Human organ transplant and sources

Md Rezaul Karim By Md Rezaul Karim, 23rd Nov 2011 | Follow this author | RSS Feed
Posted in Wikinut>Writing>Columns & Opinions

People donate body parts for hunger, on the contrary if no one donates where would you get it?

Micro credit impact, Human organ donation, Law, Rights and Human tragedy- A Dilemma

This side of the story:
In a country where more than 40% of the population lives below poverty line and 20 million suffer from kidney diseases, the link between kidney trade and poverty is not very difficult to correlate. The recent tracking of kidney traders buying kidneys from poor people for transplantation within and outside the country has raised serious concern among general public and also among medical practitioners, coloring it as no one didn't know it before now! The poor people who have sold their kidneys have become fell short of what a healthy person could perform, arbitrarily saying. Money did solve some problems momentarily, affecting in the long-term impairment.

There were 41.2 million poor in rural areas and 14.8 million poor, hardcore poor was 18.7 million in rural areas and 8.3 million in urban areas in 2005. The per capita income of people in the lower poverty line was Tk 630.53 in rural areas, and Tk 741.52 in urban areas in 2005. Now the offer to sell kidneys made to these poor people who are poor and, at the same time, indebted. The kidney priced US$2,000 to US$3,000, concern is that the promised amount was not delivered to donors. This money will never be able to help them get out of poverty, rather make them disabled forever.

Why the issue raised or gets impetus?

After 1971 Bangladesh has become a fertile plot for social research, particularly in the field of Micro credit. The program first started in the name of coordinating and managing foreign donations that were pouring in to help the disaster affected people. As days go by there was a fear among the Capitalist countries at that time not let the country affected by Socialist doctrine of poverty alleviation, as the West Bengal was a natural breeding center for Socialists. So, the local agents who are much smarter exploited the situation, like frying fish with fish-oil! Getting funds and using it by lending poor who indeed needed money to survive with a hefty rate of interest, far above the bank rate. Logic was helping the poor with funds in need, to help them to sustain, to improve economic conditions, to be self sufficient, or most popularly women empowerment. The secret is women are the most trusted loanee, as they cannot leave homes, or could balk down under pressure. Moreover, women are relatively sincere in paying installments, even by selling their own secret savings, which every woman have in our country. Fact is very seldom majority could settle the loans once taken and stood up high. To adjust, they seek helps from friends, relatives and other peers, but as usual become frustrated. The next step is to eat the bait alluring nearby, that is another loan provider NGO. When the second loan is taken, actually the stepped in the micro-credit trap, from where they would never be able to escape, if something miracle happens. Situation at this point in time is much graver than in the first place without loan, when one is only lack of money and fulfilling demands and wants, now another added – anxiety and psychological and mental pressure. This actually forces them to take decision like selling human organs. There are examples where to save one all family members again fallen in the organ donating trap.

Other side of story:
In Bangladesh more than 18 million people suffer from kidney diseases and 40,000 of them could not survive every year, and due to the lack of treatment facilities, 90% of these patients remain untreated. Hardly 5% of those patients can afford to the costly treatment including dialysis and transplantation. High use of pesticides and food contamination are also important causes of kidney diseases.

Bangladeshi patients are traveling to Singapore and India for kidney transplantation taking along the ‘donors/sellers on the trip overseas. Although transplantation in a foreign country is much higher than in Bangladesh, the main reason for Bangladeshi patients kidney transplantation in hospitals abroad is to bypass the law. They can make false papers to prove that the kidney donor is a relative of the recipient.

The law relating to Kidney donation:
All these have been done after the law on organ transplantation was enacted in 1999. A kidney donation by a poor person to a Japanese citizen in exchange for money sparked the need for the law, which also raised ethical concerns among medical professionals.
The law in a nutshell is as follows:
-In Bangladesh the Human Organ Transplantation Act 1999 stipulates that only close relatives and blood relations can donate organs voluntarily.

-The law allows father, mother, son, daughter, maternal and paternal uncles and aunts, husband and wife to donate their organs.

-Unknown people can in no way donate organs for others, as per the law.

-Anyone, even doctors, involved in influencing others to donate human organs, will face a maximum of seven years and a minimum of three years in prison or a fine of Tk 300,000 or both.

Interpretation of the Law:
From the legal point of view there cannot be any trade, i.e. buying and selling of kidney from external sources but can only be ‘donated’ voluntarily. Kidney is not a commodity produced by anybody; it is a body part of a person and cannot be reproduced in the body and ‘donated’.

The Third Eye view:
-the shortage of organs is virtually a universal problem, for in some countries, the development of a deceased organ donation program is hampered by socio-cultural, legal and other factors.

-Even in developed countries, where rates of deceased organ donation tend to be higher than in other countries, organs from this source fail to meet the increasing demand.

-The use of live donors for kidney and liver transplantation is also practiced, but the purchase and sale of transplant organs from live donors are prohibited in many countries.

Medical Research history and Bangladeshi case of success and confusion in Kidney Transplantation:
-Kidney transplantation was first done in the Institute of Post-Graduate Medical Research Hospital in 1981.

-Besides, a number of private hospitals also conduct kidney transplantation. So far the number of kidney transplantation performed within the country is 700 and outside the country 300 since 1988.

-Again, if no transplantation is done in Bangladesh for strict laws do we think trade will be stopped, critics doubt. This will be done more cautiously and with high stakes.

-Last but not the least, our expert doctors will be deprived of being experienced in this field with comparison to other countries where more surgery is happened.

-Country will also lose foreign currency in this regard, as it is a big stake business. One could not deny this reality.

Humanitarian dilemma:
When some one sick and need and cannot get an organ for laws, no matter if any third person beyond blood ties, and going to die slowly before ones eyes even though have bag full of money. It is not acceptable to the ailing family, not to the patient who is pretty important to the family, economically and socially. In one sense the question of price of white and black blood will derive. On the other hand personal sacrifice and love and affection from the ailing family and helplessness is really a matter to address. Living and dying have become subjective matter in this case.

-On the other hand, the donors are hard laborers, cannot do any heavy work, feel pain in the abdomen and suffer from ailments that they did not have before. The money received will be going back to the doctors for treatment.

-The kidney sellers are supposed to be a healthy person, but once they decide to sell or donate the kidney they are also on the operation table. After the surgery he/she also falls in the category of a patient, and needs further support of health care. Unfortunately, when it becomes a case of trade, there is no option for such care after the payment for the organ is made.

-No record is kept so no donor can come back and claim compensation for the health hazard caused by donation. For those lawful ‘donors’ as described in the law, there could have been protection and ensured follow-up care.

The following recommendations could be tried in order to pacify this burning issue of conflicts between organ donation and micro credits.

-the law relating to human organ donating must be reviewed carefully, justifiably;

-all parties interests must be addressed otherwise it would fail;

-Micro-credit lending either should be stopped, or, the total process and operations must be reviewed and accountable and transparent;

-What the NGOs are claiming and actually happening must be verified by regulatory bodies;

-Law enforcing agents must support the causes of people first, at this moment NGOs exploit the law enforcing agents and laws too, since they have resources, corrupts could easily be bought in.

It is time to think about the responsibilities of all the related stakeholders to protect the rights of poor people for proper health care and the right of the kidney patients to have treatment, including transplantation, without causing threat to the life of the poor people. The necessary amendment of the law that ensures protection and proper care must be made. However, poor people must be brought out of the deception, allurement and the trap of organ trade. Kidney selling is not a way out of poverty, it will rather enhance poverty.


Credit, Kidney, Medical, Poverty, Transplant

Meet the author

author avatar Md Rezaul Karim
I am a teacher engaged with the Southern University Bangladesh. I Like to use my spare time by writing and reading. I take it as a fun and source of inspiration in pursuing knowledge.

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author avatar Buzz
24th Nov 2011 (#)

Insightful, Md. A sad dilemma posed, indeed.

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author avatar Md Rezaul Karim
5th Dec 2011 (#)

Thanks Buzz....

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author avatar Ivyevelyn, R.S.A.
2nd Dec 2011 (#)

Md Rezaul Karim: Thank you so much for this article. I am late responding as my messages have piled up.
The information you give is very much appreciated; I was unaware of all the ramifications of organ harvesting. Your article is extremely important and I hope your research and hard work in putting this together receives a great deal of attention. Ivyevelyn .

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author avatar Md Rezaul Karim
5th Aug 2013 (#)

Thank you and I am happy that you liked it...Ivy..

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author avatar Doctor Richard Smitt
27th Sep 2017 (#)

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