Illegal organ donation rackets are not uncommon in India. But the latest one unearthed in Karnataka last month has exposed how the trade has flourished unabated in a systematic manner and has direct connections with private hospitals and even the State Authorisation Committee, a body that is meant to weed out illegal organ transplants.
The epicentre of the racket is the unassuming >dusty town of Magadi , 55 km from Bengaluru, and known to many people in Bangalore as only a pit stop on the way to Mysuru. In the illegal organ trade, Magadi seems to have become an organ market. Three rackets have been busted here in the last eight years and, shockingly, it is the same gang all three times. The touts were arrested each time and let off.
However, while earlier probes ended with the touts, the latest racket has for the first time led to the arrests of employees of a leading private hospital chain and members of the State Authorisation Committee for organ transplants.
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It all started with Shashikala, 32, a Dalit woman from an economically-backward family. In the first week of July, based on a tip-off, the Magadi police registered a suo motu case. Shashikala revealed to the media that she sold her kidney for Rs. 3 lakh. The reason, she said, was to repay debts incurred after an unsuccessful bid for the Gram Panchayat polls.
Investigations led the police initially to a gang of touts headed by a former private bus operator, Mahadeviah. Mahadeviah and his gang were arrested for the same racket in 2007 and 2013, but got away on bail each time. Clearly, they went right back into business.
“ Police believe at least 12 illegal renal transplants were conducted over the last two years that involved this gang, which targeted Shashikala and convinced her to part with a kidney. ”
The modus operandi is simple. Vulnerable donors from backward areas of Magadi and Ramanagaram are identified, as they make easy targets. They are desperately in need of money. The racket area lies between Bengaluru and Mysuru, hubs of super-speciality hospitals but also with a large poor and migrant population.
Documents are forged to show that the donor is a close relative of the recipient. In Shashikala’s case, she was shown as a daughter-in-law using a fake marriage certificate and other documents procured through the recipient’s son and local officials.
But how could all this routinely make it through the state level committee and not raise any suspicion?
This is where investigations revealed the big and ugly picture of how the trade had infested the systems that were meant to curb it.
Syed Wajahatullah, transplant coordinator of a leading private hospital chain, and P.M. Vinod Kumar, medico-social worker with the state level authorisation committee, have been arrested for engineering and facilitating several such illegal transplants.
The details of the patient would be shared with the touts by Syed; the touts would identify a suitable donor. The police verification process would be “managed” by the touts who would forge documents using their connections in several government offices.
Next, Vinod Kumar would push the forged documents through the committee for approval. Police are ascertaining whether other committee members knew about the racket or were misguided. A departmental probe is also underway.
But how could the same gang arrested twice before for the same crime continue unhindered? The failure of law enforcement agencies is reflected in this simple fact: at least four major rackets have been exposed since 1995, but not one person has been convicted so far. In fact, for the 2013 racket, not even a charge sheet has been filed.
Dr. Chandragupta, Superintendent of Police, Ramanagaram, who is probing the latest racket, says that the entire process of checks and balances for renal transplant — from private hospitals to state authorities — appears to be compromised. “The donors, treated as victims of the touts, have also taken money and have things to hide. Everybody in the chain from the donor to the recipient is a beneficiary in this. The entire process is collusive and compromised, at the cost of law,” he said.
An argument for legalising incentives is made by Dr. S. Sundar, director and chief nephrologist, Columbia Asia Group of Hospitals. “We must understand that these kidney rackets don’t exist in a vacuum. We must think out of the box to harvest the maximum kidneys to match the demand and yet prevent exploitation.” He argues for India to adopt the Iran model, which incentivises an organ donor monetarily and provides medical insurance and aid. “An organ donor needs to be treated like a hero. Just because our soldiers are paid salaries, are they not heroes? Legalising incentives for donors is becoming an accepted trend across the world and is the best way to prevent exploitative middlemen,” he says.
But in a country like India, beset with wide socio-economic disparities, providing incentives for organ donation would institutionalise the exploitation of the poor to provide kidneys for the rich, says Dr. G.K. Venkatesh, urologist and former chairman of the State Level Authorisation Committee for organ transplants.
Multiple kidney rackets have revealed that donors are economically backward, and often from scheduled caste and scheduled tribe families. Dr. Venkatesh believes more kidneys can be legally harvested by promoting cadaver organ transplants, where incentives don’t play a role. “It is also not exploitative, nor is there harm to a living person,” he points out.