agents who promise them jobs in Delhi. The unsuspecting victims are
[00:00:36] transported into India, a border that is virtually open and taken to hospitals where doctors
[00:00:41] conduct illegal surgeries venue a kidney to be sold to a buyer. Once the victims arrive,
[00:00:47] they are given some money and send back to Nepal. The kidneys are usually sold to rich buyers
[00:00:51] who are desperate to skip the Q4 organ transplants. When they return home, the victims once again
[00:00:57] find themselves jobless, the money they were paid, lasting only a short while and now without a kidney.
[00:01:03] As a list of organ seekers, far outpaces that of willing donors such practices are spreading fast,
[00:01:09] what can be done to curb the illegal organ trade in India and how can we meet the high demand?
[00:01:17] All Indians Matter Let's return to Myanmar. It has been three years since the military
[00:01:24] grew in this very poor country. More than half of its 54 million people live below the poverty line,
[00:01:30] a number that is doubled since 2017 according to the United Nations Development Programme.
[00:01:36] This is a very troubled, violence-rural country, unemployment is rampant and prices are skyrocketing
[00:01:41] its a situation ripe for the illegal organ trade. The kidney black market in India is large
[00:01:46] and it prays on the poor in neighboring countries. Both buyers and sellers work with middlemen
[00:01:51] who match donors with recipients and forge the documents needed. In India, the sale of organs is illegal
[00:01:57] and only relatives can donate organs, so the agents even forge family records with the help of lawyers
[00:02:02] and notaries. These documents are reviewed by the Myanmar Embassy and the cases cleared for the
[00:02:07] state or hospital authorization committee. The authorization committee's job is to catch those trying
[00:02:12] to cheat the system. The documents are reviewed and interviews conducted for good measure but it's
[00:02:17] not easy to spot fake. The committees tend to look at the case sympatheticly because they have
[00:02:21] before them a person for home is a matter of life and death. For the committee, once the
[00:02:26] embassy signs off on the documents, it's a formality for it to follow suit. It does not have
[00:02:30] the capability to authenticate documents from another country. What follows is a long chain of
[00:02:35] illegality in which hospitals, doctors, other medical professionals and government officials are
[00:02:40] all complicit. All this isn't sharp contrast with the internationally accepted process for kidney
[00:02:45] transplant. Written consent is sought from the donor and in most cases, he or she is related to the
[00:02:50] recipient. It is a certain that the donor is not under any pressure and is not getting paid.
[00:02:55] The responsibilities spread across the government and the medical professionals involved as well
[00:02:59] as the hospitals. Hogan transplants have been taking place in India since the 1970s.
[00:03:04] Once the scope for commercial sale of organs came to light, Palmin passed the
[00:03:08] transplantation of human organ and tissues at 1994 which was amended in 2011 and came into force
[00:03:14] in 2014. The law banned the sale of organs and only allowed them to be given to close family members.
[00:03:21] As medical science progressed, an organ donation became more common, some cities became
[00:03:25] hubs for transplants of organs such as the kidney's heart and liver. The disease donor program
[00:03:30] through which organs are harvested from brain dead donors has also become popular.
[00:03:34] As of 2022, India was performing 13,300 living transplants and 2,700 disease donor transplants.
[00:03:41] Yet, it had more than 3 lakh patients on the waiting list for organs and 20 people dying each day
[00:03:47] for a month of an organ. Government data shows that the number of transplants grew from
[00:03:51] 6,916 in 2014 to 16,041 in 2022. From 2014 to 2022, the number of liver donors increased from
[00:04:01] to 3,911. Kidney donors increased from 5,512 to 11,705, hard donors from 53 to 243
[00:04:11] and lung donors from 15 to 144. It is estimated that one person is added every 10 minutes
[00:04:17] to the waiting list for organ transplants. Over the years, several steps have been taken to promote
[00:04:21] organ donation. Doing away with the domicile rule, removal of the HBAR for a sequence, removal
[00:04:26] of fee for registration for transplant, easing rules on withdrawal of life support and
[00:04:31] facilitation of organ transport. The government also implemented the National
[00:04:35] Organ Transplant program to promote donations from the deceased to bridge the gap between
[00:04:39] demand and supply of organs. The major reason for people turning to illegal donations is
[00:04:44] the duration of the wait for an organ. Often, it's years and usually is the poor who suffer the most.
[00:04:49] Often, the organ sellers are from urban slums or poor regions and it's very difficult to trace them.
[00:04:54] The fear is that as the demand supply gap widens, organ trafficking will increase too.
[00:05:00] Everyone other than the donor benefits. I'm referring to the agents, doctors,
[00:05:04] transplant centers and farmer companies. Often, illegal surgeries happen in the so-called five
[00:05:09] star hotels. The exploitation is such that it is now a human rights issue. Indeed, in April,
[00:05:14] the National Human Rights Commission took cognizance of a media report about an organ trafficking
[00:05:18] racket in Harian and Rajasthan and asked for a thorough probe. These such as and doctors say that
[00:05:23] so long as the demand supply gap has not bridged, the racket will continue. They point out also that
[00:05:28] it is more prevalent in India because it's easier to get away with it here. Sadly, corruption
[00:05:33] is common and often such profiteering is even celebrated. As far back as 2007, a world-head
[00:05:39] organization bulletin described in India has a commonly known organ exporting country.
[00:05:44] Horgans from local donors are regularly transplanted to foreigners for commercial
[00:05:47] considerations at set. According to a study conducted with the All-Indian Institute of Medical
[00:05:51] Sciences and Delhi, roughly 1500 in a million people in India have chronic kidney disease.
[00:05:57] Around 350 to 400 per million population have end-stage renal disease.
[00:06:01] Patients of chronic diseases are increasing therefore demand is too. The situation is
[00:06:06] worrisome so many have suggested a system that allows commercial trade of organs. That would be
[00:06:10] disastrous because legitimizing sale and purchase organs in an unequal society will mean
[00:06:16] even greater disparities in health care. It is commonly believed that even with
[00:06:19] the dead end-stage renal disease, the organ is going to be paid by the child.
[00:06:23] India must do a way with the VIP culture and waiting list and encourage more people to
[00:06:28] donate. If the poor are short that donated organs are not just meant for the rich,
[00:06:32] more people across the social spectrum would come to register, increasing the availability of
[00:06:36] organs from the dead end-stage. Here are some ways to increase voluntary organ donations.
[00:06:41] One, awareness building. A large scale campaign funded by the government would lead to
[00:06:49] tackle myths and misconceptions. Military brain dead decorations. This would increase
[00:06:55] instances of organ donation and also spark discussions between doctors and relatives of the
[00:06:59] brain dead. The point of transplant coordinators could be pivotal in establishing trust with the
[00:07:04] patient's relatives. The coordinator would explain the need for donation and facilitate
[00:07:08] retrieval of the organ from the deceased or brain dead patient's body. Three, better hospital
[00:07:12] infrastructure. Transportation should be available in all government hospitals as the majority
[00:07:17] of patients cannot afford treatment at private hospitals. There is a need for better infrastructure
[00:07:21] at all public hospitals to store and transport organs and train staff first transplantation
[00:07:26] procedures for sensitizing police. Most brain dead cases are accident cases. There is a
[00:07:32] legality involved, and therefore sensitized police force could go a long way in facilitating
[00:07:36] donations. These are only some of the ways the demand supply gap can be bridged.
[00:07:41] A legal organ donation is exploitative of the very poor, widened inequalities in society and is unsafe.
[00:07:47] Indian needs urgent action on this front.