Do You Want To Buy Kidneys?

I thought there was only the drug trade, the illegal arms trade, the child trade, and the prostitution trade. I've heard of rumors about body organs getting sold for a hefty amount of money but that's just what they were to me --- rumors. During medschool, I've also heard of people selling their blood to blood banks to earn a living. But I never thought that there was (or should I say, is?) indeed a booming black market of organs, mainly "kidneys" and "livers." Now, the NYT ran a comprehensive report on a gruesome trade known as the kidney trade on its Sunday online issue. Click here to read the full article (requires simple registration for new readers).

Here in Manila, we have a hospital known as the National Kidney and Transplant Institute (NKTI) where kidney transplants are being done. It was established on January 1981 during the Marcos administration and since then, more than 1,000 kidney transplants as well as liver and bone marrow transplants had been done on its operating rooms. That's the good news. Years ago, there were investigative TV documentaries about this illegal organ trade, but after several months it died down.

Last year, the country's legislative body passed a law that restricts the number of foreign patients who can obtain kidneys from living donors, thereby ensuring that foreigners do not outbid locals for desperately needed organs. In theory, donors are supposed to be motivated by kindness and idealism, not profit; however, the government has not outlawed giving cash gifts to Filipino organ donors.

There's a place in Metro Manila called Bagong Lupa (in English, it means, "New Land"). It is an area where hundreds have sold their kidneys over the years for as little as $1,800. Nobody from there knows about the new law and I am certain that the kidney trade continues to thrive there.

The NYTimes article describes a dynamic global black market for organs, including livers, kidneys and lungs, that touches dozens of countries (like Brazil and South Africa) and makes millions of dollars a year. Organ trade has opened up medical and financial connections, spawning a new movement of human beings that is part transplant tourism, part traffic in slaves.

Here's an example of the gruesome global business as described by TowardFreedom magazine:

"In one well-traveled route, small groups of Israeli transplant patients take a charter plane to Turkey, where they are matched with kidney sellers from rural Moldova or Romania. The transplants are handled by a pair of surgeons, one Israeli, one Turkish. Another network unites European and North American patients with Philippine kidney sellers in a private Episcopal hospital in Manila, arranged through an independent internet broker who advertises on the web. Meanwhile, a Nigerian doctor/broker facilitates transplants in South Africa or Boston, with a ready supply of poor Nigerian kidney sellers, most of them single women. The purchases are notarized by a distinguished law firm in Lagos."

Kidneys can go from $2,000 to $10,000 each, depending on where you are getting it. Here in my pathetic Manila, you can get it at its cheapest price. India and China are also countries well-known for the underground organ trade. But foreigners usually go to Manila because the price here is better. At the NKTI, a friend doctor says a kidney transplantation costs about $10,000 (or about half a million pesos) plus whatever other perks the recipient has to give or pay for the donor. Higher fees are certain if there are brokers involved.

The demand for human organs for transplantation is always at an all-time high. Only a few relatives approached after the death of a family member accept donating organs for people in need. And not all patients have relatives willing to sacrifice one of their own kidneys. This situation makes some rich patients choose to open their wallet in search of a person who is willing to help save their lives. And "rich clients" never ran out. They come as far as Canada, the US, and Europe.

In Bagong Lupa, hardly anybody donates their kidneys out of kindness or because they are good Catholics. Instead painful poverty and human despair are the motivating forces behind their acceptance. Thus, it contributes to quick transformation of kidneys and livers to commodities. Kidneys become like your shoes or like an appliance you badly need. The reason is quite obvious: It is a question of money. For both donors and recipients, the issue also involves life, death and despair.

Should we or shouldn't we?