Saturday, November 25, 2017

Global Financial Integrity identifies Bangladesh a place of illegal kidney trade

  • Nurul Islam Hasib,
    Published: 2017-03-30 04:14:59 BdST

Representational Image: Surgeons extract the liver and kidneys of a brain-dead woman for organ transplant donation at the Unfallkrankenhaus Berlin (UKB) hospital in Berlin Jan 12, 2008. Reuters

The Washington-based Global Financial Integrity (GFI) in a report says that a kidney can be available in Bangladesh for $2,000.

The report also showed that the illegal trade also goes on in the United States where it takes a minimum $20,000 to buy a kidney.

The report titled ‘Transnational Crime and the Developing World’ produces analyses of illicit financial flows, advises developing country governments on effective policy solutions.

This follows a similarly named report it produced in 2011, which received considerable attention around the world.

The prices for organ transplants vary widely by type of organ, by the country in which the operation is performed, and by the nationality of the transplant recipient.

Bangladesh Organ Donation Law 1999 allows posthumous or brain-death kidney donation apart from living close relatives, but steps have never been taken to introduce such donation.

It is illegal to take a kidney from people other than brothers, sisters, father, mother, maternal and paternal uncles and aunts under the 1999 law.

Police in 2011 discovered an organ trafficking racket responsible for persuading people to sell their kidneys.

According to the GFI, many in Bangladesh, particularly in the rural areas, are compelled to sell their organs primarily to settle debts or for brief moments of financial respite.

They are poor, uneducated, desperate and unaware of the post-selling complications. Some end up with chronic health complications. Few are better off.

The brokers downplay the risk of future complications— sometimes even doctors tell potential vendors that their kidney will grow back. Serious postoperative complications, such as infection, chronic pain, fatigue, and impaired function of the remaining kidney, are common.

These complications, besides the obvious impact on the vendor’s health, sometimes actually drive a vendor deeper into debt.

Desperation and greed drive the illegal organ trade. Both recipient and vendor are desperate. Although both are breaking the law, neither fits the image of a typical criminal, according to the report.

The illegal organ trade that includes kidney, liver, heart, lung and pancreas conservatively generates approximately $84O million to $1.7 billion annually.

It is estimated that up to 10 percent of all transplants rely on organs that have been illicitly acquired.  In Bangladesh, the report point to kidney trade only.

Kidneys are the most commonly transplanted organs, legally and illegally because donors can give up one kidney without considerable impacts to their health. Living donors increase the supply of available organs, thus lowering the price paid by recipients and received by donors.

For the liver, heart, lung and pancreas, partial organ transplants from living donors are possible, but whole-organ transplants require deceased donors. Prices of these organs are almost double since they can be much more difficult to acquire.

The traditional kidney brokerage model sees the broker recruit the vendor, recipient, and surgeon. The emerging model for kidney transplants sees the recipient recruit the vendor.

Recipient and vendor frequently connect online, through social media and transplant blog sites, but on the dark web as well.

The recipient can always find willing transplant surgeons by going through agencies or medical centres that cater to medical tourism.

These businesses usually connect patients with medical professionals in foreign countries for legal procedures, such as plastic surgery or dental work. However, some agencies also facilitate illegal transplantation.

“Compared to other illicit trades, organ trafficking has a much greater impact at the personal and community level than it does on the economy or security of a country,” the report says.

Bangladesh does not have any study to say the actual prevalence of kidney disease and the need for organ grafting.

But some estimates suggest at least 20 million people suffer from some form of kidney diseases in Bangladesh and 35,000 of them die of kidney failure every year.

The annual demand for the kidney transplant is estimated 5,000, but on an average, only around 120 people can manage kidneys from their relatives to undergo a transplant in Bangladesh.

Doctors have been calling upon the government to promote cadaver organ donation in Bangladesh as they find living relatives are becoming less interested in donating kidneys.