…Don’t call it my ‘deathbed’,
Call it my ‘bed of life’-
Let my body be used by others,
To lead fuller lives'…
-Robert N.West

For almost a week now, India is agog with the news of yet another kidney racket in Gurgaon, near Delhi. It was only last year that the story of Tsunami victims becoming targets of kidney brokers made the headlines.

In this instance not less than seven doctors were allegedly involved, along with several middlemen. The leading characters in this 6-year ‘mega’ drama had an uncanny penchant to target the most needy. The devious plot, when unraveled, shook the collective conscience of the nation.

The modus operandi followed a ‘by now familiar’ pattern, whereby hundreds of the jobless or daily laborers were targeted. Under the pretext of finding jobs, they were lured to hospitals run by the kingpins and possibly without their consent, relieved of their one kidney.

Although a few arrests have been made, the prime accused has fled the scene. What remains are a flurry of discussions and mindless debates on the subject, all in the name of public welfare!

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Rise of the Rackets

Why do these organ rackets take shape and flourish? Are these rackets all about exploiting the poor or is there more to it?

According to statistics available there are more than two lakh people suffering from terminal kidney ailments in India. However, only a few thousand individuals are able to afford an expensive transplant surgery which will cost anywhere between 1 to 3 lakhs with an additional Rs.5, 000 to 10,000 per month for the immunosuppressive drugs.

Of these it is estimated that 50% are able to get a relative to donate and the other 50% procure it from the 'Grey-Market'. All the ethical and legal problems originate from these 1500 to 2,000 kidneys. In many instances even if a relative donates the attitude that prevails is 'why you can buy? why should we donate?'

As a result the voluntary donation of kidneys, by friends or relatives, has never quite picked up the much-needed momentum. Cadaver donation (now called deceased organ donations), which is very popular in the west, is almost non-existent in India. Our donation rate is 0.05 to 0.07 per million whereas even countries like Turkey and Poland have a donation rate of 4 to 6 per million population.

The reason why cadaver donation has not picked up in the country is the lack of awareness among the public and the medical fraternity and not so much due to our to our religion and culture.

Besides, doctors don’t help the situation as they are often reluctant to declare a person ‘brain dead’ in the ICU.

Long arm of Law

All the afore mentioned factors lead to a shameful shortage of kidneys and a never-ending tale of exploitation, black marketing and racketeering.

There are several loopholes in the Transplantation of Human Organs Act of 1994. According to this law, only altruistic donation of organs is acceptable whereby, close family members donate organs to the needy. But the law also agrees for donation by those who are emotionally attached to the recipients.