In Afghanistan, the business of raising kidneys for the poor continues

 

HERAT, Afghanistan – Amidst the hustle and bustle of beggars and patients outside the crowded hospital here, sellers and buyers look at each other: the poor, begging for cash for their vital organs, and the critically ill or their surgeons. Are looking for Buy.

Illegal kidney trafficking is on the rise in the western city of Herat, fueled by sprawling slums, surrounding poverty and never-ending war, a business hospital that calls itself the country’s first kidney transplant center. And organs and doctors who keep an eye on organ trafficking.

In Afghanistan, as in most countries, the sale and purchase of organs is illegal, as are the procurement of organs by physicians. But the process is a worldwide problem, especially when it comes to the kidneys, as most donors can only live with one.

“These people need money,” said Ahmad Zain Faqiri, a teacher looking for a kidney for his critically ill father outside Luqman Hakeem Hospital. William Ahmed, a 21-year-old man who had heard of the kidney market and was looking to sell it after the harvest failed, had tears in his eyes.

The consequences will be serious. Poor kidney sellers, who rehabilitate sprayed paint and concrete floor apartments in Herat, temporarily get rid of the crushing debt but are too weak to work, in distress and unable to afford medicine, the agreement said. There is a center of new anxiety. At one such residence, a half-sack of flour and a modest container of rice were the only food for a family of eight last week.

For Luqman Hakeem Hospital, transplant is a big business. Officials are proud to have performed more than 1,000 kidney transplants in five years, bringing patients from all over Afghanistan and around the world. It offers them a bargain basement operation in the twentieth century at the cost of a similar procedure in the United States, in a city with a seemingly endless supply of fresh organs.

Asked if the hospital had made good money from the operation, senior finance manager Masood Ghafoori said: “You can say that.”

The hospital handles the removal, transplant and initial rehabilitation of both patients without question. Vendors say their hospital fees come from buyers, and a few days later in the recovery ward, they are sent home.

Doctors say how the donor is persuaded to agree with the organ recipient is not a hospital concern.

“This is not our business,” said Dr. Farid Ahmad Ijaz, a hospital physician whose business card reads “Founder of Kidney Transplantation in Afghanistan.”

Dr Ijaz first claimed that more than a dozen poor Herat residents were lying when they told the Times that they were selling their kidneys for cash. He later admitted that he “probably” was not. Interviews with other health department officials followed the same arc: initial denials, followed by a confession complaint.

Dr. Mehdi Hadid, a member of the Herat Provincial Council, said, “Everything in Afghanistan has a value except human life.

According to the United Nations, India has accounted for organ sales since the 1980s, and today the process accounts for about 10% of global transplants. Iran is the only country less than 80 miles from Herat where the sale of kidneys is not illegal, as long as the parties are Iranian.

Asif Afrat, a faculty member at Israel’s Interdisciplinary Center Herzliya, said: “There is always a difference between what international guidelines and governments do in practice, pointing out that Afghanistan belongs to these countries. There is a new player in the competition where the member of the trade is most useful: China, Pakistan and the Philippines. He said, “The current international consensus is against the ban, but the governments have the privilege not to follow it. ۔ “

The moral turmoil that has kept business elsewhere underground is hardly evident in Herat. Dr. Ijaz and health officials point to the strict logic of poverty. “People in Afghanistan sell their sons and daughters for money. How can you compare that to selling a kidney? He asked. “We have to do this because someone is dying.”

Dr. Ijaz was shocked when he showed the business card of a kidney “broker”, saying, “In Afghanistan, you people get business cards for killing others.”

On the fourth floor of the hospital, three of the four patients who recovered said they had bought their kidneys.

“I’m fine now,” said Imam Gulabuddin, 36, who received a kidney from Kabul. “No problem.” He said he paid about $ 3,500 for his kidney, which he bought from a “complete stranger” and paid 80% to the broker. He got a good deal: the kidneys can cost up to 500 4,500.

“If there is a consensus, Islam has no problem with that,” Gulabuddin said.

Dr. Abdul Hakim Tamana, director of public health in Herat Province, acknowledged the rise of the kidney black market in Afghanistan, but said the government could do little.

“Unfortunately, this is common in poor countries,” he said. “There is a lack of rule of law, and a lack of rules and regulations for this process.”

According to the World Bank, Afghanistan’s poverty rate was expected to reach more than 70 percent by 2020, and the country is heavily dependent on foreign aid. Domestic revenues finance about half of the government’s budget. Without a strong net of public safety, healthcare is just another opportunity to exploit the country’s weakest.

In the dark depths of the sandy streets of Herat’s slums, Mir Gul Atai, 28, regrets every other decision he made to sell his kidneys. A construction worker who made 5 a day before his operation last November has now failed to raise more than پا 10, and can barely afford it.

“I’m in trouble, and I’m weak,” he said. “I’ve been sick, and I can’t control my urination.” Four children lay naked in front of him on the concrete floor in the room. He said he supports 13 family members in all, and has accumulated a debt of about 000 4,000,000.

“It was difficult, but I had no choice. No one wants to hand over a part of their body to anyone else. It was very embarrassing for me.”

For your kidneys, Mr. , Mr. Atai received 83,800. That was barely three months ago. He is still in debt, unable to pay his rent or electricity bill.

He said he “feels sad, frustrated, angry and lonely.” One night he was in severe pain, hitting his head against a wall and breaking his skull.

Other people around Herat cited similar reasons for selling kidneys: arrears, sick parents, a marriage that would be unbearable.

“My father would have died if we hadn’t sold,” said Jamila Jamshidi, 25, sitting on the floor with her 18-year-old brother, Ameed, in a Farjida apartment on the outskirts of the city. They both sold their kidneys – he, five years ago, and he, a year ago – and both were weak and in pain.

In the mud-walled camp just outside Herat, the sun, wind and mud straw, full of war refugees from the neighboring province, tribal elders in white turbans, Mohammad Zaman and Luqman Hakeem talked about the unexpected attraction of kidney surgery. More than 20 people from his village, who are now chasing homes, have sold their kidneys.

“My people are hungry. We don’t have land. We can’t be shopkeepers. We don’t have money. I can’t stop it.”

At a local restaurant, five brothers talked about being forcibly snatched from their land in Badghis Province by repeated Taliban attacks. In Herat, everyone sold their kidneys. The youngest was 18 years old, 32 years old.

“We had no choice,” said one brother, Abdul Samir. “We were forced to sell. Otherwise we would not have sold fingernails.”

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