Organ trafficking

Unearthing of an illicit kidney-transplantation racket in central Assam's Morigaon district has exposed loopholes in the implementation of existing organ donation laws. It has also uncovered the invisible rural Assam where the poverty of low-income households is being exploited for running such organ donation racket. Interrogation of three persons arrested so far is expected to shed more light on the modus operandi and lead to the apprehension of the kingpins and all those involved. A section of "kidney donors" have gone on record that they were lured by the racketeers to donate one of their kidneys in lieu of money and taken to a hospital in Kolkata for the required surgical procedures. They have also alleged that they were duped as the entire amount promised has not been paid while admitting receipt of amounts varying from Rs 1.5 lakh to Rs 3 lakh paid by the middlemen. Some of the "donors" claim that the racketeers promised to pay Rs 5 lakh for each kidney which speaks volumes about the high stakes involved in the racket. Several victims of this organ donation racket have cited the reason of financial requirements for the treatment of their children or to pay outstanding debts that led them to "sell" their kidneys. Such heart-wrenching tales mirror the hard realities of an affordable healthcare system still being out of reach for the marginalised and downtrodden and poverty pushing many rural households into a debt trap. The 'Transplantation of Human Organs Act-1994', amended in 2011, prohibits buying or selling of human organs. The Act provides for fines and imprisonment for violators, who make or receive any payment for the supply of, or for an offer to supply, any human organ; seeks to find a person willing to supply for payment any human organ; offers to supply any human organ for payment; initiates or negotiates any arrangement involving the making of any payment for the supply of, or for an offer to supply, any human organ and abets in the preparation or submission of false documents includinggiving false affidavits to establish that the donor is making the donation of thehuman organs, as a near relative or by reason of affection or attachment towards the recipient. Such violation attracts imprisonment of "five years but which may extend to ten years and shall be liable to fine which shall not be less than twenty lakh rupees but may extend to one crore rupees."Even such provision of stringent punishment failing to act as a deterrence against kidney or other organ-trade racket is a wake-up call for finding the gaps in the implementation of the Act and taking corrective measures. The Transplantation of Human Organs and Tissues Rules, 2014 makes it mandatory that when the proposed donor and the recipient are not "near relatives", as defined in the Act, the Authorisation Committee shall evaluate that there is no commercial transaction between the recipient and the donor and that no payment has been made to the donor or promised to be made to the donor or any other person; (ii)prepare an explanation of the link between them and the circumstances which led to the offer being made; (iii)examine the reasons why the donor wishes to donate;(iv)examine the documentary evidence of the link, e.g. proof that they have lived together, etc.; (v)examine old photographs showing the donor and the recipient together; (vi)evaluate that there is no middleman or tout involved; (vii)evaluate that financial status of the donor and the recipient by asking them to give appropriate evidence of their vocation and income for the previous three financial years and any gross disparity between the status of the two must be evaluated in the backdrop of the objective of preventing commercial dealing. The victims of the kidney trade racket in Morigaon alleging that they were groomed by middlemen to impersonate as near relatives of kidney recipients raises questions as to why the Authorisation Committee failed to detect the forgeries despite the elaborate rules. These Rules also require that the committee should ensure that the near relative or if the near relative is not available, any adult person related to the donor by blood or marriage of the proposed unrelated donor is interviewed regarding awareness about his or her intention to donate an organ or tissue, the authenticity of the link between the donor and the recipient, and the reasons for donation, and any strong views or disagreement or objection of such kin shall also be recorded and taken note of. The consent of "donors" in Morigaon was not informed consent. The state government ordered a high-level probe of the crime and bringing to the book every culprit involved in the racket will serve as a strong deterrent against any violation of the existing laws and prevent exploitation of the poor for organ donation and transplantation through coercion or inducement.