ORGAN trafficking is, in essence, a crime against society. Preying on the despair of the poorest of the poor, it is a self-perpetuating cycle and further deepens social inequities. A report in this newspaper yesterday exposed the various players — the doctors, the police and the middlemen — who are part and parcel of the lucrative business, and the impunity with which they have thus far operated. This, despite the fact that the Transplantation of Human Organs and Tissues Ordinance, 2007, followed by parliamentary legislation in 2010, specifically criminalised the practice. In October 2016, after shocking reports emerged of 24 people being detained for weeks in a building in Rawalpindi so that doctors at the city’s Kidney Centre could harvest their organs, a comprehensive crackdown against the mafias that sustain the racket seemed inevitable. That, however, would have meant discounting the role that connections — social, political and institutional — play in Pakistan when justice is at stake, particularly when one side is manifestly powerless. As the report illustrated, the cases filed against the accused doctors, as well as the ongoing suo motu action at the Supreme Court on the organ trafficking issue, have not deterred others involved in this criminality.

Read: Organ trafficking: doctors, police and middlemen

What makes organ trafficking all the more reprehensible is that the offending doctors cloak their actions in the garb of social service. In reality, it is pure and simple skullduggery, fuelled by greed and a breathtaking contempt for humanity. Certainly, it is true there is a dire shortage of organs for those who need them, and their yearning for restored health is understandable. Nevertheless, that need cannot — must not — be met by exploiting the most disadvantaged amongst us. This is not a situation to which market forces of supply and demand, in the ordinary sense of the term, apply. Those driven by circumstances to offer their organs for sale — let alone those who are duped into parting with their kidneys — cannot be considered autonomous actors with freedom of choice. Moreover it is an unequal, one-way exchange: if the impoverished organ vendor’s remaining kidney fails — a reasonable possibility given his less than optimal health plus the lack of post-operative care he receives — will anyone from a (usually privileged) kidney recipient’s family step forward to offer him his kidney for free?

The answer to the apparent conundrum lies in deceased organ donation, practised in many parts of the world, including several Muslim countries. The provincial governments here should proactively promote this procedure which can, to an extent, meet the requirement for organs as well as address the reasons for the prevalence of kidney disease in Pakistan. But first they must ensure that those involved in the illegal organ trade are punished without fear or favour. As long as organs can be purchased on the market, the efforts of those trying to promote ethical transplantation and deceased organ donation will always be undermined.

Published in Dawn, January 17th, 2017