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India: A Pound of Flesh
Selling kidneys to survive

TEXT OF STORY

KAI RYSSDAL: The bio-ethical debate over stem cell funding has ended. At least for now. But money and medicine are really never far apart. And the more crucial the care, the bigger the controversy. Organ transplants are just one example. Supplies are naturally limited. Demand is growing. Kidney transplant hopefuls might have to wait years for a donor match. The cost can run into the tens of thousands of dollars. Samantha Grant found a way to cut to the front of the line. For Marketplace and public television's Frontline/World, she filed this dispatch from India.

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SAMANTHA GRANT: I met Koteeswari in her home outside the Villivakkam slum in Chennai. She is well-connected to the kidney trade here. She said she could introduce me to at least 50 families who'd sold kidneys for money.

The Villivakkam slum is also known as "Kidney-vakkam" or "kidney-neighborhood" because it's said that at least one person from every household there has sold a kidney. And it's usually women.

At a local woman's home, we readily found women willing to talk about kidney sales. In fact, one of them even offered to sell me her kidney on the spot.

There were only four men in the village who'd sold a kidney, and two had already died. The other two, the women explained, were ashamed that they'd had to resort to selling their organs. Selling a kidney, they said, was commonly known as a woman's way of earning money. Geetha is a woman in her early 30s. She sold a kidney just three months ago. She said that she sold out of compassion for her former employer. But she also admitted she received $750, which she was happy about, though she was promised $1,000.

GEETHA [interpreter]: I am healthy and I can get all my housework done myself. I don't ask anyone else to do it for me.

She doesn't complain of ill effects. But other donors complain of intense leg, back and stomach pains. Infections that require costly medical care also set in. And that's rarely covered by the broker or the recipient.

Though her operation went well, Geetha said she wouldn't recommend selling a kidney to anyone she knew.

GEETHA [interpreter]: When I was in the hospital, I saw someone who died from giving a kidney. That's why I wouldn't recommend it to anyone else.

When I visited a local transplant clinic there were 20 people waiting for consultations. Though selling organs in India was outlawed in 1994, the trade continues because there is a loophole in the law. The loophole allows people who are not blood relatives to donate their kidneys if they say its done out of altruism. However, many of these surgeries are actually commercial transactions cloaked in compassion.

Koteeswari took me to the home of a broker who asked not to be identified. She herself has donated a kidney in the past. She says typically the recipient will pay about $1,300 for a kidney. Of that, $1,000 is promised to the donor, though many times they only receive half. The rest is divided between the broker and the doctors.

BROKER [interpreter]: In the past 14 years, I've brokered between 60 and 70 deals. People find us because when we help one person in one place, they will tell others.

They often come looking for the brokers because they are deep in debt or because families need to raise money for a dowry.

Dr. H. Sudarshan, an activist who's opposed to the kidney trade, says donors are often lied to. He says the doctors who perform the surgeries don't always fully inform the donors of the health consequences for giving up a kidney. And the risks are even higher for the poor.

SUDARSHAN: Especially the poor are prone for more infections and more renal problems so they can't really afford to donate one kidney. It's a myth. They need two kidneys much more than any rich person.

As prosperity spreads through India, diabetes, often associated with a lifestyle that includes fatty foods and little exercise, is rising dramatically there. The World Health Organization estimates that there are currently 31 million people in India with diabetes. The spread of diabetes, which can lead to renal failure, accounts for the high demand for kidneys in India.

But Indians aren't the only ones seeking kidney donors. India's Ministry of Tourism is promoting what's being called Transplant Tourism, aimed at drawing wealthy foreigners in search of a cheap medical fix. Its website even has a page called "high-tech healing" and boasts that a "kidney transplant package" in India would cost only $7,000, a fraction of what it costs in the developed world.

In Chennai, I'm Samantha Grant for Marketplace.

RYSSDAL: A longer version of Samantha's story will air tonight on Frontline/World on PBS.