Pakistan's 'kidney bazaar'

JANDALA, Pakistan — Nassem Kausar has done it. So, she says, have her sister, six brothers, five sisters-in-law and two nephews.

Each has sold a kidney to a trade that has led Pakistan's media to dub the country a "kidney bazaar."

"We do this because of our poverty," said Kausar, who is in her 30s and lives with her family in Sultanpur Mor, a village in eastern Pakistan.

A kidney nets the donor $2,500, sometimes less than half that amount, while recipients — about 2,000 per year — pay $6,000 to $12,000, compared with $70,000 in neighboring China.

Critics blame an economic system that enmeshes farmers in chronic debt, forcing them to sell their kidneys, and they say the trade should be banned. The government says it is taking action.

In the United States, donating kidneys for money is banned. But the Belgium-based International Society of Nephrology has suggested expanding the pool of kidney donors by legalizing payment of about $40,000 to donors.

At least 20 transplant clinics exist in Pakistan, and 10 percent of the patients are foreigners, many from the Middle East and "one or two" from Europe, said Bakhsh Ali, a senior official at the Sindh Institute of Urology and Transplantation.

The institute, a free transplant clinic run jointly by the government and private organizations, has joined the call for banning the sale of kidneys.

The government has drafted legislation to "regulate" kidney transplants, monitor surgeries and "encourage family donors," said Health Ministry official Athar Saeed Dil, who has helped draft the proposed law.

He would not say if an outright ban was planned, but Mukhtar Hamid Shah, a prominent surgeon who opened a transplant center in 1979, said the government plans to outlaw donations for money by non-family members and impose seven-year prison sentences on surgeons who break the law.

Shah, a former army surgeon, opposes any ban. "We have no interest in whether or not a donor is a relative of the recipient. The patient should have life," he said at his hospital in Rawalpindi, near the capital, Islamabad.

The Sindh Institute's Ali said donors need constant checkups to keep their blood pressure and sugar under control, and to protect the remaining kidney. In Jandala, another eastern village, kidney donors said they received no follow-up care.