New Delhi: Illegal kidney racket, the ugly side of healthcare in India

New Delhi: Organ transplant trafficking is one of the fastest, but least reported crimes in India as well as in other countries around the world. It has often been described as a deep-rooted menace affecting the medical profession, both domestically and globally.

Backed by unscrupulous personnel linked to the medical profession, including touts and doctors, it is estimated that across the globe, roughly 100,000 illegal kidney transplants alone take place.

So entrenched is the organ transplantation process, that at times well known hospitals and doctors don't even know that the critical replacement organ they are inserting in a patient is illegal.

Take for instance the kidney racket in India, which records show has raised its ugly head from time to time. There are past examples of this racket being run by a nexus of middlemen (touts), doctors and lawyers etc, who harvest kidneys from poor people in dire need of money for paltry sums and then sell them to recipients at substantially higher prices.

The genesis of the kidney racket stems from a huge mismatch between the demand and supply for kidneys in the country and a loophole in the law, which is often misused by these scamsters.

They seem to have mastered the art of using loopholes in the system to smoothly push through necessary documentation and clearances, that at times, even doctors and hospitals don't suspect anything and become victims of the racket.

It is a finely tuned modus operandi, where middle men arrange kidneys from the poor; get false affidavits made and provide the required organ to the recipient.

Sometimes, the donor may even be positioned as a relative as per documentation. Doctors, hospitals and even screening committees are beguiled by such foolproof paperwork, that clearances are often obtained in a jiffy and the scamsters make off with a neat sum of money.

Delhi and the National Capital Region (NCR), Tamil Nadu capital Chennai and the Union Territory of Chandigarh have emerged as prime centres for transit and organ transplant trafficking.

Senior nephrologists, speaking on condition of anonymity, said organ transplant trafficking across several states cannot take place without the knowledge of the management at hospitals.

In the year 2003, a kidney racket was busted in Amritsar, where they were sold anywhere between Rs.5 to Rs.8 lakhs. In 2004, a Bombay Hospital-based kidney racket was busted and the kingpin along with his accomplices was arrested. After the arrests, it was learnt that the kingpin had deceived the hospital authorities by producing forged documents for conducting the transplants.

In the past one decade, Chennai, has emerged as the breeding ground for a thriving organ racket whose primary targets have always been the poor. The arrest of a Chennai-based medical representative in 2007 by Mumbai police for allegedly running an inter-state kidney racket revealed the enormous size of the illegal organ market that had grown into a syndicate with international links.

In 2008, a Gurgaon-based kidney racket was busted by the U.P. police and the subsequent arrest of Dr. Amit Kumar, the suspected kingpin of the racket, revealed that he had links with an international racket that was operating in Nepal, Sri Lank and Indonesia.

Asia's biggest kidney harvester T. Rajkumar Rao, conned over 15,000 debt-ridden farmers, Tsunami sufferers and impoverished tea garden workers to build a Rs.75 crore organ transplant empire before he fell into a cleverly-laid police trap along with his partner in crime Dipak Kar late last month. According to Delhi Police, the duo had a 250-strong staff spread across South Asia to help them zero in on potential victims. Delhi Police said that Rao had confessed to supplying kidneys to more than 15 top hospitals across India and nowhere was asked about who were the donors.

The World Health Organisation (WHO) estimates around 2,000 Indians sell a kidney every year. The WHO says South Asia is now the world's leading transplant tourism centre, with India among the top kidney exporters. Kidneys taken from Indians are delivered to Americans, Israelis, Canadians, Britishers, Saudi Arabians and residents of the Gulf region.

In the last two years, cases of illegal organ transplants have surfaced in Maharashtra, Hyderabad and Gujarat. As per police investigations, four Colombo-based hospitals have been identified for performing about 60 illegal transplantations for Indian recipients.

In most of these cases, reputed hospitals and doctors have suffered irreparable damage to their reputation and credibility on account of these rackets.

The government has mandated that under the Transplant of Human Organ Rules 2014, only organs of immediate blood relatives, including parents, siblings, children, grandparents and grandchildren can be accepted for transplant. The Indian Transplant Registry shows that roughly 100,000 to 200,000 people require a replaced kidney every year, but only about 5,000 manage to get a transplant.

For following the process legally, a comprehensive set of documentation is required, including affidavits with photographs of both the donor and the recipient certified by a first class magistrate. There are in-camera interviews too. Two separate committees for related and unrelated donors evaluate and clear cases. The committee that looks at procedures involving related donors comprises hospital staff, but people who are not part of the treating team. For unrelated donors, there are two nominees of the government who evaluate the cases.

Last December, Health and Family Welfare J P Nadda, highlighting the problem in parliament, admitted that there is a huge gap between the demand and supply of human organs for transplantation, and added that the government is giving priority to increasing donation of cadaver organs to bridge the gap and save lives.

That does not take away from the fact that middlemen appear to have placed themselves in key positions at some hospitals and nursing homes to meet the demand of this ugly side of healthcare in India.