Illegal Organ Trade: Doctors played dubious role

[Clark]

http://www.thedailystar.net/newDesign/news-details.php?nid=219660

Illegal Organ Trade
Doctors played dubious role
They 'donated' livers out of poverty; now blame doctors for their sufferings
Emran Hossain and Kongkon Karmaker

Although he was tempted by the prospect of quickly overcoming his poverty, 20-year-old Mehdi Hasan was not sure whether it would be wise to sell a lobe of his liver until three doctors of LabAid told him it was safe to do so.

“Don't worry. The part of liver we cut off from you will grow back soon, in only three to four months,” one of them told Mehdi, a poor landless orphan from Bamongram of Joypurhat who earned a living by pulling a rickshaw van.

“It is safer to donate a liver than a kidney,” another doctor told him at the hospital, explaining, “When you give the liver, you give a part of it. But a kidney has to be given in full.”

What the doctors had told Mehdi that day was scientifically true. But for a donor to be in safe health, he must stay at least a fortnight in post-operative care to avoid contracting infectious diseases. After he is released from the hospital in a healthy condition, the donor must follow a regulated life for about six months, which is the period required for his liver to regenerate completely, doctors say.

For a kidney donor, the pre-conditions are even tougher. The kidney donors must follow a set of regulations and take some medication for the rest of their lives.

But given the realities in the country and the blatantly commercial manner in which organ traders lure poor and mostly illiterate people, neither the liver “donors”, nor the kidney “donors” are given the required medical care.

In fact, as soon as they are released from their post-operative facilities, they are on their own.

Mehdi and 100 others from Joypurhat, who had gone to various hospitals in the capital to sell their organs, have all now turned into health refugees.

The Daily Star met 10 such “donors”, who revealed that no one had warned them about post-operative complexities and all of them were released in a mere three to four days after the transplant surgery, when at least two weeks' rest is required. Four of them did not even face a doctor before going under the scalpel.

Most of the 10 “donors”, who have all donated kidneys, say that they can no longer do heavy work. Some complain of problems in discharging urine.

For Mehdi the problem is even more severe. He says that he can no longer pull rickshaw vans or do any other work. His belly has swollen abnormally and he feels pain all the time on the right side of his chest where the operation was done. He cannot breathe easily when he lies down.

“It hurts even when I am drinking water,” Mehdi said.

Mehdi's “donation” turned out to be of little significance as the recipient of his organ died less than a month after the transplant.

Mehdi is the fourth person to have undergone a liver transplant operation in the country. The first two liver transplants, which were carried out at Birdem Hospital, went well for both patients and donors.

The donor of the third operation, conducted at LabAid, died.

“Liver transplant is complex. But the death of a donor cannot be accepted in any transplant surgery,” said Prof AK Azad Khan, president of the Diabetic Association of Bangladesh.

“Kidney transplants are often done and are easy to do. Kidney donors should not face any physical complexities unless the kidney donor is physically unfit for the donation or post-transplant care is seriously hampered,” he added.

Mehdi's post-transplant care was indeed hampered.

“You have already recovered. Then what is the point of raising hospital bills?” Mehdi quoted his doctors as telling him twelve days after the 16-hour-long surgery.

“At that moment I could not even eat, let alone walk,” recalled Mehdi. Nevertheless, he was released immediately afterwards and taken to the home of his organ recipient.

For some inexplicable reason, the doctors discharged Mehdi without removing his stitches and without looking into his requirement of regular dressings.

Mehdi says that in such a condition he had to scale all the stairs up to the fourth-floor home of his organ recipient. He stayed there for another two weeks with the same bandage. Later, he was taken to the hospital to have the stitches removed before being sent to Joypurhat.

“Doctors in Bangladesh are butchers. In their full knowledge they endanger the lives of human beings only for money,” said a bitter Mehdi.

Estimates suggest that 1,000 kidney transplants have already taken place in the country.

Doctors usually dupe individuals into selling their kidneys through recourse to moral pretence, that is, by telling them that helping a dying man to survive is the noblest of all things to do.

Organ traders particularly target poor people in the villages of Joypurhat. Around 100 people have sold their kidneys in the last six years in that region. Depending on how the haggling went, each seller got between Tk 30,000 and Tk 2.5 lakh.

The affluent organ recipients, mostly patients with kidney failures, accuse brokers of cheating the “donors” since they pay the brokers between Tk 2 and Tk 3.5 lakh for a kidney.

Shaharul, who sold his kidney to a recipient at United Hospital, believes that in most cases doctors know that the organs are being bought and sold.

Mehdi says that he has observed doctors correcting mistakes in the fake identity documents prepared by brokers.

“Organs cannot be traded in packages. They require transplantation, man to man, involving doctors,” said F Karim, former investigation officer (IO) of the case filed in connection with luring people sell their organs from Joypurhat.

Investigation officer of the case has been changed after F Karim, who was also officer-in-charge of Kalai police station till October this year, has been transferred to railway police station in Ishwardi. The current IO is the current officer-in-charge of Kalai police station Mukhlesur Rahman.

A doctor receives around Tk 1 lakh for an operation. In private hospitals kidney transplant surgeries cost between Tk 5 and Tk 7 lakh and liver transplant Tk 30 lakh.