Nigeria – India Strange and Illegal Kidney Trade

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A syndicate that specialises in organising the illegal sale and purchase of donor kidneys in India to patients of end-stage kidney diseases and end-stage renal failure, is currently operating in Nigeria.

The sale and purchase of human kidneys is being carried out in violation of the Indian Transplantation of Human Organs Act, 1994.

The syndicate which is made up of medical doctors and other hospital personnel, takes advantage of the high demand for donor kidneys and the relatively low acceptance of voluntary organ donation in developing countries, particularly Nigeria, to continue the illegal practice of commercial kidney exchange.

The mode of operation of the syndicate, Good Health Weekly, gathered, begins with touts who scout for and recruit commercial kidney “donors” in India in readiness for potential recipients in Nigeria.

After being certified fit enough to give a kidney, these “donors” who are actually indigent persons, are paid an agreed sum to pose as a relative of a kidney recipient.

Another set of touts operates in Nigeria, scouting for patients of end-stage kidney disease that are in desperate need of donor kidneys.

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“What they do is advertise online as consultants to kidney transplant hospitals in Mumbai, New Delhi and other big Indian cities,” noted a 45-year-old woman diagnosed witth end stage kidney disease in May this year.

“When I was diagnosed, I had two immediate worries. Apart from the high cost of the surgery, the follow-up tests and medications estimated at about N4 million, I had no idea how or where to get a compatible donor kidney,” said the woman who had been undergoing series of haemodialysis sessions for before her kidneys failed completely and doctors prescribed a kidney transplant as solution to the endless dialysis sessions.

But while there was at least a chance she could raise a substantial part of the required sum, her chances of getting a compatible kidney were remote as no member of her immediate and/or extended family was willing to donate voluntarily.

Experience

Relating her experience, the patient recalled how in her search for the elusive donor kidney, she was introduced to someone who linked her with an agency that arranges medical trips to India for various organ-replacement/repair surgeries such as for renal, cardiac, oncological problems.

“They made all the arrangements and connected me with the hospital in India, and even assisted in hotel reservations, processing of visas and other travel papers. When I indicated that I had no donor kidney, they told me I could purchase one in India for N1.5 million.

“All payments had to be in advance. The surgery was to be carried out one week after my arrival in the hospital in Bangalore.”

It was like a dream come true until a few days to her departure when her neigbour’s daughter, who had lived in India, was home on a visit and during conversation, there was a mention of the intended trip. It was the visitor who first raised pointed out the existence of an illegal kidney black market which caters to the kidney buyers from around the world. According to her, it was illegal to buy or sell kidneys in India, with a warning that even if the patient succeeded in leaving Nigeria without a donor accompanying me, she might likely have problems with the Indian immigration who would suspect she was in the country to buy a kidney, in violationof the law.

Reaction

In a reaction to the development, Dr. Vijaya Rajakumania, Senior Consultant Surgeon, Kidney Transplantation, Vascular Access and Laparoscopic Surgery, Apollo Transplant Institute, New Delhi, India, acknowleged that shopping for kidneys in India used to be a common trade.

“Donating a kidney isn’t particularly risky to health, and combined with the biting poverty and absence of legislation, the poor could afford to sell off a kidney.”

Rajakumania, who transplants an average of 30 – 40 kidneys every month, observed that once upon a time, when commercial kidney trade was legal, so many persons sold off one of their kidneys to make money. “But it later got to a stage when there were large numbers of people with one kidney around the country and government was compelled to outlaw the practice. Today, there are some other countries where you can buy kidneys from the shelf, but not from India.”

Stages

Rajakumania observed that the kidney goes through five stages before it ends up in the end stage disease. “When it reaches this stage, the patient may require either a dialysis or transplant. So depending on the age of the patient, and if there is a donor available, they can now become candidates for a transplant.

“In the pediatric group, it is either that they are born with certain abnormalities like hyperplastic kidneys where the kidneys are not properly formed, or ballistics kidney disease, and a birth abnormality. These are things which could have been corrected and prevented after birth, but if they are not picked up, we then have persons at 10, 12 years of age with renal failure.

Patients from Nigeria, Rajakumania noted, are usually very sick and on wheelchairs when they arrive. “So what we do first is to stabilize them on haemodialysis. With good quality haemodialysis, they start improving. So, we dialyse them, make them fit to go through a transplant, they can get their family donor, we evaluate them and then we proceed with the transplant. On the average, it costs $12,000 – $14,000 (N1.92 millon – N2.24 million).

Precaution

“I will tell everybody that at the time they reach 20 years of age, they should have an annual health check. Women during pregnancies go through health checks and at least that is the reason why renal failures are less prominent in women.

Also, four to five kilometers a day of walking and dieting is important. Take note that tress contributes to health failure but exercise is the best de-stressor because there are a lot of endorphins which get released and improve the mood. Endorphins released take care of stress. You can do whatever suits you such as playing music, dancing, playing instruments.”

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