Why the organ donation mafia again?

Once again after an interval, concerns have started rising about the resurfacing of organ trade in Kerala, following a report by Crime Branch IG Sreejith submitted to the DGP. The report reveals that the organ donation mafia is active in the state, as clear from preliminary enquiry, that the modus operandi of that mafia upends the 'mritasanjeevani' scheme of the government, and also expresses suspicion about the role of government officials in it. Based on this finding, the government has registered a case suo motu and has entrusted SP Thrissur, Sudarshanan with the probe. A number of people living in a colony in Kodungalloor, Thrissur were found to have been duped by agents into donating their kidney. The investigation has also been extended to three colonies in Kochi. The preliminary finding is that in recent times, over 35 organ transplants were made in the state.

The trump card of the organ traders is the gap between the patients who need organs and the number of organs genuinely donated. The 'mritasanjeevni' scheme of the government, formed to facilitate voluntary posthumous organ donation, has 2329 willing donors registered with it. But, as per unofficial estimates, there are over 25,000 people in the state with damaged organs and seeking transplantation. For organ transfers under the scheme, 35 hospitals are authorised to transplant organs received from patients after brain death. Since 2012, under 'mritanjeevani', 888 organs were made available from 314 brain dead persons. The delay in obtaining organs under this scheme, the stringent legal stipulations and the high number of applicants make it inevitable for organ seekers to ask for live donations. Despite strict rules and regulations, in cases of genuine need, there is provision for donors even other than close relatives to donate organs out of philanthropic consideration, and it is this loophole that the organ trade mafia smartly exploit.

On the one hand there is the last struggle before death, and on the other the pathetic compulsion to cut off and donate an organ without which their lives cannot move forward. It is this helplessness that organ trade agents, and certain hospitals who bring disrepute to the whole health sector, cash in on. Some donors have confessed to the police that they opted for organ donation out of sheer poverty. It should make the entire Kerala ashamed that during the lockdown period, at least six women in Ernakulam district alone, had to sell their kidney in order to survive. Further, the fact that a woman, who once had to trade her kidney was made an agent for subsequent victims and thus the trade got fattened, convinces us of the need to turn urgent attention to the living conditions prevailing in certain colonies of the state. To be read with this is the fact that in the earlier phase, when kidney trade was more rampant, it mostly happened in adivasi colonies.

At a time when serious debates are ongoing about the backward among forward communities, news about living clusters and slums of organ trade fail to get enough public attention. Organ sale becomes the last resort for survival for those in privation among the landless and homeless in about 26,000 such colonies. There are even reports about those poor being betrayed without agreed payment after fixing a deal between government officials, hospital authorities and agents. Given that a formal complaint will land both the donor and the recipient in legal trouble, the victims in the deal - deprived of any social power - will not go for litigation and it is this certainty that keeps the trade going unhindered.

Two years ago, Manikantan, a native of Nellimedu was injured in Salem, had brain death and his organs were extracted after an inflated medical bill forced them to choose between death and donation. Chief minister Pinarayi Vijayan had written to the Tamil Nadu chief minister demanding an investigation into this. Under the coercion of the hospital authorities in which the dead body would be released only on either paying the bill or donating organs, the patient's relatives were forced to sign consent for organ donation. And without a social transformation that can route out such duress situations, mere legislation will only punish donors and let the guilty go scot-free. There are adequate laws and rules in place even at present, to stop organ trade. The sad current-day reality is that they all serve only as a net of exploitation and a loophole for the real culprits.