- The Washington Times - Friday, December 1, 2006

JANDALA, Pakistan — Nassem Kausar has done it. So, she says, have her sister, six brothers, five sisters-in-law and two nephews.

Each has sold a kidney to an industry that has led Pakistan’s media to dub the country a “kidney bazaar.”

“We do this because of our poverty,” said Mrs. Kausar, who is in her 30s and lives with her family in Sultanpur Mor, a village in eastern Pakistan.

A kidney nets the donor $2,500, sometimes less than half that amount, while recipients — about 2,000 a year — pay $6,000 to $12,000, compared with $70,000 in neighboring China.

Critics blame an economic system that enmeshes farmers in chronic debt, forcing them to sell their kidneys, and say the trade should be banned. The government says it is taking action.

In the United States, donating kidneys for money is banned. But the Belgium-based International Society of Nephrology has suggested expanding the pool of kidney donors by legalizing payment of about $40,000 to donors.

Ban on sales urged

At least 20 transplant clinics exist in Pakistan, and 10 percent of the patients are foreigners, many from the Middle East and “one or two” from Europe, said Bakhsh Ali, a senior official at the Sindh Institute of Urology and Transplantation.

The institute, a free transplant clinic run jointly by the government and private organizations, has joined the call for banning the sale of kidneys.

The government has drafted legislation to “regulate” kidney transplants, monitor surgeries and “encourage family donors,” said Health Ministry official Athar Saeed Dil, who helped draft the proposed law.

He declined to say whether an outright ban is planned, but Mukhtar Hamid Shah, a prominent surgeon who opened a transplant center in 1979, said the government plans to outlaw donations for money by nonfamily members and to impose seven-year prison sentences on surgeons who break the law.

Surgeon against ban

Dr. Shah, a former army surgeon, opposes any ban. “We have no interest in whether or not a donor is a relative of the recipient. The patient should have life,” he said at his hospital in Rawalpindi, near the capital, Islamabad.

Dr. Ali of the Sindh Institute said donors need constant follow-up checks to keep their blood pressure and sugar under control and protect the remaining kidney. In Jandala, another eastern village, kidney donors said they received no follow-up care.

“I pant. I cannot run. I cannot pick up heavy things,” said Allah Yar, 50, a farmer who has suffered poor health for seven years since selling a kidney. The father of six said he needed to pay off a $3,000 loan to his landlord, but got only about $1,200 for his kidney, meaning he remains deep in debt.

Sitting nearby, Mohammed Akram, 22, a brick kiln worker, said he sold a kidney to pay off his father’s debt.

“I cannot work like I did before. I cannot walk. I cannot run,” said Mr. Akram. “I did this for my father, but destroyed myself.”

Postoperative trust eyed

Dr. Shah, the surgeon, said the government and transplant clinics should form a joint trust to give money to donors and give them postoperative care. Meanwhile, he said, he charges Pakistanis half what foreigners pay. Kidneys are not shipped abroad because Pakistan does not have any facility for storing and transporting them, he explained.

Ahmed Jama, 47, a Briton of Somali origin, was recuperating at Dr. Shah’s clinic after a transplant that cost him $10,000.

Describing his meeting with his donor, the former schoolteacher and father of six said: “I thanked him many times. I told him ‘you saved my life and starting from today, I feel as if we are brothers.’ ”

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