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Kavre, Nepal. Seven years ago, Nepalese farmer Madhab Parajuli faced an agonizing choice: lose his small plot of farmland to mounting debts or sell one of his kidneys to an organ trafficker.

In desperation, Parajuli accepted the trafficker’s offer of 100,000 rupees ($1,400) and traveled to India to have the organ removed — a decision he now bitterly regrets.

“I didn’t get paid until we got back to Nepal, and then only around a third of what I’d been promised,” the 36-year-old said in his home village of Jyamdi, around 50 kilometers east of the capital, Kathmandu.

“I lost my farm anyway, and if I’d known then what I know now, there’s no way I would have sold my kidney.”

Parajuli’s family abandoned him after he lost all his property. Now a day laborer, he said he found heavy work difficult. “I occasionally feel the pain on the side,” he said, pointing to the scar on his right side.

Under Nepalese law, kidney transplants are allowed only if the organ is donated by a blood relative or spouse. But India’s laws are more lax, allowing a non-relative to donate an organ “out of affection,” subject to the approval of a medical committee — a checking process which can often be circumvented.

Everyone knows someone who has given up a kidney in Jyamdi, one of a cluster of poor villages in Nepal which have become centers for the traders because of the proximity to Kathmandu and the Indian border.

Most of the villagers are subsistence farmers, but many cannot produce enough food for the whole year, and are forced to seek work in Kathmandu or India.

“The organ traffickers trawl the villages looking for poor donors like Madhab,” said Krishna Bahadur Tamang, a former village chief. “People here are poor and uneducated so it’s easy. But in most cases they get only a tiny fraction of the money they were promised.”

Some are even lured into India with cover stories, and only told the true purpose of their journey once they are over the border.

That is what happened to Mohan Sapkota, 43, who was told he would be paid to accompany a Nepalese kidney patient traveling to India.

He became suspicious when the trafficker told him he would have to undergo a blood test and a health check-up before traveling, but it was only after he arrived in the southern Indian city of Chennai that the true reason emerged.

“I had no money and no property and the trafficker promised to pay for my children’s education, so I agreed to give up a kidney,” Sapkota said. “But in the end, all I got was 60,000 rupees.”

Ganesh Gurung, a sociologist, has conducted research into organ trafficking in the district of Kavre, where the villages are located. Once the victims arrive in India, he said, they are more vulnerable to traffickers’ demands.

“The donor is in a very weak position in India, where he often cannot understand the language and has little bargaining power,” he said. “And then when they get back to the village, many of them spend the money on alcohol.”

A survey conducted by a Nepalese nongovernmental organization last year put the number of people in Kavre who have sold a kidney at 300. No official statistics are available, but many people believe it could be higher.

Many organ rackets in India cater to foreigners dubbed “transplant tourists,” but most of the kidneys from Nepal are actually destined for Nepalese patients.

Wealthy Nepalese people suffering kidney diseases travel to India for the transplant operation, said Rishi Kumar Kafle, executive director of the National Kidney Center.

He said the paucity of health care in Nepal meant kidney disease often went undetected until it was too late, leaving the victim with a choice between expensive dialysis treatment or an illegal transplant.

Nepal’s weak law enforcement and open border with India make it easy for the traffickers to ply their lucrative trade, and reports suggest a kidney can fetch up to $20,000 on the black market.

Police say they have struggled to make arrests because the traffickers live outside the area, but some accuse authorities of ignoring the illegal trade.

“Our village has developed a reputation as a place where you can buy kidney,” said Raman Pariyar, a farmer.

“Local people see that you can give up a kidney and still try to live a healthy life,” he said. “So a prospective donor leaves the village first to Kathmandu and then to India and comes back with a scar on his side.”



Agence France-Presse