Friday, March 02, 2007

Suspect Surgeons Advise Tamil Nadu Organ Transplant Future; Get Government Nod

Health Minister KKSSR Ramachandran

This afternoon I attended a meeting held by the government of Tamil Nadu that was meant to be the beginning of an official response to the kidney racket. In the last thirteen years thousands of kidney have been sold on the black market with the tacit approval of the ethics board that is charged with monitoring organ transplants. A month ago I wrote a story for Wired News where a member of the ethics committee admitted to knowingly authorizing illegal transplants through brokers.

The meeting today was meant to be a step forward out of a ethical murkiness of organ transplants and call together a wide array of doctors, NGO-wallas and ethical savants for their opinions on live-donor transplants and the solutions that might lie ahead. But intentions are not everything.

"The kidney rackets have been operating in this community for a long time. . .90% of the donors we know about come from below the poverty line, and 90% of those donate for money," said V.K. Subburaj Deputy Secretary of Health and Family Welfare during his inaugural address.

From a statement like that it would follow that the attendees charged with formulating Tamil Nadu's future policy would decide to get tough on organ donations and look for positive solutions through cadavers.

Yet when K.K.S.S.R. Ramachandran, the minister of health, asked for people to introduce themselves from the audience, it soon became apparent that the agenda for the meeting was actually being set by the kidney brokers. Just about all of the doctors who came are currently under investigation by the police for assisting in illegal kidney transplants. Representatives from hospitals in Madurai, Coiambatore, Chennai and Trichy that have all been outed in the media for working closely with brokers sat self-satisfied in their easy chairs waiting for their chance to influence policy.

The most obvious among them was Dr. K.C. Reddy of Devaki Hospital--who allowed a broker named Dhanalakshmi to operate for years outside his hospital and in the past has been a vocal proponent of live-donor donations. He was practically jovial. Though he wouldn't say a word to me.

When the opening remarks were over the press was kicked out and the doctors began to discuss their recommendations in private.

It was like putting the inmates in charge of the prison. The very people who were implicated in creating the organ racket in the first place were allowed to chart the course for the future. Allowed to set the clock backwards and make it seem like all their illegal actions over the last dozen years were actually for the best.

So it was no shock when the results came in and the doctors had reached a consensus that 1) Live unrelated donor transplants should be legal and that people should be allowed to buy and sell kidneys on the market. 2) Foreigners should be allowed to buy organs in India, but need to seek approval from the committee 3) All of the committee's authorization decisions should be final and not open to appeal 4) Members of the ethics board in charge of overseeing that the system is not abused cannot be held accountable for coercion between brokers over donors or forged documents. And, to put it in the speakers own words, "should not be harassed by the police or press".

So lets just throw transparency out the window and start an open-air-organ bazaar in Nungabakkam why don't we. If the committee's statements get taken up by the government (which is a real possibility) then we can look forward to thousands of completely above the board organ thefts. There were no stipulations to properly look after the rights of the people donating kidneys (except for one proposal for 5-10 years of free health insurance) and no mention of brokers at all.

But some people, thankfully, were not completely taken in by the committee's organ mafia. V.K. Subburaj said that there was still need for further debate, and that cadaver donations were still the only real option. The same went for members of the MOHAN Foundation, who have organized 200 cadaver donations in the last three years.

To top it off, no people from the press were permitted to ask questions or attend the closed door sessions with the gang of doctor-criminals discussing how to divide the spoils if the laws change.

At this point it is in the hands of K.K.S.S.R Ramachandran ,the health minister, a DMK appointee who's claim to the ministerhood seems to rely on his loyalty to the party and an incident in his past when he was burned by acid during a political rally. I don't know much about Ramachandran except that he has endorsed cadaver programs in the past and that he doesn't speak much English. Though one quote that he said during the meeting (which was translated for me) ran a chill though my veins:

"If there was a situation today where I needed a kidney I am sure that my son wouldn't offer up his own, instead he would say that he would pay any price for one."

And the price today is the blood of the poor.

Before he left a reporter from the Hindu asked if he would prosecute hospitals that had preformed illegal transplants. He said he would when the investigation turned up evidence. So far, it seems, he hasn't looked very hard.

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6 Comments:

At March 03, 2007 10:07 AM, Anonymous Anonymous said...

Why don't any of the local papers pick up on this story?

Have you submitted this story to local papers?

Please do. Words needs to get out...

 
At March 05, 2007 4:50 PM, Blogger Gwen said...

This is horrendous, disgusting, and almost too evil to believe. I think my faith in humanity has been significantly lessened after reading this. On the other hand, Kudos to you, Scott, for putting this story out there. I hope it reaches the right people. Keep up the good work.

 
At March 10, 2007 5:01 PM, Anonymous Anonymous said...

You say you've been in India for the last 10 years and yet you're surprised? Most of the politicians in India are ex bandits and village thugs, so it's not surprising what happened at the meeting. They say India has the most billionaires in Asia, but if you count the politicians and mafia types the number would be much higher.

http://www.guardian.co.uk/india/story/0,,2030341,00.html

 
At March 12, 2007 10:32 AM, Anonymous Anonymous said...

I think it would be a good idea to have the number for the U.S embassy in Chennai on your speed dial...these goons are probably figuring a way for you to sample the delights of a chennai police lock-up, or maybe a water tanker gone wild on you.Maybe even some immigration charges on you and your wife. Have you read 'Shantaram' with Gregory David Robert's description of a mumbai jail?

 
At April 03, 2007 2:38 PM, Anonymous Anonymous said...

Who is not a criminal...we all are in some way or the other.Its just that some criminals stop at nothing and we wade through life keeping our eyes and ears closed to others suffering or simply take advantage of somebody elses suffering and each year land up at the holy Ganges to take a bath to rid our feelings of all guilt!

Joydeep Saha

 
At April 19, 2007 4:09 PM, Blogger sunfever said...

Scott, you've got only half the story. If you check with the donors they aren't complaining that their kidneys have been "harvested" (to use a word). The donors know it and they are fully for it. Their gripe is that they are being shortchanged. The brokers pocket the money. Now I don't know if there is broker-doctor angle but it is unlikely. The price point is not high enough to make it worthwhile for doctors to risk it. The real problem is that the government policy on organ and especially kidney transplants is half cocked. There are more than 100k renal failures in the country while the supply of cadavers is about a few thousands. I don't have the exact numbers right now but this is the range, something like 1 cadaver for every 1000 people with a failed kidney. Those who cannot get transplants have to wait on dialysis. In dialysis the blood in the cleaned thro an external machine. This requires at least one or two trips to a dialysis unit every week. It's expensive and basically eliminates the patient's options in moving about freely. There are home dialysis kits available but those require a level of hygiene which is difficult in most Indian homes. And again in the Indian context, being on dialysis for an extended length of time increases your risk of catching other diseases. You have to have a tube permanently stuck into your body (I think).

I too used to believe that selling organs for money is the pits, but when you come across the practical aspects of it, the sheer numbers overwhelm you.

Bottom line:
1. The cadaver program is a joke, there isn't enough supply to meet demand.
2. Dialysis is a short term solution.
3. What is needed is a solution that gives priority to the well being of patients and donors without getting myopic on the ethical aspects. Possibly rather than just hand out cash for kidneys the donor could be put in some mandatory self improvement program thats rigorously (ha!) enforced.

The problem is not simply one of brokers shafting the donors - there is a juggernaut of demand weighing down that requires reasoned response not just ethical fluffery. None of these guys will stop to think about the ethical aspect if it was their kidneys that was on the blink.

 

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