February 04, 2007	Sunday	Muharram 15, 1428

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LAHORE, Feb 3: The spectre of illegal kidney transplantation and subsequent trade has once again raised its head after a brief gap that was effected by the Supreme Court’s intervention, it is learnt.

The Punjab government, too, was stirred into action when the apex court took cognizance of the alarming increase in illegal kidney transplantation and sought a complete ban on the practice through legislation.

The health department authorities directed all principals and medical superintendents of autonomous medical institutions, deans and heads of special institutions, Director General Health Services (Punjab), EDO (health) and MS’ of DHQ and THQ hospitals to report to the IGP if they find transplantation and sale of kidneys anywhere.

Sources told Dawn that the nasty business, which was being carried out in private health facilities, was immediately stopped when the health department issued the instructions and warned the wrongdoers of police action.

However, they said, the illegal practice had resumed in many private hospitals in Lahore in particular and all over the province in general.

A senior urological surgeon, on the request of anonymity, shared with Dawn that the private hospitals had now started charging higher fees compared to their regular kidney transplantation charges on the pretext that “there is strict monitoring and the operations are being conducted under the constant fear of police action”.

He said in response to a question a private hospital had also called him to perform kidney transplantations the cases of which had been piling up for the last few weeks. “When I asked the hospital management why it didn’t call its regular surgeon, the management answered that the surgeon had asked for very high fees,” he revealed.

Many other urological surgeons said no urologist was willing to complain about the illegal practice as directed by the health department for fear of reaction of the culprits. They minced no words revealing that the surgeons who were involved in illegal kidney transplantation were earning up to Rs200,000 daily.

Some urologists, however, suggested that the police along with journalists should visit different private hospitals which had earned notoriety for their involvement in this business, and check out the actual situation. They said the inspectors could find patients who were kept in hospitals for post-operative care.

It is pertinent to mention that there is currently no legislation on organ transplant in the country. The federal government had submitted before the Supreme Court that a draft law had been prepared and an ordinance to check the illegal kidney transplantation would be promulgated by Prime Minister Shaukat Aziz.

Urologists this correspondent talked to also claimed that a draft cadaveric law was lying with the Senate for the last one decade. At an international urological surgeons conference organised by the Pakistan Association of Urological Surgeons in February 2005, according to them, Senate chairman Mohammadmian Soomro had said a bill on transplantation of human organs had been cleared by the National Assembly standing committee and would soon be presented before parliament.

However, they said, no headway was made in enacting the law until the Supreme Court took notice of the situation.

Meanwhile, the provincial health department had also informed all those concerned that the organs were being transplanted without any regulatory control and there was a strong need for preparing and implementing a regulatory mechanism or policy.

In a letter it issued to the officials concerned, it made a mention of several stories that had been circulating in the foreign press regarding “transplant tourism” in Pakistan wherein it had been alleged that there was a racket involved in the trade. It also said Pakistan had been dubbed as a “kidney bazaar” where cheap kidneys were available in abundance for as low as Rs100,000.

It said this racket highlighted not only the illegal practice of selling kidneys, but also carrying out transplants without even certifying the antecedents of the donors.

However, the letter said, owing to lack of appropriate regulatory mechanisms in the absence of an enabling legislation on the subject, certain unethical practices had emerged to the detriment of patients, particularly the poor ones. It said the incidents of kidney selling by the poorest of the poor were on the rise and patients from certain developed countries visited Pakistan to purchase organs for transplantation at local kidney centres.

The health department admitted that the situation had risen to such an alarming level that it had become imperative to put in place an effective regulatory mechanism to curb this menace and exploitation.