People & Their Problems

New Delhi, 2 November 2007

Racketeering In Human Organs

IMPETUS TO ORGAN DONATION VITAL

By Radhakrishna Rao

For more than two decades now, a thriving, well organized illegal trading in human organs in general, and kidneys in particular, has been going on in virtually every part of India. Touts hand in glove with a microscopic section of the medical fraternity that has no regard for ethics continue to sustain the tempo of the underground business in kidneys and other vital human organs.

Despite vigorous efforts by the voluntary organizations and the Government agencies to promote organ transplantation in a “legal and transparent manner”, there has been no let up in racketeering in human organs.

In order to minimize the vicious impact of the illegal trading in human organs, the Union Health Ministry has proposed setting up a country-wide network of nodal centres to retrieve organs from brain dead patients. To be named the Organ Retrieval Bank Organisation (ORBO), it would be set up in ten cities --- including Chennai, Hyderabad and Bangalore with a view to serve as a central organ registry and retrieval centre. These nodal centres will be set up under the National Organ Transplantation Programme.

Meanwhile the Union Health Minister Anbumani Ramdoss hinted at amending the Transplantation of Human Organs Act to make organ transplantation a “smoother and transparent affair”. One of the likely amendments to the Act would be the inclusion of provision to provide incentives to the family members of cadaver donors. Currently only 0.1 per cent of our transplantation are cadaveric .We have a long way to go” said Ramdoss.

In September last, a major kidney racket was exposed in Bangalore. According to the local media, the accused got kidney transplantation operations done in three hospitals with organs procured from four fake donors.

The Bangalore City Police who unearthed this scam said that the accused received commission of Rs.15,000 while each fake kidney donor got Rs 1.25 lakh. The police also said that “organizing the unrelated live kidney transplantation was like a profession for the accused.” He along with his accomplices went around looking for “vulnerable people, mainly the poor, in the rural areas and lured them into donating the kidney,” asserted one Bangalore police official.

As per the law, only organs donated by the blood donors or harvested from a dead body could be transplanted to a patient. As medical professionals point out in an unrelated kidney transplant —   implying that the kidney is not from the blood relatives — there is a higher rate of rejection by the recipient’s body.

According to Dr.Venkatesh Krishnamurthy, a well-known Bangalore nephrologist, in an unrelated kidney transplant, the cost of maintaining the transplanted organ is higher as the dosage of medicine has to be more.

A member of the Authorization Committee set up by the Karnataka Government to prevent illegal trading in kidneys stated that in most cases it is the poor who are lured into parting away with their vital body organs in return for monetary compensation. Adding, that cases had also come to light wherein the touts even marry the donors to provide credibility to the illegal commerce in human organs.

In recent years, many private corporate hospitals in Bangalore are known to be performing unrelated kidney transplantation operations on patients from India and abroad. As pointed out by a spokesman of the Karnataka Medical Council, the kidney racket in the city and other parts of the State could not have thrived without the support of hospitals and doctors. “In my opinion, the police cannot say that the doctors and hospitals are not at fault. It would not have been possible without the connivance of the hospitals” said he.

As things stand now, renal transplants and follow-up medi-care are terribly costly. A kidney transplant, surgery and post-operative care in a well-equipped hospital could cost as much as Rs.5 lakh. Moreover, the chances of the transplanted kidney getting rejected could not be ruled out. As such prevention is easier and a more cost-effective strategy.

According to Dr.M.K.Mani, Chief Nephrologist at the Chennai-based Apollo Hospital, diabetes accounted for around 30 per cent of all chronic renal failures in India and hypertension another 10 per cent. Not surprisingly then, controlling these two major maladies could result in the declining incidence of kidney-related ailments.

The programme run by the Kidney Help Trust in the villages of Tamil Nadu has helped create awareness about the gravity of kidney-related problems. “This is something which can fit easily into a Government programme” said Dr.Mani.

In India, more than 20 million people develop kidney problems at any one given time with nearly one lakh developing the end-stage renal failure each year. Any wonder that lakhs of kidney transplants are performed clandestinely with the kidneys being procured for a price from the poor inhabitants of shanty towns forming a part of India’s urban landscape.

In western countries, information about the availability of organs including kidneys for transplants is available on a compute system in every country. Sadly, India lacks such a communications network.

As it stands, the Transplantation of Human Organs Act 1994 adopted in 1995 paved the way for harvesting organs from brain dead individuals. However, the machinery to supervise the extraction, transportation and transplantation of the organs is far from well-organized. As such very few organs are harvested from accident victims, the most ideal and major source of human organs for transplantation.

On an average 70,000 people die in accidents in the country each year. Of these, 20,000 people end up as brain dead cases. But the process of donating the organ of a brain dead person is a far from smooth task. Often the relatives decline to donate organs. Many are averse about an organ being removed from a brain dead body whose heart beats and pulses continue to be recordable.

Further, according to the Chairman of the Apollo Group of Hospitals, Dr.Pratap Reddy, the recipient should be able to reach the hospital within three hours of the procurement of an organ from the corpse.

True, there are many medical institutions, which carry out kidney transplants without transgressing the canons of law. For instance, the Bangalore Kidney Foundation (BKF) is a far cry from the rash of private clinics that have become notorious for trading in kidneys. As pointed out by a spokesman of the BKF, it is always possible to carry out transplants as per the existing laws

.As medical experts stated, for a successful cadaveric kidney transplantation programme, coordination and interface between private hospitals, where most of the kidney transplants are performed and public hospitals from where most of the donor organs come, is vital. However, in the context of the fast growing waiting list for kidney transplants in the country, quickening impetus must be given to the organ donation campaign. ---- INFA

(Copyright India News & Feature Alliance)