Pakistani men reveal the scars where their kidneys were removed at a police station in Lahore. Photo: AFP / Arif Ali

Last month, Pakistan’s federal investigation agency (FIA) busted a gang involved in trading human organs. Dozens of doctors, agents and suppliers who had made significant sums of money in the illegal sale and transplantation of kidneys and other human parts were arrested.

On a tip-off, the agency then raided a hotel in Pakistan’s summer resort, Murree, on May 11, apprehending the gang’s main “ringleader” along with three of his accomplices.

Punjab’s Chief Minister Punjab, Shahbaz Sharif, subsequently ordered a major clampdown on the illegal kidney trade, saying “these elements do not deserve leniency.”

A handful of arrests and noises from politicians about reining in the trade fail to reckon with it scale, however. Pakistan is a hub for the illegal organ trade, with clients from all over the world driving demand. Plagued by poverty, many in Pakistan – particularly in Punjab – resort to selling their organs to pay off high-interest debts, fund small-scale startups or even solemnize marriages. Their desperation ensures a steady supply of organs for prospective local and foreign customers, with middlemen fetching hefty sums after paying donors a pittance. Surgeons and clandestine operating centers also take their share.

In October of last year, a Standing Committee in Pakistan’s National Assembly made the shocking disclosure that 85% of the world’s illicit trade in kidneys revolves from Pakistan. The committee’s report also showed that prominent politicians and big private hospitals were hand-in-glove with the criminal traffickers, buyers, financiers, and facilitators of this vile business.

Arguing for new legislation, the committee proposed a penalty of US$ 0.4 million on hospitals involved in organ trafficking. Since then, nothing has happened: legislators and influential surgeons quickly shelved the report’s findings.

Last August, the Supreme Court took suo moto notice of a letter written by Dr Adib Rizvi of the Sindh Institute of Urology and Transplantation (SIUT), in which he had said that “transplant tourism” was earning Pakistan a bad name. Dr Rizvi cited Rawalpindi’s Kidney Centre, also known as Al-Sayed Hospital, as a major offender and reproduced emails from overseas urologists to support his claim.

“I had learned from my neighbors that most of the people of Kot Momin have sold their kidneys but I was reluctant and apprehensive of the consequences. I told nobody in the family I will sell my kidney”

To grasp the extent of the toll the organ trade has taken on Pakistan’s poor,  one need only visit the village of Kot Momin, 216 kilometers from Islamabad. Here, every third person has sold a kidney, in most instances to settle debts with local landlords who own the citrus orchards on which they toil from dawn to dusk for the paltriest of sums.

Azmat Bibi, who is 40 and a mother of six, lives in a muddy one-roomed house in the middle of one such orchard. She is gloomy and lacking in vitality – and it’s not difficult to understand why. She and her husband earn around US$150 a month, but half of that sum is paid to Mian Zahoor, their landlord. Struggling to make ends meet, they asked him for a loan, which accumulated over time to about US$800. Eventually, Azmat decided to dispose of her kidney to pay off the family’s debts.

“I had learned from my neighbors that most of the people of Kot Momin have sold their kidneys but I was reluctant and apprehensive of the consequences,” she told Asia Times. “I told nobody in the family I will sell my kidney.”

A middleman named Khalid arranged for her to visit a kidney center in Rawalpindi. The operation took three hours. Azmat was discharged from the hospital a week later but her wounds took two months to heal. “I had severe pain in my other kidney and needed treatment but I can’t afford the treatment,” she said in a choked voice. She was paid US$1,000 for the kidney but an agent deducted US$100 that sum.

Zaffar Iqbal, 40, is self-styled president of Kot Momin’s Anti Kidney Sale Association. He claims to possess documents relating to 440 people who sold their kidneys in the local area alone. He himself sold a kidney in 2004 for US$900. “If the figures from Bhalwal, Jalal Pur Jattan, Gujranwala, Sargodha and other districts of Punjab province are compiled, the mark could go up to thousands,” he says.

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