Desperation spurs illegal kidney trade in Jordan

A thriving black market that targets the poor is propelled by growing instances of kidney failure and a lack of genuine donors.

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AMMAN // Although it has been six years since "Mohammed" sold his kidney for US$3,000 (Dh11,010), there is not a moment that he does not regret what he did. "It started out as a bit of fun when two of my friends took me to Baghdad for a holiday. When we got there, they told me that they had sold their kidneys, and they were in good health and made money.

"The Lebanese broker there told me that my left kidney was not working anyway, so why not sell it," said Mohammed, 28, asking that his real name not be used as organ trafficking is illegal in Jordan. Jordanian laws only allow organ donations from first- and second-degree relatives, including spouses, and from patients considered brain-dead. Those found selling their organs either in Jordan or abroad face a prison sentence of up to one year and a $15,000 fine.

"I regret it. I feel fatigue, and since the operation, I have developed an allergy. It wasn't like that before. Besides, the money was spent quickly," he said. Mohammed dropped out of school in his early teens and spent much of the remaining years in and out of prison for street fights. But, after his operation, he changed, his mother said. Five months ago, he talked five of his friends out of going to Egypt to sell their kidneys.

"I told them 'tomorrow you will regret it. You will be tired all the time and the money will soon evaporate'." Jordan is battling a thriving black market trade in kidneys, fuelled by growing instances of kidney failure and a lack of genuine donors. The dangers of the trade were brought to light last month when the government said that over the past three years, 35 people had died in kidney transplants, many of whom had sold their organs.

Last year, 81 cases of illegal organ trafficking were uncovered in Jordan, and several middlemen and medical service providers arrested, however, the vast majority are now free due to the lack of evidence. Also last year, authorities foiled three illegal transplant attempts after investigations revealed the sellers and recipients were not blood relatives. "We have noticed that there is an increase in the number of victims in the past three years who are lured into selling their kidneys outside Jordan," said Mu'men Hadidi, a spokesman for the National Commission to Promote Organ Donation.

"This is a serious problem, and it worries us. And what concerns us more is that there are people willing to sell their organs for money." Part of the problem is the growing demand for kidneys. The Jordan Society of Nephrology estimates that there are some 2,750 kidney failure patients undergoing dialysis in the country, costing the state $75 million annually. But with organ donation in Jordan not very common, the number of patients waiting for a kidney has been increasing.

"Illegal kidney trade is increasing as the number of patients with dialysis is growing between 250-300 cases a year, creating demand for kidney transplants," Mohammad Ghnaimat, the president of Jordan Society of Nephrology, said. "Kidney trafficking is not an easy problem to solve, because the brokers target the impoverished neighbourhoods, exploiting the needs of both; the patient who is in need of a kidney and seller who is desperate for money."

Poverty in Jordan stands at about 14.7 per cent, and rising inflation is pushing more people towards the poverty line, defined as living on $700 a year. A government survey, which studied 127 cases of kidney trade transactions in the past three years, showed that 90 per cent of those who sold their kidneys lived in absolute poverty, but with no criminal records. Patients pay an average of $20,000 for a kidney, while the seller gets about $3,000, although some times it is less as the broker will deduct travel expenses and medication.

The bulk of operations used to take place in Iraq, but since the US-lead invasion in 2003, brokers are sending young men to Pakistan, India and Egypt, where the laws are believed to be less stringent. However, many of the hospitals have poor hygiene and could result in complications for both the seller and the patients, doctors said. Abeer Ahmed recalls how her 65-year-old father was on dialysis two years ago for four months after he was diagnosed with kidney atrophy. He needed a kidney transplant, and his only option was to go to Germany, but there was a one-year waiting list. Her older brother turned to a broker in Jordan for a kidney.

"It was a hassle," said Ms Ahmed. "After a series of medical tests, the seventh seller had matching tissue with my dad." Two months after the kidney transplant in Egypt, Ms Ahmed's father died. "It wasn't clear if it was from the complications of the transplant or a viral infection he caught while undergoing dialysis in Egypt," Ms Ahmed said. It is a common sight for Dr Ghnaimat. "Both the patients and sellers come to me when there are complications. The sellers are regretful because they end up being cheated. They tell me their stories but refuse to give information about the brokers.

"When the seller and buyer are not related the chances of rejection are high, and then the buyer suffers from complications." "Every year an average of 900 people die in road accidents, and we could use their organs, but we still need more awareness to convince the families who lose their sons to donate them," said Dr Hadidi, who is also the director of the National Institute of Forensic Medicine.

The government is also working on a draft law that would criminalise doctors who perform illegal transplants inside and outside Jordan, where they could be tried in absentia or in Jordanian courts should they be brought to the country by Interpol. smaayeh@thenational.ae