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Inside Bangladesh’s organ bazaar

In what is supposed to be a microfinance mecca, many go to extreme measures to pay off debts.

kidney patients in Dhaka with willing sellers in the villages, creaming off fat commissions in the process.

Mehdi Hassan, from Bamongram 
(Sebastian Strangio/GlobalPost)

“The brokers roam around the diagnostic centers where kidney dialysis takes place. They know it’s a good hunting place for kidney patients,” Inspector Karim said.

Once a willing donor was identified, and brought to Dhaka for the necessary tests, brokers and hospital administrators produced legal documents fabricating a family relationship between the seller and the recipient. (Under Bangladeshi law, only family members are legally permitted to donate organs).

At his office in Joypurhat, Karim showed GlobalPost the documents that “legalized” Mehdi Hasan’s liver transplant — one claiming he was the nephew of the recipient, and another claiming he was the son of the man’s sister. The all-inclusive fee charged by Sattar and his associates would typically range from 400,000 to 500,000 taka ($5,280 to $6,600), but only a fraction of this was actually passed along to the seller.

So far, police have arrested nine people accused of involvement in the Joypurhat trade, including three in Dhaka, and are confident the local organ market has been shut down.

But some say Joypurhat is just the tip of the iceberg. Dr. Monir Moniruzzaman, an anthropologist from Michigan State University who has studied the Bangladeshi organ trade, estimates that roughly 250-300 people sell their organs in the country each year.

If anything, he said, that figure is likely to fall on the conservative side. “Joypurhat represents only a fraction of the trade of Bangladesh. The other parts of the country are unexposed, where the majority of the trade is going on,” he said. “If you combine it the picture is really grim.”

None of the accused were available for comment for this story, but Moniruzzaman said that in his own interviews with organ brokers, most claimed they were helping to save lives — that the sale of kidneys to the sick was “a win-win situation”.

Indeed, the exposure of the Joypurhat organ ring has prompted calls for the liberalization of Bangladesh’s organ-donor law.

Critics of the law say the scant availability of legal donors has created a flourishing black market. “We should make it liberal, so liberal that people cannot make profit out of it,” said Dr. Tareq Salahuddin, the health editor at the Daily Star newspaper. “If it’s open, there can be no way of making someone a loser.”

 (Sebastian Strangio/GlobalPost)

Mohammed Mozzamel Haque, the Joypurhat police superintendent, said the law needs to create a new regulatory board to establish family links between donors and recipients, utilizing DNA tests if necessary.

He argued that the law should also be amended to allow “emotional” donors — those with close non-familial relationships to recipients. “Sometimes blood relatives are not willing to donate kidneys, but friends should be able to donate a kidney. But the present law does not permit it,” he said.

Others warn that legalization would only succeed in turning the body parts of the poor into commodities for the wealthy. “It’s an unequal, unjust system where the rich can afford to buy [organs] and the poor are selling their own body parts,” said Moniruzzaman from Michigan State University. “It is expanding every year, so the law has to be stricter.”

He said the country’s demand for kidneys or other organs could easily met by establishing a cadaveric organ donation system similar to that in many Western countries — something he said would be a “moral and ethical” source of life-saving organs.

There are few studies showing the health effects of organ donation on the rural poor, but Moniruzzaman said that based on his interviews with organ sellers across Bangladesh, many suffer from post-operative pain, intermittent fever and body-weight problems.

But the most lasting cost he saw was often not medical, but psychological.

“Some sellers said they feel they are living like sub-humans,” he said, “as if they sold one of God’s gifts.”