I had once briefly met T Ram Kumar Rao, who had by then already conned over 16,000 people, mostly poor and extremely gullible, and harvested their kidneys for some big bucks. Harvesting kidneys sounds like harvesting apples, probably because there’s loads of cash in the business.
Conning over 16,000 people is not a joke. It was 2016 September and I was shocked when a cop narrated about Rao’s empire, his modus operandi. Rao was the Sansar Chand — the tiger poacher — of kidney business, operations spanning across the whole world. His clients came from the far, faraway Caribbean countries and Japan. You can easily imagine the grip he had on the world kidney bazar where India is the dominant leader.
And every time he was caught, powerful lawyers pulled him away from the jails.
Kidney Transplants & Scams: India’s Troublesome Legacy from Sage Publications reminded me of those days of interaction with the kidney merchants who operated out of plush buildings, Apple computers and drank expensive Darjeeling tea and offered a wide array of sandwiches, savouries and desserts to visitors. Some came willingly to sell their kidneys and a large number of visitors were conned.
It is a brilliant read. The author, Dr Ramesh Kumar, counted among the country’s top kidney specialists, opens up a whole new world to his readers, listing examples after examples of how and when these operations take place across India. And how these illegal harvesters pocket cash. Most interestingly, the book highlights why kidney sale is the biggest organ transplant business in India, the rates much higher than that of open heart surgeries. The author observed the market from within the hospitals, the cops tracked the illegal business from offices set up across India.
So how does it work? Smooth as silk, a young operator once told me. People from the hinterland are lured, almost everyone is promised anywhere between ₹ 40-45 lakhs and then sent to the operation theater (read gallows). The author cites several examples. Some of them, interestingly, were known to me. There was one Sangeeta who shifted to the Indian Capital from Kanpur. Her husband was promised a good job. She and her husband were over the moon. The couple was promised ₹ 40 lakhs. But tensions started once they were in Delhi and put up in a flat in Ghaziabad. Sangeeta was asked to do medical tests because it was mandatory before getting a job. But once paramedics started asking her to change her name to Amina Begum, she smelt the rat. She and her husband rushed back to Kanpur. She thought the worst was over but the nightmare had only begun. Her husband’s friend trailed them back to Kanpur and tried to convince her that she should sell her kidney. If not, she would have to pay Rs 50,000 for her travel and medical expenses. Frightened and broke, she approached the local cops and an FIR was filed. And then, the lid was blown off on one of India’s biggest kidney rackets.
In chapter after chapter, Dr Kumar narrates how the illegal kidney racket continues to flourish in India. Delhi, as expected, is the epicenter of this illegal bazaar and the web of criminals include cops, physicians, paramedics, hospital administration staff and kidney donors. The market is a little over Rs 250 crore. In the latest case, 15 people, including the CEO of Pushpawati Singhania Research Institute (PSRI), Deepak Shukla, were arrested, and notices served to two leading doctors at Fortis Hospital in Delhi for violation of the Transplantation of Human Organs (and Tissue) Act, 1994. But this was just the tip of the iceberg. As Dr Kumar says in the book, the market is thriving despite several raids and laws against it because those who sell their organs are desperate for money. It is a solid trade, a genuine trade and one that guarantees high profit. Why not? India needs 150,000 kidneys every year. For the records, the Health Ministry says against the demand of 2 lakh kidneys, only 6,000 were available. And against the demand of 30,000 livers only 1,500 were available, and against the demand of 50,000 hearts merely 15 were available in India. Worse, in India, the deceased organ donation programme is largely restricted to big institutions and the private sector which makes it less accessible for all.
The book says why it is not easy to crack the system and nab the operators. Top private hospitals that are protected by a battery of lawyers and donors — mostly poor — hardly want to testify before the cops. In most cases, the patients are paid Rs 2-4 lakhs and the harvesters pocket 50 lakhs, the rest — 10-12 lakhs — is distributed to those who keep the big chain smooth.
The poor in India have no saviours, rightly says the author and they continue to get exploited. It is a pity that the Indian government has not pushed a law that would enable the cops to hand over road accident victims, unclaimed bodies for such transplants. Former Chief Election Commissioner Navin Chawla wrote in the foreword how Delhi alone has eight to ten fatalities. The laws are strange in India. Under the present law, only those related to the patient are allowed to donate organs. That means there will be a huge reduction in the number of prospective organ donors. If you take a random sample, you will realise that out of 300 patients declared brain dead in just one hospital in a month in Delhi, only 10-12 are potential organ donors. A large, probably larger section of Indians believe donating a person’s organs after death would affect the Next Life.
So someone needs to bell the cat.
But who will bell the cat in this country, will the health minister spare sometime to think about the big kidney racket and put in some stringent rules in place or will it be another big debate in the two houses of Parliament?
If this happens, India will be able to check and mate the big kidney bazaar. If it does not happen, then gullible donors will be forced to join the gang and seek more and more kidneys. It works in the same way sex workers do their business. One girl is lured and forced into prostitution, and when she attains middle age, she starts another cycle. And then the cycle gives birth to more, more and more cycles. That is the way body hunters work, that is very much the way kidney harvesters work, it is largely by word of mouth.
It is certainly not a beautiful world.