KAVREPALANCHOK, NEPAL — A thick fog envelops the hilly areas of Kavrepalanchok, a central district, widely known as Kavre. This rural village is situated 55 kilometers east of Nepal’s capital, Kathmandu. Passenger buses and trucks heading to Tatopani, a trading hub near the Chinese border along the Araniko Highway, struggle to negotiate blind turns. Visibility is low. Near the highway, Sambar Tamang, 49 of Hokse village, is unfazed by the honking buses moving by at a snails pace.
He basks in the sunlight in the courtyard where his four grandchildren are playing, braving the chilly weather. The sunlight fails to warm Tamang’s spirits as he sits near a bonfire, brooding.
”I desperately want to work, but my health prohibits me,” says Tamang, as he watches the children play. At 49 years old, he is a skinny and lanky man. He risked his life to become the owner of one-story thatched house — built of the local red clay and stone boulders, the roof is made of old tin sheets. There is just one room, which is used for lodging, cooking and all domestic purposes.
Three years ago, Tamang had nothing but a piece of land. He lived in a hut in the village with four children and his hearing-impaired wife, whom he married after his first wife died of malnutrition in 1994.
“I often used to dream of becoming the owner of a house one day in my life,” he says. To follow his dream, Tamang took out a loan from a local merchant and built a medium-sized house.
No sooner had he bought the house than he was pressured to pay back the loan, which amounted to 25,000 rupees ($330 USD.) He had pledged to return this money at any cost within four years. Tamang had been paying 700 rupees as interest every month from the daily wage of 200 rupees ($2.60) he earned as a porter in Kathmandu, where he spent over a week each month. “Repaying the huge amount of [the] loan within the maturity period was like a hard nut to crack,” he says. “So I went to Kathmandu one month [after] the house construction was over hoping that I could make money for it.”
This went on for three years. Finally, one day, he met three people who assured him that they would turn his dream into reality — they would help him pay off his home loan.
Tamang says he was willing to do anything to earn the money to pay back the loan. The group he met in Kathmandu were in a black market trade. Later, he learned, their trade was human organs.
“I was lured with money to sell one of my kidneys,” he admits. Since Tamang was feeling the burden of debt, he agreed. ”I sold my right kidney for 50,000 rupees.” For about $650 USD, Tamang underwent a dangerous operation that left him with a deep scar, long-term health problems and only one kidney.
A Booming Black Market Business
Just like Tamang, many people have a similar story to tell. In Hokse and the neighboring villages, local residents estimate nearly 100 people have sold kidneys on the black market. The total number of individuals who have sold kidneys in Nepal is unknown. Although many say this black market business is thriving. There are still no nongovernmental organizations working against the organ selling business. Police say they do not have exact records of kidney agents or sellers.
”In the marginalized settlements of Kavre and its neighboring district Sindhupalchok, many people are living with one kidney,” says social worker Uddhav Hamal of Singapur village. ”My 40-year-old neighbor [Krishna Sahi] went to India six months ago and sold her left kidney. Just a month ago, she died after her right kidney ceased to function.”
”In this village five people have already died,” Hamal confirms. ”We stopped some villagers from going to India, but some still sold their kidneys secretly.”
Tamang had a tough time working in Kathmandu. ”I could not earn [enough] to feed my family, even working for 18 hours a day,” he says. “When I was approached by a kidney agent to sell my kidney, I was startled in the beginning. But later I gave in to his offer of 50,000 rupees.”
The agent took the illiterate man to the Indian city of Siligudi with Tamang’s consent. They boarded a train and got off at an unknown place, which Tamang says he could not make out. “He took me to a hospital there,” he says.
On the very first day of his admission at the hospital, Tamang had his blood tested. “Then I was kept at the [hospital] for 19 days. The agent told me I have to sit in the hospital for at least two weeks. But I don’t know why,” says Tamang.
After 20 days, his turn finally came and his right kidney was removed by the Indian doctors. “After [the] operation I thought I was dying for a while, but the greed of [the] much-needed 50,000 rupees didn’t let me feel the pain,” he says. “Three days later I returned to Kathmandu with [a] fresh wound.”
Upon reaching home, Tamang realized that his decision to sell his kidney was a mistake because he could no longer work in the field or the house like he used to do. “I am weak and fall ill constantly now. I cannot control [urine],” he says of his newly developed incontinence. “Doing heavy work is out of my thinking nowadays.”
Tamang’s youngest daughter was also approached by the kidney agents, but luckily for her, the blood test showed that she didn’t have enough hemoglobin in her blood and was declared unfit for organ donation.
Kavrepalanchok is a hot bed of the kidney trade, says Deepak Adhikari, a local reporter of Kantipur Daily, Nepal’s largest newspaper. “In the past five years, kidney sales have gone up significantly,” says Adhikari who suspects hundreds of thousands of Nepali people have sold their kidneys.
Sociologist Rajya Laxmi Koirala claims more than 100,000 Nepalis have sold a kidney during the last decade. Due to economic hardship, lack of awareness and the seemingly “easy money,” she says many poor Nepali people are lured to India to sell their kidneys. “I have seen Nepali students in India selling their kidneys to pay their tuition fees,” Koirala adds.
Organ Agents Thrive in Urban Kathmandu
Adhikari says about a dozen kidney agents are known to be active in Kathmandu and police statistics agree with this figure. The investigative department of the police department here are aware of many active kidney agents baiting rural villagers with the promise of money if they travel to India to sell a kidney.
The growing kidney trade in Nepal came to light on February 5, 2008, when wanted Indian kidney kingpin, Amit Kumar, was arrested in southern Nepal near India. Kumar had been hiding there since his clinic in Gurgaon, India, was raided by police earlier in the year.
Kumar was, according to police, behind 600 illegal kidney transplants. He and his associates obtained kidneys illegally from poor people in Nepal, then transplanted them to needy patients who could pay exorbitant rates. The normal cost of a renal transplant is around 300,000 rupees ($4,000) in India. However police suspect around half a dozen kidney agents serve clients from the U.S., U.K., Canada, Saudi Arabia and other countries. “These agents even charge up to one million rupees ($13,000) from rich clients,” says Adhikari.
Government Remains Motionless
Nepal’s law considers the sale of human organs a crime based on the Human Trafficking (Control) Act and the Human Organ Transplant Act, says lawyer, Dilli Ram Mainali. “The Human Organ Transplant Act prohibits conducting the transplant-related activities without prior licensing from the concerned authority,” says Mainali. “[The] Human Trafficking Act considers illegal organ transplant as an act punishable as trafficking of [a] human being.”
Those found to be selling human organs or aiding in this activity face a jail sentence up to 10 years and a fine of 500,000 rupees ($6,500), Mainali adds.
However, poor implementation of the law is taking its toll, he says, adding, “The government should tighten the rules if the kidney agents [are] to be reigned in.”
Though the law allows only a blood relative to donate a kidney to ailing kin, kidney brokers exploit the poor by making false documents, says senior kidney specialist Dr. Rishi Kumar Kafle.
“We have repeatedly informed government authorities to control this unscrupulous act, but they are still silent on this matter,” he says.
Doctors and lawyers argue that the illegal organ trade is flourishing in Nepal because of the demand from rich patients suffering from renal failure in Europe, Canada and the United States. Other nearby countries are also known to battle with the illegal trade of human organs.
“As long as the demand stays, the supply will continue,” says Koirala. “And the legislation designed to prevent it is failing.”
“We are well aware of this thriving illegal [act]. Thus, we have instructed police to take stern action against them,” says Home Minister Bhim Rawal. However, the police have yet to make a single arrest.
“Kidney victims lodge complaints at police offices against the agents,” says police officer Dirgha Bogati. “There were two cases related to illegal [sale] of [a] kidney, but police could not move to court due to lack of necessary documents and evidence.”
