Every law enforcing agency, every medical practitioner in Nepal is aware of the

rampant evil in the process of human organ trade racket

Kathmandu, February 13:

The past week saw some nerve-racking stories on kidney transplant racket in India. Doctors involved in the crime are reported to have conducted nearly 600 illegal kidney transplants, with most beneficiaries being foreign nationals. And to the horror and dismay, a patient undergoing dialyses in a hospital told an Indian journalist that he, too, would have contacted the doctor for having a kidney transplant than lay in the hospital bed.

To add to the woes, Amit Kumar, the kingpin behind the racket is learnt to have adopted several illegal means to keep on going with the illegal transplantation. The doctor has also visited Nepal several times and recently he got caught from Chitwan.

Who can say, many of the persons whose kidneys were extracted did not come from the remote villages of Nepal?

Several reports have exposed how middlemen lure poor people on the outskirts of Kathmandu to India to undergo nephroectomy.

The procedure for any Nepali to undergo kidney transplant is to find a donor here in Nepal and then go to India for the transplant. There are, however, no provisions whatsoever to guarantee the health of the donor or any mechanism to negotiate the price for the donation. This is a true matter between the rich recipients and the poor donors, in which the latter thinks organ donation (selling?) to be the final resort to escape from the vicious cycle of poverty.

The donors, because they belong from the lowest rung in society, are vulnerable to exploitation and fraud, and same is the case when they agree to sell their kidneys. Every law enforcing agency, every medical practitioner in Nepal is aware of the rampant evil in this whole process of human organ trade racket. Thanks to several national and foreign reports on the issue.

In this backdrop, should the government not regulate and allow sales of human organs?

Particularly kidney, because live donors can give up a kidney and still live with lesser health risk, unlike transplant of other organs such as livers and lungs, which pose a greater complication to the living donor.

From the perspectives of the kin of the patients direly in need of kidney transplantation, the logic of having someone ready to donate an organ for the life of the other sounds rational.

If we believe legalising highly controlled sale of kidneys is apparent that we are favouring black markets of human organs, exploitation of kidney donors by unscrupulous middlemen, endangering lives of donors undergoing nephrectomy in poor, unregulated conditions, promoting transplant tourism and simply ignoring the increase in commercial transplantation like the one unveiled last week in India. There are countries which have taken radical steps like setting up institutions to regulate kidney sales! Government regulated organ sales in Iran is playing an important role in preventing black market of kidneys. Such state-sponsored organisations work in transparent, non-commercial, middleman-free manners where there is all consideration towards eliminating any form of exploitation against the organ donor.

The general mechanism is that a government agency creates a link between the donors and recipients and sets price for the organ and also ensures that the donor’s post-nephroectomy health care insurance is duly guaranteed.

In Nepal, there has been in place the Human Body Organ Transplant Regulation and Prohibition Act 2055 and its Regulation 2058 in place. These legal documents have paved way for organ transplantation and related activities in Nepal but nothing has happened in this front as of yet, not because our doctors are not trained enough or our hospitals are not equipped enough.

The provisions in the Act and the regulation have strictly outlined the conditions for performing kidney transplants that any such act can only be done after taking permission from the Organ Transplant Coordination Committee, which has remained dysfunctional from the past two years because the government has not nominated four doctors in the panel.

Lack of such a committee has hindered any effort by the private hospitals to invest to create infrastructure to provide kidney transplantation services.

An issue as serious as this one must be handled with utmost care, because it is directly related with life and death of people, but it must be understood that inability to start transplantation services in Nepal would see more ignorant Nepalis losing their kidneys for want of little money and largely because of ignorance.