In Afghanistan, a Booming Kidney Trade Preys on the Poor

HERAT, Afghanistan – Amidst the bustle of beggars and patients outside a crowded hospital, there are sellers and buyers, wary eyes on each other: the poor, demanding cash for their vital organs, and the critically ill Or buy in search of your surrogates.

The illegal kidney business is booming in the western city of Herat, spread across slums, surrounding land poverty and growing war, an enterprising hospital that advertises itself as the country’s first kidney transplant center, And officers and doctors have turned a blind eye. Organ trafficking.

In Afghanistan, like most countries, the sale and purchase of organs is illegal, and therefore implantation of organs purchased by physicians. But the practice remains a problem worldwide, especially when it comes to kidneys, as most donors can live with just one.

“These people need money,” said Ahmed Zan Fakiri, a kidney-seeking teacher outside of Lokman Hakim Hospital for his critically ill father. He was restlessly watched by a 21-year-old young farmer, Walim Ahmed, who had heard of the kidney market and was looking to sell after his crop had failed.

The consequences will be severe for him. For those with impaired kidney sales, who recover in the frizzles, peeling off the paint and concrete floors unlocks the apartment, temporarily delivered from a crushing debt, but weak at work. , In pain and unable to afford medicine, the deal is a portal to new misery. In one such accommodation, half a bag of flour and a modest container of rice were the only meals last week for a family of eight children.

For Lochman Hakim Hospital, transplants are big business. Officials claim that it has performed more than 1,000 kidney transplants in five years, attracting patients from all over Afghanistan and the global Afghan diaspora. It offers them the operation of one-city cellar cellars at the cost of such procedures in the United States, which supply fresh organs to a city.

Asked whether the hospital had earned good money from the operation, a senior finance manager, Masood Ghafuri, said: “You could have done that.”

The hospital handles both patients removal, transplantation and early recovery, without asking questions. Sellers say their hospital fees are covered by buyers, and after a few days in the recovery ward, they are sent home.

How the organ recipient gets the donor to agree to the procedure is not a hospital concern, doctors say.

Hospital physician Dr. Farid Ahmad Ejaz said, “It is not our business. In English” is the founder of kidney transplant. “

Dr. Ejaz said for the first time that more than a dozen poor Herat residents were lying when they told the Times of Cash to sell their kidneys. Later, he admitted that “maybe” they were not. Here the same arc followed in interviews with other health officials: initial refusal, followed by gratitude.

Members of the Provincial Council of Herat, Drs. Mahdi Hadid said, “Everything in Afghanistan has value except human life.”

Accounts of organ selling date in India in 1980s, According to the United Nations, And today the practice accounts for about 10 percent of all global transplants. Iran is the only country less than 80 miles from Herat, where it is not illegal to sell kidneys, unless the parties are Iranian.

Asif Efrat, a faculty member at the Interdisciplinary Center Herzliya, said, “There is always a difference between international guidelines and governments. A University of Israel says Afghanistan is a new player compared to the countries where organ trade takes place. Most More prevalent: China, Pakistan and the Philippines. “The current international consensus is in favor of prohibition, but governments have incentives not to abide by it,” he said.

The moral scrutiny that keeps the business underground elsewhere is rarely evident in Herat. Dr. Ejaz and health officials point to the harsh logic of poverty. “The people of Afghanistan sell their sons and daughters for money. How can you compare selling kidneys? ” He asked. “We have to do this because someone is dying.”

Dr. Ejaz was shown a kidney broker card when the broker said, “In Afghanistan, you guys get business cards to kill others.”

On the fourth floor of the hospital, three out of four patients in recovery said they had bought their kidneys.

A 36-year-old Imam from Kabul told Gulabuddin, who received the kidney, “I feel fine now.” “There is no pain.” He said he paid about $ 3,500 for his kidney, which was purchased with an $ 80 commission to the broker, a “complete stranger”. He got a good deal: Kidneys can cost $ 4,500.

“If there is agreement, Islam has no problem with this,” Gulabuddin said.

Director of Public Health of Herat Province, Drs. Abdul Hakim Tamanna acknowledged the rise of the black kidney market in Afghanistan, but said there was little the government could do.

“Unfortunately, it is common in poor countries,” he said. “There is a lack of rule of law, and a lack of regulation around this process.”

According to the World Bank, Afghanistan’s poverty rate was expected to reach 70 percent in 2020, and the country remains largely dependent on foreign aid; Domestic revenue finance is only about half of the government budget. Without any concrete public safety nets, health care is another opportunity to exploit the most vulnerable people in the country.

Deep inside 28-year-old sandy streets in the slums of Herat, Mir Gul Atae, 28, regrets every moment of his decision to sell his kidney. A construction worker who earned up to $ 5 a day before her operation last November is now unable to lift more than 10 pounds of weight, and barefoot.

“I’m in pain, and weak,” he said. “I’m sick, and I can’t control my urine.” Four children hid in front of him on the concrete floor in the bare unlit room. He said that he supports all 13 family members, and has accumulated a loan of some $ 4,000.

“It was difficult, but I had no choice. Nobody wants to give part of their body to someone else, ”he said. “It was very embarrassing for me.”

For his kidney, Mr. Atae received $ 3,800. That was barely three months ago. He is still in debt, unable to pay his rent or his electricity bill.

He said he felt “sadness, frustration, anger and loneliness”. One night he was in such severe pain, he beat his head against the wall and fractured his skull.

Others around Herat cited similar reasons for selling the kidney: outstanding debts, sick parents, a marriage that would otherwise have been unaffected.

Jameela Jamshidi, 25, said, “My father would have died if he were sitting on the floor with his 18-year-old brother Omid in an apartment on the edge of the city.” Both had sold their kidneys – that was five years earlier, and that, a year earlier – and both were weak and in pain.

In a mud-walled camp just outside Herat, a vortex of sun, wind, and dust filled with war refugees from a neighboring province, a tribal elder in a white turban, Mohammed Zaman, spoke of Lukman Hakim’s fascination for kidney operations. I talked More than 20 people from his village, who have now come out of their homes, have sold their kidneys.

“My people are hungry. We do not have land. We cannot be shopkeepers. We have not received any money. “I can’t stop it.”

At a local restaurant, the five brothers spoke of forcibly closing their land in Budgis province due to frequent Taliban attacks. In Herat, everyone had sold their kidneys. The youngest was 18, 32 years old.

“We had no choice,” said Abdul Sameer, one of the brothers. “We were forced to sell. Otherwise, we would not be selling a fingernail. “

Asad Timori and Kiana Hayeri contributed reporting.

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