Living in pieces

JUST what compels someone to turn the body into a commodity, selling it piece by piece to stay alive, will perhaps always be subject to conjecture; or to the countless forces of the human condition. Legislation, although mandatory and much hailed, is only a part of the answer. Two alarming incidents in the region have brought the grave issue of organ trade into sharp focus yet again, making claims by the authorities that the practice had been stamped out ring sadly hollow.

Last month, Amit Kumar, dubbed ‘Doctor Kidney,’ dealt quite a blow to India’s efforts to purge itself of the tag of an organ farm with possibly the highest rate of organ tourism and trade, when he was arrested for running a substantial live kidney racket that stretched to other countries. An outcry was also raised here in Pakistan when the shocking tale of Musarrat Bibi, 23, was published in this paper last week.

The young woman has accused her husband Mukhtar Ahmed of forcing her to sell one of her kidneys to compensate for the bride price of Rs140,000 that he paid her father at the time of their marriage in 2001. Eight torturous years and three children followed this heinous ‘contract,’ after which her father divorced her mother and absconded with the money.

However, Musarrat’s breaking point was what is inconceivable for most: Mukhtar kidnapped her brother to force her into a kidney removal procedure. He later exchanged her brother for her kidney and sold it for Rs150,000. Although she managed to flee Hafizabad with her children and reach her mother in Karachi, Musarrat failed to escape her ordeal — Mukhtar located her in the city and took two of their children back with him.

A range of issues such as insufficient nutrition, a shoddy living environment, polluted basic amenities such as water and a variety of viral infections set the stage for a perfect target. And as in Musarrat Bibi’s case, it was her gender that made her particularly susceptible to brutal coercion.

Although the Transplantation of Human Organs and Tissues Ordinance, 2007, is seen by doctors and civil society as a promise of a new lease of life to kidney failure patients, eradication of the abusive organ business that plagues the country and its medical institutions must remain its primary aim. More importantly, the law is not less than a godsend for hapless victims as it recognises that some are helpless to the point of sacrificing their physical integrity.

However, it is pertinent to mention that Musarrat Bibi’s kidney was taken out before the ordinance was promulgated in September, 2007. But though the ordinance may be a result of an arduous 15-year battle, it still has a long way to go before it becomes a fully implemented act that can come down hard on Mukhtar Ahmed and his ilk, as it prescribes severe penalties to violators.

When put into complete execution, it can keep a check on the transplant tourism underworld with evaluation teams that monitor transplantation cases to ensure that commercialism becomes a past demon. These groups are crucial to the edict to prevent corrupt, inhuman elements from dodging laws and keep non-related living donors from becoming easy prey.

However, a dramatic drop in statistics — from the dark days of 1991 when as many as 75 per cent of kidney transplants in Pakistan were from live, related donors to the present day, when proportions stand almost reversed — must be applauded.

We may bear the ignominy of being an organ tourism hub but mercifully, we are still far from China, where in the eighties and part of the nineties, prisoners on death row made for an open buffet for organ traders. Those who have lived to tell the morbid tale recount instances of fellow inmates being prepared for organ removal against their will.

What many among us like Musarrat have in common with such prisoners is that choice is never an option. The greatest challenge for lawmakers lies in overcoming the curse of cold-blooded, calculated consent, which we have in abundance.