Transplant travails

Organ trafficking networks and the inability of law enforcement to curb those

These villagers sold their organs for meagre sums. — Courtesy AFP file photo
These villagers sold their organs for meagre sums. — Courtesy AFP file photo


euters has claimed in a recent report that according to some high-ranking officials about 1,000 kidneys are ‘sold’ in Pakistan for live-donor transplant every year. Most of the donors hail from rural areas. Many have said that they agreed to the arrangement to pay a part of their mounting debts.

According to the human organ transplantation law of 2010, the ‘sale’ of human organs is punishable with a prison term of up to 10 years. The law also provides that medical practitioners found guilty of performing or facilitating an illegal transplant surgery will have their licences suspended for three years for the first such offence. Those convicted a second time permanently lose their licence. Additionally, a fine of Rs 1 million is imposed.

The Punjab, once the province leading in reported cases of illegal kidney transplant, has seen some improvement following a crackdown by the Federal Investigation Agency. However data suggest that the illegal transplant networks have moved to the other province, particularly Khyber Pakhtunkhwa rather than go out of business. In recent years, the number of such cases in the Punjab, too, has increased.

There is a sizable local as well as global demand for organ trafficking. Pakistan and Bangladesh were at one stage the go-to destinations for those needing an organ transplant. Recently the case of a fourteen-year-old donor came to light. The police learnt that the cash-for-kidney deal had been reached in Lahore before he was taken to a clandestine facility in Rawalpindi, where his kidney was removed.

Speaking to The News on Sunday, 33-year-old Awais from Muridke, said he had sold his kidney for Rs 100,000 about ten years ago after his father passed away and the family needed money to marry away his younger sister. “Nearly every family in my village has a member who has been a kidney donor.”

In many cases, the patients and their families have no other options. Today, the first thing a patient seeking a transplant is told is that the donor has to be a relative. In many cases, it is impossible to find a donor in the family. In the absence of a tissue-match, a lengthy and arduous process involving the Human Organ Transplant Authority and the court ensues. Meanwhile, the patient is placed on a waiting list. This is something many patients cannot afford. They then find themselves compelled to resort to illegal means.

Harris, a 44-year-old from Lahore, who has been on dialysis for five years, says, “I have been on dialysis for five years and am still waiting for a transplant. Unfortunately, fund allocations are low, and the costs of the procedure and medication are mounting. I cannot afford to wait very long for a transplant as the cost will then bankrupt me. Had it been possible earlier, I would have been living a healthy life by now.”

Once a patient opts for an illegal solution, several complications arise, the most important being the medical repercussions for the patient.

The desperation for a quick kidney transplant has to be weighed against the risk of getting caught while attempting an illegal one. The doctors involved in the procedures are rarely convicted as most of them are prepared for the eventuality and flee the country once their networks are exposed. The patients, particularly local ones, are the ones mostly who have face prosecution, jail time and fines.

Dr Awais Zakah, a nephrologist trained in the US, talked to TNS about the issues surrounding kidney transplants. “According to HOTA rues, it is legal for patients to obtain a kidney from first, second and third relatives. However, most patients need ‘connections’ to speed up the process,” he said. The HOTA is the governing body responsible for organ transplantation. They approve patients for a transplant after reviewing their documents.

Many patients are turned away as the donor is not a first relative. It has been argued that it should be the HOTA’s responsibility to clear patients for a transplant regardless of their relation to the donor, says Zakah. However, this does not happen and some people are forced to resort to illegal means.

Once a patient opts for an illegal solution, several complications arise, the most important being the medical repercussions for the patient himself. Most of the illegal transplant facilities are unsafe. This leads to several problems for the patients. In the end, the patient has to deal with the risk of being found out, as well as the medical risks involved. The hospital managements count on rampant corruption and the patients’ vulnerability to engage the risk.

It is imperative to provide those in need with adequate legal facilities for transplantation. It is mainly the high demand that is fuelling the market for organ trafficking. The HOTA should help patients receive quick transplants at secure facilities, rather than driving them to illegal means.

Speaking to TNS about this issue, Caretaker Health Minister Dr Javed Akram, stated, “We are working on making the process more streamlined for the patients. I have had a meeting with Punjab Human Organ Trafficking Authority and discussions for making it legal to obtain a kidney from third relatives or strangers are under way so that people will not be forced to turn towards illegal transplants. We aim to make court proceedings and the process for gathering intelligence faster and easier. This will reduce the waiting time for a transplant.”

The writer is a freelance journalist who mostly writes on human rights, literature and lifestyle. Her debut novel, Our Tainted Souls is available all over Pakistan. She tweets at @MinaalMaan and can be reached at minaalmohsin@hotmail.


Transplant travails