About eight million Bangladeshis suffer from kidney disease, mostly because of high rates of diabetes, and at least 2,000 need transplants annually. But kidney donation is only legal between living relatives, resulting in a chronic shortage of kidneys for transplant. However, a lucrative black market has filled the void with a steady stream of desperate buyers and equally desperate and poor donors.
Almost every household in Kalai, 300 kilometers (185 miles) northwest of Bangladesh's capital Dhaka, has someone with the tell-tale, foot-long scar from the operation. Local police chief Sirajul Islam said, "This year alone 40 people from Kalai have sold their kidneys and 200 villagers since 2005. Another 12 villagers are currently missing, suspected to have traveled across the nearby border to India to hospitals to have the operations." Most donors end up suffering health problems because of poor post-surgery care, and can no longer labor on the farms.
Bangladesh police had busted a major scheme in 2011 involving doctors, nurses and clinics, many of the illegal surgeries moved to India. Mustafizur Rahman, a Bangladesh nephrologist said, "This racket has a lot of influential people on their pay rolls. They can easily prepare all papers including fake passports and national identity cards in order to facilitate unlawful transplants."
In September 2015, police cracked down on the trade, arresting a dozen people in Kalai and Dhaka, including a donor turned 'kingpin'. Authorities were spurred into action after a gang cut out a six-year-old boy's kidney and dumped him in a pond.
Police and local authorities have now launched campaigns warning of the dangers, distributing leaflets to homes, schools and madrassas in the area. But many people in Kalai doubt much will change. They say, "Previous efforts have failed, thanks to an inefficient criminal justice system." The villagers say that Abdus Sattar, one of five arrested in 2011 for allegedly kick starting the trade, is back in business.