Over the last decade-and-a-half, several cities in India have become hubs for transplant surgeries of organs such as kidney, liver, heart, eyes, brain and pancreas. Close to 18,000 organ replacement operations are performed annually in the country, the highest after the US and China. The bulk of these procedures take place in the private sector and attract patients from other parts of the world, especially countries in India’s neighbourhood. They are a testament to the growing capabilities of the country’s healthcare sector. However, along with compassionate donors and efficient surgery teams, the ecosystem is rife with dubious networks of doctors, hospital administrators and organ traffickers, many of whose operations extend beyond India’s borders. Last year, for instance, a UK newspaper revealed that a Myanmar-based syndicate had arranged paid kidney donors and got transplants performed in a prominent Delhi hospital by faking documents. Now, an analysis of police records by this newspaper has shone a light on an international kidney transplant racket centred at two prominent hospitals in the NCR. The investigation has revealed an illicit network stretching from Delhi to Dhaka that relied on fudged documents and questionable tie-ups between big hospitals and smaller health firms. The ring seems to have bypassed screenings at the international border.
India’s organ transplantation law recognises three kinds of donations: Those by near-relatives, altruistic donations and swap donations when a near relative is medically incompatible with the recipient, the pair is permitted a swap transplant with another related unmatched donor-recipient pair. Foreign nationals must submit a certificate from their country’s embassy to confirm that the donation is not driven by money or coercion. Like most illegal organ trading, the India-Bangladesh illicit market seems to have flourished for more than eight years by disguising trafficking as “altruistic donation”. The newspaper’s analysis shows family trees were fabricated and impoverished donors were lured with Rs 4-5 lakh to part with their kidneys.
Over 1.5 lakh patients in India require an organ transplant every year. Most other developing countries also have a large mismatch between needy patients and organs that can be harvested. Several countries in South and Central Asia and Africa have not developed transplantation capabilities. A section of patients from these regions travel to India for medical care. More alacrity by law enforcement agencies can help address part of the problem. The police have usually been up to the mark in busting illicit rings. However, as this paper’s analysis shows, they do not bring this zeal to the criminal investigation. Letting alleged organ dealers off the hook reduces trust in the transplantation system. In the long run, trafficking should be seen as more than a law and order problem. There is an urgent need to increase awareness about organ donation, remove misconceptions, address skews — women constituting a majority of donors, and men a majority of recipients, for instance.
