We are flooded with stories of Good Samaritans who save lives by donating their organs. Yet, unscrupulous elements have made organ trafficking an illegal industry even in Kerala. Even as the police crime branch launched an investigation into organ trafficking, we probe how common people are deceived by the organ mafia.

As 2019 dawned, the Pulloottu Fire Station Colony in Kodungallur near Thrissur was yet to recover from the impact of previous year’s flood. One of the residents, neck-deep in debt and struggling to make both ends meet, was visited by an agent from Marad in Kochi. The visitor had a preposition – sell a kidney for a handsome amount. The desperate resident agreed. He not only sold his own kidney but also persuaded his wife to sell hers too. The agent gladly returned. That was the beginning of a shocking kidney-shopping racket. The hidden deals were disclosed in a report Inspector General of Police S Sreejith submitted to the state police chief.

Every time the agent visited the colony, he convinced someone to sell their kidneys. The first one to sell the kidney for money himself turned into an agent. Their victims were mostly women buried under mountains of debt. They were offered handfuls of money and a carefree life thereafter. The agents even offered to manage the money for the women.

The agents also targeted nearby colonies including the Azheekode Tsunami Colony and the Eriyad Neethivilasam Colony. They harvested as many as 26 kidneys from the three colonies, the police have found out.

The police also found out that only the first two donors were given Rs 10 lakh each as promised. That was a strategic investment to lure in more victims. The later donors received no more than Rs 3 lakhs, including expenses related to their hospital stay. The hapless women could not even raise a complaint because the entire operation was so secretive. They had told the others that they had gone to the hospital to remove a tumour in the uterus.

The toxic smile

A 50-year-old civil police officer attached to the crime branch in Ernakulam was admitted to a private hospital in Kochi with a liver disease. He was told that the only remedy was liver transplantation. Though some of the relatives volunteered, there were no matches.

As the policeman’s wife sat dejected in the hospital hall, she was accosted by a man who said that his relative had undergone a similar situation. He also said that he was helped by another man to find a matching piece of liver. The small talk proceeded to a deal. The stranger asked for Rs 25 lakh for the liver but the price was later negotiated to Rs 22 lakh. Rs 5 lakh was given in advance.

The donor was a woman from Alappuzha. The transplant was delayed for a variety of reasons. Meanwhile, the patient was infected with the coronavirus. He died on October 4, ahead of the surgery. The advance amount of Rs 5 lakh was never returned. The ordeal was narrated by the cop’s colleague.

Tricky situation

The police are handicapped in investigating complaints of organ trafficking because organ donation is normally based on concerns for a fellow being’s life. The police have to arraign the organ donors and receivers to reach the agents running the racket. Legally valid documentation is hard to find. With little chances of getting hold of the agents, the police wouldn’t want to put organ donors and receivers into further hardship.

Though the present crime branch probe faces the same challenges, the sleuths are planning to target only the middlemen. There were instances when the donor was promised Rs 25 lakh and given only less than Rs 5 lakh. The patient who received the organ, however, has paid Rs 25 lakh.

The most sought after organ in the shady market is kidney. Naturally, most of the fraud centres around kidney donation.

The kidney market

The trafficking gang starts its work by laying the trap. The mafia members, mostly women, roam around nephrology wards and dialysis units looking for patients. They take the patients and their bystanders into confidence before offering to arrange a kidney. The relatives and well-wishers of the patient raise the amount somehow through donations and debts. The racketeers even source details of kidney patients from the hospital. All they have to do is to bargain with them.

Simultaneously, the agents go to slums and colonies of poor people. They would persuade the poor people to sell kidneys. Once somebody in the colony sells a kidney and receives a handsome amount, the news is spread fast in the locality. The agents' job is made easier. Other people who are in dire straits would also offer to sell their kidneys. The agents might even give Rs 1 lakh or Rs 2 lakh in advance to build trust.

Once the agents have found a needy patient and a willing donor, they take the donor to a hospital for examination. Once the kidney is found acceptable in cross-matching, a full-body check-up follows. If the donor's kidney is no match, it is tried for a match against another needy patient.

A transplant can be done only after preparing about 20 documents. One of them is a certificate from the local deputy superintendent of police that the donor has no criminal antecedent and has no monetary interest in donating a kidney. The local people’s representative has to certify the relation between the donor and the recipient. The agents are so enterprising that they can conjure up fake documents to establish these connections.

The donor and two close relatives have to appear before a board in a medical college along with the recipient and a relative to rule out any foul play. In practice, the recipient is seldom produced before the board because they would be bedridden. The donor and the witnesses are often tutored by the agents to put up a show of charity before the board. Most cases are approved because the paperwork would be in order.

Once the permission is granted, the transplant is done without delay. The agent would give the donor the rest of the promised amount. The money is never transferred to a bank account to avoid any traces in case the transplant comes under scrutiny later. At this stage, the agent just disappears. The donor is left to tend for themselves no matter whatever complication arises from the donation.

How to keep agents at bay

Paul Komban has a sure recipe to ward off organ traffickers. The resident of Pang near Thrissur has been living with his younger brother’s kidney for 32 years. When Paul was diagnosed with a failed kidney, his brother, sister and mother-in-law volunteered to donate one of their kidneys. Kidney transplants were rare in Kerala those days. The cross-matching and transplant was held in the Vellore medical college in Tamil Nadu in January 1989.

The brothers lead perfect lives. They believe that they are without any complications because they share the bloodline. They say that the only way to stop organ trafficking is relatives volunteering to donate organs for their loved ones.

Lyricist Beeyar Prasad has a similar story to share. He received a transplanted kidney at a Kochi hospital in October 2019.

(Reporting by Jayan Menon, Santhosh John Thooval, A S Ullas, S V Rajesh, Vinod Gopi; Compiled by Jaison Parakkatt)