Focus on Shadow Economies: India

By Samantha Stevenson
Staff Writer

Some people joke about selling their kidneys for a profit during financial hardships, but for many in India, it is not a joke—it is a necessity. Live Mint reports that an estimated 200,000 Indians need an organ transplant every year. This large consumer base, coupled with India’s strict donation laws, have increased demand for illegal organs drastically.

Quartz reports that under Indian law, donations from unrelated parties can only occur if the procedure receives government approval to ensure that no money transaction is involved. Besides this and transplants from close relatives, those in need can only receive an organ from the recently deceased, or from patients with clinical brain death, given their families’ permission.

The report went on to say that the organ market has become so popular in India, entire villages in places like West Bengal and Bihar have citizens living with only one kidney due to local operations. Kidney sales in the city of Calcutta are so great that it has been nicknamed “the Great Kidney Bazzar,” said Al Jazeera.

The demand for organs does not stop domestically, as India ranks number eight on Havoscape’s list of countries most at risk from the global black market. India’s large contribution to the black market for organs, an estimated $68.59 billion, has earned it a spot among the “organ importing and exporting countries,” reports the World Health Organization.

The Transnational Institute conducted research into the interconnectedness of illegal clinical operations within India in order to see how deep the organ market penetrates Indian society. They found that one doctor, Dr. Amit Kumar, has an operation which runs three hospitals, five diagnostic centers, and 10 laboratories, with more than 50 accomplices. These accomplices include doctors, nurses, “spotters”, and touts. Touts, also known as brokers, are the individuals who lure potential “donors” with promises of payment or jobs, and then take them to someone who removes their kidney.

Al Jazeera spoke to a broker referred to as Vikas, who admitted to helping foreigners in need of a transplant find locally based donors. When foreigners request Vikas’ service, he posts on social media promising monetary compensation for a single kidney. These posts are often disguised as a plea from a “distressed relative” in need of a quick procedure.

Vikas told Al Jazeera that he often posts as a woman because women are perceived to be more trustworthy. He also chooses English names as foreign organs cost more. “When anybody calls I tell them she is my sister.” Said Vikas.

The ideal donor is usually a healthy non-smoker, in their 20s or early 30s, and men are preferable as they can travel alone easier. Having a valid passport is not required as, if the match is good, all the documents, including passports, are arranged in a matter of days, said Vikas.

After trust is established, the potential donor is put through a series of health tests, including blood tests and tissue type tests. The broker then arranges to meet the donor, and safely delivers them to a hotel or guesthouse. After the procedure, donors are typically able to return home within 18-25 days.

The purchase and sale of organs is illegal and punishable by prison time and fines up to Rs25 lakh, which is just under $40,000.

So if the procedure comes with so many risks, why do it? Simple—a majority of the donors are desperate for money.

The donors typically receive around 300,000 rupees, or $4,500, for their kidneys. It is nowhere near the amount that brokers and doctors earn, but it is enough of a reason for the impoverished and debt-ridden who have no other way to make ends meet.

Comparatively, a US citizen could theoretically sell their kidney on the black market for a sum total of $262,000 according to Gizmodo. It is unsurprising that this is a market that preys on the poor, but that doesn’t make it any less unfortunate.