People asking for kidney treatment are frequently seen on Kathmandu's streets.The capital city of Nepal is no different from other cities around the globe where aging populations, unhealthy diets, and a lack of health insurance systems lead to an increase in organ disease.Kidneys are the organ most in demand, and black market traffickers are able to supply this demand. According to a research by Global Financial Integrity, up to 7,000 kidneys are procured illegally each year.
The global commerce in illegally obtained organs is flourishing.The same estimate indicates that between $514 million and $1 billion in earnings are made annually through the illegal organ trade.We saw a couple in Kathmandu pleading on the streets for money to pay for their son's kidney surgery.
The kidney illness that Jeet Bahadur Magar's son had required the couple to use all of their savings to treat it.They have run out of choices and are now begging for money on the street in an effort to pay the medical fees.Jeet Bahadur prayed to God that no one will ever experience kidney failure issues.Many Nepalis do, though.
The Nepal Kidney Center in Kathmandu was crowded with patients receiving dialysis during our visit; dialysis is a laborious, four-hour process of cleaning blood using a machine.By receiving dialysis at least three times per week, a patient may be able to avoid a kidney transplant.Those who are fortunate enough to be able to pay for a transplant still have to overcome challenges because by Nepali law, the organ donor must be a relative and the donor's blood type must match the recipients'.
The "renal bank" in Nepal
We went to Kavre, a small area near to Kathmandu that activists and authorities claim is the epicenter of the country's illegal organ trade.Here, well-organized and well-funded kidney trafficking rings con the ignorant and underprivileged into parting with a piece of themselves.The district has earned the unfavorable moniker "renal bank of Nepal."According to activists, for more than 20 years, patients in need across Nepal have primarily received their kidneys from residents of Kavre villages. However, the figures are currently being monitored.
According to Forum for Protection of Persons's Rights, a Kathmandu-based non-profit human rights organization, over 300 people have been recorded as kidney trafficking victims in just this district over the past five years. According to some campaigners, the figure is significantly higher.Human rights attorney and director of the Forum for Protection of People's Rights Rajendra Ghimire stated that "social stigma and threats from traffickers prevent many victims from coming forward."
Regrowth of the flesh
One of the several kidney traffickers' victims is Nawaraj Pariyar.Pariyar, like many people in Kavre, makes a living by selling cow's milk and working seasonally on adjacent farms. He only owns two cows, a house, and a tiny plot of land because he is poor and illiterate.
Pariyar previously traveled to Kathmandu in search of building jobs. In the year 2000, the foreman of a construction site approached him with a questionable proposition: if he allowed doctors to remove a "hunk of meat" from his body, he would receive 30 lakhs, or roughly $30,000.
He was not informed that the "meat" was actually his kidney.The meat would regenerate, the foreman assured me, Pariyar.Then I reasoned, "Why not if the flesh will grow again and I get roughly $30,000?"What if I pass away? Pariyar recalled approaching the foreman.The foreman gave Pariyar his word that nothing would occur. He received wholesome food, nice clothes, and even movie tickets.
He was then driven to a hospital in Chennai, a southern Indian state.Pariyar was given a false name by traffickers, who informed the hospital that he was a relative of the recipient. According to Pariyar, the traffickers had all the fraudulent paperwork prepared to demonstrate his false identity."The doctor at the hospital enquired as to whether the patient was my sister. The traffickers told me to respond positively. So I did," replied Pariyar.
"I heard them mention 'kidney' several times. But I didn't know what a "kidney" was. All I knew was Mirgaula (the Nepali term for kidney.)
I was unable to understand any conversations between the trafficker and the hospital staff because I didn't speak the language.
Pariyar was released and returned home with 20,000 Nepali rupees, or less than 1% of the agreed upon sum, along with the assurance that he would receive the remaining funds soon.He never got any additional cash and never tracked down the trafficker."After I returned to Nepal, I questioned myself. I thus saw a doctor. I discovered I was missing a kidney at that point, said Pariyar.Pariyar is now ill and becoming worse daily. He struggles with his bladder, and chronic, excruciating back ache. He is concerned that he will pass away, but he cannot afford to go to the doctor.
"My last remaining hope is that the government will look after my two kids if I pass away. I'm not sure if I'll pass away now or tomorrow. I'm just keeping track of the days, Pariyar added.The incident of Pariyar is just one of many like tales we heard in Kavre.The key to understanding why so many individuals in this area succumb to kidney traffickers so easily is to comprehend the economic condition here.There aren't many other sources of income besides extensive farming and animal raising. Families can easily destroyed by a single poor harvest or hefty medical expenditure."Poverty and ignorance are the main causes. The brainwashing of the villagers by the traffickers is fairly simple. Additionally, Kavre's villages are close to and accessible from the capital, according to Ghimire.
The Links Thereafter
At several points throughout the process, traffickers use proxies. A person will first contact the victim, a different person will make the donor's phony documents, and a third person will then accompany the donor to the hospital.Kidney transplants are not common in Nepali hospitals. Even Nepal's medical professionals are aware that the majority of wealthy patients choose to travel to India.
"They demand better services and Indian medical professionals. They visit Indian hospitals for this reason, according to Dr. Rishi Kumar Kafle, the National Kidney Center's director."
However, activists have other reasons for why people want procedures done in India.Traffickers prefer to take the donations to India since it is difficult to cross-check Nepali records beyond the border, according to Ghimire.We noted that the hospital in India required a No Objection Certificate, a letter written by the Nepali embassy in New Delhi proving the donor's relationship to the kidney recipient, before any kidney operation may be performed there.Before recently, the letter did not contain images of the recipient or the relative who would have been the real donor.
Since Indian hospitals recognize legitimate Nepali documents, anyone might visit the facility, present the necessary documentation proving their identity, and have their kidney removed.Activists claim that for many years, this was the gap that traffickers exploited.The system is easily circumvented by traffickers thanks to the accessibility of fake documents.The Nepali police are attempting to crack down on the crime networks while the government of Nepal strives to tighten regulations.Authorities detained 10 people in Kavre last year on suspicion of trafficking organs. Their legal matter is still pending.
Stopping the illegal trade, according to sub-inspector Dipendra Chand, who oversaw the police probe, is challenging.If we crack down in one village, Chand claimed, the traffickers will just move to another.The trafficking organizations, according to Rajendra Ghimire, are already expanding outside of Kavre.According to reports, this issue is also spreading to other districts, Ghimire stated.In Kavre, awareness of this issue is developing. Stories about kidney trafficking are currently dominating both local and national press.The public attention, however, comes too late for victims like Pariyar and others.
References
https://edition.cnn.com/2014/06/26/world/asia/freedom-project-nepals-organ-trail/index.html
https://www.google.com/amp/s/ng.opera.news/ng/en/health/amp/4d60a28047737f1a1288f565f1aae4da