Stolen Kidneys in India

Mohammad Salim Khan, 33, was squatting on a corner where unemployed day laborers congregate, looking for work, in the Uttar Pradesh town of Meerut, when a bearded man offered him a three-month job in Delhi that would pay about $3 a day. Khan jumped at the chance. But when he eventually reached Delhi, the promised job never materialized. Instead, Khan was taken to a house in Gurgaon where two men held him at gunpoint and knocked him out with an injection of sedatives. When he woke up hours later, he had a horrible pain in his abdomen, and a man in a surgical mask was leaning over him. "Your kidney has been removed," the man said. "Don't tell anyone after you leave here. Not your friends or family or relatives or anyone. If you say anything, one of our guys will find you and shoot you."

It sounds like a sci-fi movie or an urban legend. But Indian police, who broke into the house where Khan was being held not long after his surgery, say that organized gangs who steal, or buy, kidneys and other organs for illegal transplant operations are an all-too-common reality here, where some 320 million people survive on less than $1 a day. The authorities believe that this ring—which was allegedly run by a man calling himself Dr. Amit Kumar, though he was not a doctor of medicine—may have performed as many as 500 illegal transplants without being detected over the past eight or nine years. The criminal network apparenlty involved four doctors, five nurses, 20 paramedics, three private hospitals, 10 pathology clinics and five diagnostic centers, police believe, and drew patients from as far afield as the Canada, Greece and the United States. Authorities are trying to talk to U.S. patients who may be involved, saying the patients will not be in trouble and that they are only seeking further information on the doctors involved.

Christened "Dr. Horror" and "Dr. Dracula" by Indian tabloids, the man who allegedly ran the Gurgaon-based racket had been arrested on a similar charge in Mumbai in 1994, but police allege that he jumped bail, changed his name from Dr. Santosh Raut to Dr. Amit Kumar and set up a new operation in Delhi. His Gurgaon clinic was raided by the police in 2000, and police reportedly failed to investigate after television and newspaper exposes alleged that Kumar was performing illegal surgeries. "In the maximum number of these cases, they [the accused] are under trial for many years, and there are very few convictions," said Bhuwen Ribhu, a lawyer and activist who specializes in cases of human trafficking. "It is quite sad. Even when the person is arrested, he gets bail within three or four months and continues as he was doing before." Comparing this case to a 2006 scandal in which police ignored complaints from poor parents, allowing a serial child murderer to go on killing for months, Ribhu adds, "In most of these incidents, I'm sure the police [are] not even registering cases."

The Gurgaon ring was broken because a former victim who had joined the gang as a recruiter approached the police with his story, but a leak allowed Kumar to escape before the police raid, and despite a national and international manhunt he remains at large. So far, police have arrested only one of the four main doctors, as well as a nurse, cook, driver and other minor figures in the gang. However, officials suspect that several private hospitals in Delhi and its suburbs may have known about the illegal transplants—or at least have avoided asking too many questions. "Due to its scale, we believe more members of the Delhi medical fraternity must have been aware of what was going on," Gurgaon police commissioner Mahinder Lal told reporters.

Similar organ-theft rings have been unearthed across the country in the past. But if these estimates can be confirmed by testimony and evidence, this would be the largest illegal-transplant network uncovered to date in India—and even so it may be just a fraction of the cases.

"It is clear that a large number [of transplants] are not being documented within the system, which means that they are being done elsewhere," said Dr. Amit Verma, chief operating officer of a Delhi hospital run by Fortis Healthcare that is one of only a few institutions to use an independent screening committee to evaluate potential donors. "For a country of our size, and for the number of renal failures that we have, we should be doing at least a thousand times the number of transplants that we do officially." Indian surgeons perform 3,000-4,000 legally documented kidney transplants per year, in part because India has strict laws that mandate that organ donors must be close relatives to the recipient.

Those laws help create a huge gap between supply and demand, and illegal transplants go on because the legal system is ill-equipped—and some say unwilling—to deal with the problem. "Most of these cases are never reported," said Manjit Ahlawat, joint commissioner of the Gurgaon police. "The person who wants a kidney benefits, and the person whose kidney has been taken benefits, because he gets a lot of money, so nobody files a complaint." He believes that the three donors that the police found in Gurgaon were likely promised large sums of money—by their desperate standards—and in exchange for their organs. Now, they must claim that they were compelled by force, because otherwise they could be prosecuted as criminals. "If they admit that they did this willingly, they will be arrested, too," Ahlawat said.

Apart from evidence derived from the interrogation of suspects and five foreigners whom the police believe were waiting for transplants and the testimony of Khan and other men whose kidneys were allegedly stolen, the police recovered letters and e-mail messages from 48 foreigners inquiring about transplants from Dr. Kumar's office. According to Gurgaon police, touts canvassed Delhi and other cities to recruit donors, focusing on the poor and unemployed. Some were allegedly asked if they wanted to sell a kidney for $1,000 to $2,500.

Khan, an unemployed laborer who earns about $2 a day when he is lucky enough to find work, says that the offer of a steady job was simply too good to pass up, and even though he was kept waiting for almost two weeks in a house with a couple guys with rifles stationed outside it, he didn't complain because he was well fed and they promised he would be paid for his time. Only when the blood test was administered did he begin to catch on. "I asked why I needed a blood test, and one of the guys pointed his gun at me and told me not to ask pointless questions if I wanted to live," he said, casually leaning against the wall on the balcony outside the isolation ward at Gurgaon Civil Hospital. Lifting up his shirt, he reveals a puckered, 10-inch incision in his side, stitched together with broad exes of black surgical thread. "When I heard that my kidney had been removed, for a long time I was in shock," he reflects. Khan, who supports five children, his mother and two sisters, has no marketable skills, and doctors say that he will no longer be able to perform the backbreaking labor that he's used to doing. "I keep thinking about how I will live now." He says he received no payment for his kidney.

Naseem Mohammad, a 25-year-old laborer from Ahmedabad, in Gujarat, has a similar story. He was waiting for work at a labor market near the Old Delhi Railway Station when a man approached him with an offer for a three-month painting contract. He was taken to a house in Uttar Pradesh for two weeks, where his recruiters told him that they were waiting for a tender to be passed before the work could begin. "I didn't try to run, because I still thought I was going to get the job," he said outside the isolation ward. "Then one day they didn't give me anything to eat. They tested my blood. Then they gave me an injection. I asked them what was in it and why they were giving it to me, and they told me it was for my own good. Then I passed out." When he woke up, his kidney was gone. "I've gone before like this with people for 15-20 days work," he said. "Nothing like this has ever happened. Once I went to Mehrauli with a labor contractor to do road work. I didn't know this will happen. I'm in shock after this. What will I do?" He, too, says he received no money for his stolen organ.

Whether they volunteered and were cheated of their payoff or were drugged and robbed of their kidneys, there is no doubt Khan and Mohammed were victims of an inescapable, suffocating poverty that made them--like millions of others--vulnerable to all kinds of exploitation.

"They were easy prey," said Gurgaon deputy police commissioner Rakesh Arya.