ORGAN TRAFFICKING AND THE RED MARKET

Dr. Shivani Vakilwala, Medical Officer

Organ Trafficking – the term itself sounds so bizarre, it is like saying somebody’s organs are up for sale. But however bizarre it may sound it is a harsh reality that this “Red market” (that is what it is often called) exists. It is an insane business of stealing or buying organs through exploitation of people by threatening them or abducting them for removing their organs and making profits by selling it to a third party.

Image source : https://www.medicaldesignandoutsourcing.com/egypt-arrests-45-organ- smuggling-ring/

It is astonishing to see that apart from sellers, brokers and traffickers, several times surgeons are also involved and the number of black market operations involving organs exceed 10,000 annually! These organ brokers reach across continents to connect the buyers and the sellers who are then guided to “broker friendly” hospitals where the surgeons are either involved with these immoral activities or are willing to turn a blind eye.

Israel, Egypt, Pakistan, China, Brazil, South Africa, Indonesia, India and Iraq are some of the biggest players in Organ Trafficking. The seller generally earns between $2000 to $6000 for a kidney and with no post- surgery care given. People are kidnapped or even murdered for this illegal activity and the commonest victims are those that are in financial desperation.

Image source : https://buzznigeria.com/fg-alarmed-rate-kidney-trafficking/

According to the UN Gift Hub, organ trafficking falls into three categories:

(1) Traffickers who trick the victim into giving up an organ for no cost

(2) Con artists who convince victims to sell their organs, but who do not pay or who pay less than they agreed to pay, and

(3) Doctors who treat people for ailments which may or may not exist, and remove the organs without the victim’s knowledge.

Image source: https://futurism.com/sale-human-organ/

In India around 2 lakh people need a kidney every year of which only 3% of the demand is met. Even if one can afford a transplant, finding a donor is very difficult as under the law only people related to the person in need are allowed to donate, therefore prospective donors are very less. The supply – demand gap for donor organs paves the way for illegal transplant and trade of human organs. There have been cases where while trying to locate missing children, many a times dead bodies are found of these children without their vital organs and the police would just claim that the body was lying in a stream and some animal must have eaten the child’s organ.

Even though India had passed an act in 1994 called the Transplantation of Human Organs Act it only managed to reduce the numbers but not eradicate this vicious trade and it what was reduced was just the tip of the iceberg. Transplantation of Human Organs Act states to stop the commercial dealing of human organs and if the donor is not a first degree relative then an approval is to be obtained by a government appointed authorization committee in each state of the country.

If any person helps in any manner in removal of an organ without authority then they may be punishable with an imprisonment which could be for five years and a fine which may extend to 10,000 rupees. If the person convicted is a registered medical practitioner then his name would be reported by the Appropriate Authority to the respective State Medical Council to take the necessary action including removal of his name from the register of Council for a period of 2 years for the first offence and permanently for the subsequent offence. See the source image

The Ministry of Home Affairs, Government of India has come up with several guidelines and instructions to deal with organ trading. These guidelines deal with the implementation of existing laws, capacity building of state machinery, investigation and prosecution of perpetrators, rescue and rehabilitation of victims, and prevention of trafficking. The document also encourages State Governments to involve Non-Governmental Organizations (NGOs) wherever possible, especially regarding prevention, rescue and rehabilitation. The ministry has also instituted awards for State Governments, police officers and NGOs for outstanding work done.

Even though the government has enacted the law (THOA) and implementing mechanism, those in the kidney market find loopholes to sustain the market.

Steps to prevent Organ Trafficking that should be implemented stringently-

Implementation of the law as well as the availability of sufficient organs through live and deceased organ donation programs should be done.

There needs to be organized strategies to educate healthcare professionals as well as the general public regarding the importance of organ donation.

Media, religious leaders and educational institutions need to be involved, and the Indian Society of Nephrology can be a significant partner in this process.

The Anti-Human Trafficking Units (AHTU) initiated by the Government of India need to be activated and strengthened. Since organ trade and trafficking is a transnational issue, international collaboration is needed to eliminate it. Affluent countries will have to sensitize and encourage their citizens, including healthcare professionals, to respect the law against organ trade and trafficking and foster altruistic living and deceased donation.