Nepal’s ‘Organ-ised Scam’: They Traded Kidney for Better Life, Got Med, Legal Hassles Instead

As Parvati Parihar winds up her household chores, she steps out of her shanty to rest on a charpai, where the youngest of her four daughters is lying half asleep. While reaching out to the charpai, the 37-year-old woman limps a bit, with her hand pressed on the left side of her abdomen. With discomfort on her face, lifting up the toddler in her laps, she says, it is “the usual” pain, which she would often feel after a busy day at home. She has been dealing with this pain for the past two years when she gave away her left kidney to an Indian patient.

In 2020, when Parvati travelled to New Delhi, from her village Rampur in Kavrepalanchok district, Nepal, to undergo the surgery, her family and she believed that when they return, their lives will be changed for the better. However, today, when she looks around, she finds her mud laden-brick hut, the makeshift stable where two of her cows rest and their small backyard full of cow dung, hay stacks for cattle and a hand pump, the same as it was before she had sold her organ.

“We had thought we will get a bigger and a pucca house when I return to Nepal with the money I was promised. I was assured Indian Rs 8-9 lakh (0.8 to 0.9 million USD), but they paid me only Rs 3 lakh (0.3 million USD). I went for it hoping for a better future for my children. Of the money, we could barely save anything to change our life,” Parvati told CNN-News18, lighting a beedi.

But this is not a first for Parihar family.

NOT THE FIRST IN FAMILY

The only reason why Parvati demanded Rs 8 lakh, was because she was aware of how high a price a kidney can fetch for her family. Ten years ago, in 2010, her brother-in-law, Ganesh Kumar Parihar, 39, too sold his kidney in India and in 2002, her husband Ramkumar Parihar, 42, did the same.

The family has cracked an easy way to quench their desperation for finances.

Even as Ramkumar claims he was fooled and his kidney was taken away back in 2002, his brother, Ganesh was aware and had demanded a good price in 2010.

“I was taken to Madras. Back then I worked as a sewing labourer and I was promised a better paying job in India. There, I was told I have developed some medical complication and that I need to undergo a surgery. I was then operated and my kidney was taken. To silence me, I was paid Rs 60,000, which at that time, meant a lot for my family. Eight years later, my younger brother sold his kidney as we needed the money and then my wife, too, did the same two years ago,” Ramkumar said.

Other than the Parihars, Nepal is not short of kidney donors, or rather victims, who have fallen prey to the syndicates operating across international borders.

The CNN-News18 team met three other men, from Jyamdi, a village 60 km from Kathmandu, who had come to India more than two decades ago to sell their kidneys.

At a discreet location outside Kathmandu, where the trio agreed to meet, they narrated how the organ trade has been active across Indo-Nepal borders for decades.

“I was taken to Kolkata for work but there I was informed that if I give my kidney to an Indian man who needs to undergo transplant, I will be paid heftily. I was promised Rs 70,000, but was paid way too less. I had to get my daughter married, hence I agreed. But today, when I look back, I only regret having given away my organ,” one of them said, requesting not to be named.

THE ECONOMICS OF ORGAN TRADE

Once the agents and middlemen, working at the behest of organ trafficking syndicates in Nepal, zero in on a probable donor, he/she is brought to the Indian city where the transplant is to be conducted.

For the next few weeks, the donor lives a life, which they had been always dreaming about. They stay at a hotel, they are served good food, they undergo a series of medical tests and most of their materialistic demands are also fulfilled.

As the day of transplant approaches, half the payment, as agreed upon, is made in most cases, while the remaining is handed over before the donor is sent back to Nepal.

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While a donor, well aware of the finances, can demand as high as Rs 8-10 lakh (0.8 to 1 million) for his/her kidney, those who are new to the trade settle for a meager Rs 4-6 lakh (0.4 to 0.6 million).

A doctor or medical technician who performs the surgery gets roughly Rs 3-4 lakh per operation, while the middlemen and agents bag Rs 1-2 lakh.

Officials from the law enforcement agencies also believe that to finance such a lifestyle for a donor, funds are also activated from backchannels. “It is not possible for small-time cartels in Nepal to spend so much money. There certainly are larger international syndicates that back these small agents and fund their actions. In order to break the backbone of such active rings, we have, time and again, targeted their financial system. Links to these gangs have often been traced to India and Middle-Eastern nations,” said an official from the Anti Human-trafficking Bureau, Kathmandu, Nepal, who wished not to be identified.

THE DEMAND

Medical experts say that the reason for such an illicit organ industry to have existed over decades is the huge gap between the demand for kidneys and their availability through legal channels.

Dr Anup Kumar, head of department urology, Safdarjung Hospital, said that every year he has two lakh patients requiring kidney transplants, but only 5,000 to 10,000 transplants are conducted annually.

“It is this huge gap that results in people going the wrong way to get a kidney. Kidney complications in India are increasing for many reasons. The Government of India, for kidney transplant regulations, had introduced the Human Organ Transplant Act and this was revised in 2011. In 2014, various other rules were also introduced to this act via gazette notification under which protocols and rules for kidney transplant have been mentioned,” said Kumar, who also is a panel member of apex technical committee to National Organ & Tissue Transplant Organization (NOTTO).

Explaining the process and complications, he said there are two types of transplants – living organ transplant where someone donates his/her organs and lives a healthy life thereafter, and diseased organ transplant, where organs of a brain dead person can be donated.

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“It is important to take precautions because kidneys of a donor and a recipient need to match. There’s this process of HLA matching. There are six antigens. A match of all six is best and up to 3-4 is also acceptable. But any unmatched kidney that is implanted may lead to death of the recipient. To avoid any such complications, before any transplant, both donors and recipient need to undergo detailed medical examination and a battery of tests. In the absence of these tests, lives of both donor and recipient are at high risk,” he said.

Kumar further explains that one effective solution to bridge the demand and availability gap is to turn victims of accidental death to donors. This will help bridge the gap so no one will go the illegal way to purchase organs, the surgeon said.

WHY NEPAL?

Whenever a demand for a kidney is raised in India, any other neighbouring country or in the Middle-East, search for a donor begins in Nepal. Most victims of kidney trafficking rackets active across international borders come from low-income groups, making them an easier target.

Social activists and human rights advocates believe that rising unemployment rates, high illiteracy and poverty are the main reasons why such organ-selling syndicates have managed to seep in and have flourished in Nepal.

Krishna Pyari Nakar, a human rights activist and lawyer from Kathmandu, said illegal organ trade is not new to Nepal, but governments over the years have done nothing significant to bring down the cases.

“Such gangs flourish and operate blatantly. Everything is in the know of the government, police and politicians. The government needs to make people more aware of their rights and about the legalities around organ donation. We also need more and more educational programs and employment schemes to help Nepalese earn better, so they do not have to go selling their organs to make ends meet. There needs to be a strong political will to curb such practices which are playing with the lives of Nepalese people,” Nakar said.

The CNN-News18 team also reached out to the National Human Rights Commission, Nepal. Responding to the queries, Murari Prasad, secretary, NHRC, Nepal, said organ trafficking is more of a police-related issue.

Acknowledging that it is the poverty-stricken class that becomes the easy target, he said mostly gullible Nepali villagers are lured and then betrayed. “It is a crime which comes under police’s jurisdiction. Whenever the police don’t do their job, it is our mandate to look into why the investigation wasn’t done properly. It is our duty at the NHRC to ensure regular monitoring,” he said.

Prasad, agreeing that it is a socio-economic crisis, said government schemes are active, but have only reached urban classes and not the poor.

“We should not be reactive but take preventive actions. There shall be more income generation programs and job schemes that will effectively bring down the problem,” the secretary said.

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“In many cases, victims don’t even want to report the cases to police or to any authority. This is one reason why police in most cases fail to find the culprits. Whenever they have caught perpetrators they’ve been arrested and have faced trial,” he said.

The officer also said that organ trafficking is an intercontinental problem and not just a crisis in Nepal. “Nepal along with other neighbouring countries need to work together and help eradicate such practices that violate rights of their people.”

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