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Inhumanity of organ trade
 
By Imtiaz Gul

The News, 13 August 2007

Looking at the cases the Supreme Court is dealing with, one could comfortably say that the government as such has failed to address issues vital to the nation — health, environment, historical heritage —and every body is looking up to the apex court for relief. Claims of good governance, local government and service delivery appear to pale in the face of some harsh realities.

While in Karachi, President Pervez Musharraf finally conceded that only the Supreme Court could block his re-election bid. His own political associates like S M Zafar, IT minister Ishaq Khakwani and senior vice president Kabir Wasti are advising him to step down as army chief and put himself to the contest as a civilian candidate.

Political issues like the presidential re-election and missing people apart, the Supreme Court deserves credit on so many other counts, some of them simply going largely unnoticed because of their apolitical nature. The very first reprimand that the court threw at the government related to the draft law on prevention of illegal human organ transplants, which has been pending cabinet's approval.

The second admonition came on Aug 6, when the court gave the Punjab government a three-month deadline to remove encroachments around the Lahore Fort and other historical sites defacing the national heritage. Automobile tyre shops, kiosks as well as illegal houses have sprung up around the Lahore Fort, while similar intrusions have also disfigured the Shalimar Gardens.

Justice Chaudhry instructed other provinces also to cooperate with the Department of Archaeology and Museums, which had prepared a detailed report on the encroachments around monuments and remove the same.

As far back as in late 2005, the court also pre-empted the virtual pillage of priceless forests of Patriata, when it took notice of the proposed New Murree Project, and stayed work on it. This was the first severe blow that the court had delivered to an extremely influential coterie comprising property barons, generals and bureaucrats. It was this influence that even President Pervez Musharraf at a press conference had brushed aside criticism of the project saying "for the sake of trees we cannot stop development".

But Justice Chaudhry and his colleagues thought otherwise and annoyed the Punjab government by ordering it to stop work on the project.

On August 6, a division bench of the Supreme Court (SC) transferred a kidney transplant case to Islamabad, because the chief justice is already holding proceedings in a suo motu case against at least eight doctors for alleged involvement in the illegal business of human kidneys. The Supreme Court is likely to take a firm position on this inhuman practice but the suo motu proceedings fly in the face of the government.

Proposed legislation on organ trade, for instance, has been extremely slow; in March 2006, health minister Mohammad Naseer Khan had told a conference in Islamabad that "hundreds of Indians have also been flooding hospitals in Lahore for transplants. This illegal transplant tourism must be stopped to prevent exploitation of the poor," he had said, promising that the draft Cadaver Transplant law would soon be placed before the cabinet but the six dozen ministers had no time for this crucial bill until the Supreme Court breathed down their necks last week of July.

Two days after the admonition by the Supreme Court the cabinet approved the draft, which one only hopes can pass through the current parliament.

India, which used to be among six organ trafficking hotspots, not only banned the sale and purchase of organs in 2005 but also severely punished some doctors after enacting the brain-death and cadaver-organ laws, which has made the trade less lucrative. Pakistan, says an early August World Health Organisation report from Hong Kong, remains among the top five organ-trafficking hotspots besides China, Colombia, Egypt and the Philippines.

"Pakistan, where trade in human organs is not illegal, is turning into a "kidney bazaar", said the chief executive of Pakistan's Kidney Foundation, Jaffar Naqvi. According to 13 centres in Lahore alone reported more than 2,000 transplants last year from bought kidneys. The foundation said patients, mostly from Europe, Saudi Arabia and India, pay about 500,000 rupees for a new kidney, he said. Donors are paid $300 to $1,000 and often get no medical care after the surgery.

The foundation, however, left out Libya, where kidney failures are more frequent, and thus a very big number of Libyans does head to Pakistan for getting new kidneys bought off poor brick kiln workers in Faisalabad, Sargodha, and their vicinity. Investigations by the author at a few hospitals in Rawalpindi, Lahore and the places mentioned had yielded startling disclosures.

Officials in the Pakistani Embassy in the Libyan capital Tripoli had also sounded wary of several surgeons in Lahore and Rawalpindi who keep sending visa requests for their prospective Libyan patients. These revelations corroborated what I had seen at the compound of the Kidney Hospital on the outskirts of Rawalpindi; discussions with several Libyan nationals in the parking area revealed that they had actually come all the way for a transplant of their relatives against charges varying between 14000- 15000 dollars. This included the cost of the kidney as well.

Officials said the doctors/hospitals arrange for the kidney and then formally invite the patient, asking the embassy to issue visas. In areas like Kot Momin near Sargodha or Yazman near Bahawalpur or Sultanpur Mela in Bhalwal, almost every family has a member or two who has sold his or her kidney to retire the family debt.

Unscrupulous doctors running their own clinics/hospitals charge up to US$14,000 for single kidneys. We also met a Jordanian there plus sent in a German friend who was offered a kidney for up to 14000 Euros. Another Pakistani from Great Britain paid about 12,000 pound sterling for the transplant.

One wonders as to whether a cadaver transplant law alone could control this inhuman practice wherein the donor is condemned to life-time misery because of absence of proper medical care. Also, the ruling elite's preoccupation with its own survival leaves little hope for those affected by inhuman and illegal practices. For how long can the Supreme Court shoulder a responsibility that is the exclusive domain of dozens of state institutions?

(The author heads the independent Centre for Research and Security Studies, Islamabad.

Email: imtiaz@crss.pk