Transplantation is the act of surgical removal of an organ from one person and placing it into another person. Transplantation is required to replace the failed or damaged organ of a person. Transplantation of human organs is considered to be a huge success in the field of medical science and technology. The first ever organ transplant was done in the year 1954 in Boston and it was a successful kidney transplant.

In India, the first kidney transplant was performed in the year 1971. Over the years gradually, the transplantation activities increased. The most commonly transplanted organs are the kidney, liver, lungs, pancreas, intestines and heart[1]. However, till now the number of patients desperately needing transplant outnumbers the number of donors available.

In India, many doctors have taken undue advantage of this scenario. Instead of creating awareness among people regarding organ donation, they started with illegal organ transplants and in that also illegal kidney transplant is most common because kidneys are the most in need. Many a times, there are even fake doctors who carry out these surgeries with fake medical certificate. Organ transplant trafficking is one of the fastest, but least reported crimes in India as well as in other countries and it has also been reported by the World Health Organization (WHO).

In India, the rough figures states that, there is a need of about 1.5 to 2 lakhs kidney transplants every year but only 8000 transplants actually happen[2]. So there is a huge gap between those who require the transplant and those who actually get it. Many people are losing their lives because of scarcity of organ donors. Mainly because of this difference in demand and supply, illegal kidney rackets are surging in the country.

There have been many cases where the kidneys are removed without the patient's consent. There have also been cases of kidney transplants which are done by kidnapping or abducting people. In some cases people agree to donate their kidneys just for the sake of money, as we all know there is no shortage of poor population in our country.

These organ traffickers convince such poor people to give up their kidney. But the worst part is these donors never receive the complete payment which they have been agreed upon to get on selling their kidney. [3]A kidney is generally sold for anything between Rs 70 lakh and Rs1 crore depending on how urgent the need is.

But the donor never gets more than Rs3 lakh. The rest of the amount is enjoyed by those who run the business, so a donor never receives his full payment. Around August 2018 which is fairly recent, a similar case related to this happened in Delhi. [4]A person named Vardhan was in a desperate need of money to pay for the operation of his two and a half year old child who was born with a hole in the heart.

So a friend of his suggested him to sell one of his kidneys and pay for his child's surgery from the money received by selling a kidney. He was supposed to get Rs2 lakh which was sufficient for his child's surgery and even for setting up a small shop for himself. But at the end, after removal of his kidney he was refused to be paid the agreed sum of money and because of which he also lost his kid. Similar to Vardhan, many people become the victim of these kidney rackets every year, in India.

During 80s and 90s, India was labelled as the 'Kidney Bazaar' of the world[5]. The kidney transplant rackets were so on the rise that by the 90s, nearly 100 transplants per month were being done in Mumbai alone. Mumbai had also become the preferred destination for international patients who were seeking paid kidney donors.

These patients were mainly from Arab countries[6]. Considering the increased rate of kidney scams and the other organ scams in general, the Government of India passed The Transplantation of Human Organs Act (THOA) in the year 1994. This Act made commercialization of organs a punishable offence and legalized the concept of brain death in India. The Act provides punishments under sections 18, 19 and 20 for those who are engaged in illegal organ transplant rackets.

The biggest kidney scandal of India known as Gurgaon Kidney scandal came to light in January 2008 when police arrested several people for running a kidney transplant racket in Gurgaon. Dr. Amit Kumar was the main offender who was arrested in Nepal on 7th February 2008.

His brother Jeevan Kumar with three more people were also involved in this scandal and one of them was a doctor. This kidney scandal was going on for around six to seven years at a local clinic in Gurgaon. They were taking the kidneys from poor people especially from Uttar Pradesh and they were being transplanted into the clients from United States, United Kingdom, Canada, Saudi Arabia and Greece. In 2013, a CBI court convicted five accused and both the doctors also got seven years rigorous imprisonment[7].

Conclusion:
So even after passing The Transplantation of Human Organs Act (THOA) in the year 1994, till date we here about different organ transplant rackets being exposed by police. The passing of an Act might have curbed these rackets to some extent but clearly that is not enough.

The real culprits are the middlemen, hospital staff and few doctors involved who are making money by doing such illegal activities. In order to make money they are exploiting poor population of our country and making their lives more miserable.

Recommendations:
In order to shut down these illegal rackets, stricter punishments should be imposed. The term of imprisonment along with fine specified in The Transplantation of Human Organs Act (THOA) should be increased as to make people understand about the grievous nature of this crime.

However, if there remains no gap between the demand and supply of kidneys i.e. if the kidneys become easily available for patients who are in need of a transplant then automatically these kidney rackets will shut down as their demand will decrease substantially. In order to make this change, the number of kidney donors must increase. In India, there are still a lot of superstitions and misconception relating to organ donation after a person is dead or after a person is declared brain dead.

Lack of awareness about organ donation is the main cause behind all of this. People should be made aware about the current scenario and the need for organ donation, via conducting awareness campaigns. If you could help someone even after your death, then that would be a gift of life and nothing is more precious than that.

Bibliography:
National Health Portal
News articles

• The Hindu
• The Print
• The Indian Express
• India Today

End-Notes:

1. Donation and Transplantation of Human Organs and Tissues, National Health Portal, https://www.nhp.gov.in/
2. Milan Sharma, Gulam Jeelani, India's organ crisis deepens, India Today (January 5, 2020 02:29 IST), https://www.indiatoday.in/mail-today/story/india-s-organ-crisis-deepens-1634029-2020-01-05
3. Bindu Shajan Perappadan, Saurabh Trivedi, The unravelling of a kidney racket, The Hindu (July 27, 2019 9:33 IST), https://www.thehindu.com/sci-tech/health/the-unravelling-of-a-kidney-racket/article28725737.ece
4. Bindu Shajan Perappadan, Saurabh Trivedi, The unravelling of a kidney racket, The Hindu (July 27, 2019 9:33 IST), https://www.thehindu.com/sci-tech/health/the-unravelling-of-a-kidney-racket/article28725737.ece
5. Dr. Ramesh Kumar, Kidney rackets in India: Where does the buck stops?, The Logical Indian (March 28, 2020 7:34 PM), https://thelogicalindian.com/story-feed/awareness/kidney-transplant-racket-20356?infinitescroll=1
6. Ramesh Kumar, How maximum city Mumbai became epicentre of illegal kidney trade with 100 transplants a month, ThePrint (January 19, 2020 4:09 PM IST), https://theprint.in/pageturner/excerpt/how-mumbai-became-epicentre-illegal-kidney-trade-with-100-transplants-month/351719/
7. Sakshi Dayal, Mahendar Singh Manral, How a rundown bungalow in Gurgaon was the nexus of a kidney racket 8 years ago, TheIndianEXPRESS (June 15, 2016 3:34 AM), https://indianexpress.com/article/cities/delhi/gurgaon-kidney-racket-bunglow-delhi-police-kingpin-2853526/
   
   Award Winning Article Is Written By: Ms.Neha Anil Joglekar
   

   Authentication No: SP36009521248-20-0921