Health Minister KKSSR Ramachandran

This afternoon I attended a meeting held by the government of Tamil Nadu that was meant to be the beginning of an official response to the kidney racket. In the last thirteen years thousands of kidney have been sold on the black market with the tacit approval of the ethics board that is charged with monitoring organ transplants. A month ago I wrote a story for Wired News where a member of the ethics committee admitted to knowingly authorizing illegal transplants through brokers.

The meeting today was meant to be a step forward out of a ethical murkiness of organ transplants and call together a wide array of doctors, NGO-wallas and ethical savants for their opinions on live-donor transplants and the solutions that might lie ahead. But intentions are not everything.

“The kidney rackets have been operating in this community for a long time. . .90% of the donors we know about come from below the poverty line, and 90% of those donate for money,” said V.K. Subburaj Deputy Secretary of Health and Family Welfare during his inaugural address.

From a statement like that it would follow that the attendees charged with formulating Tamil Nadu’s future policy would decide to get tough on organ donations and look for positive solutions through cadavers.

Yet when K.K.S.S.R. Ramachandran, the minister of health, asked for people to introduce themselves from the audience, it soon became apparent that the agenda for the meeting was actually being set by the kidney brokers. Just about all of the doctors who came are currently under investigation by the police for assisting in illegal kidney transplants. Representatives from hospitals in Madurai, Coiambatore, Chennai and Trichy that have all been outed in the media for working closely with brokers sat self-satisfied in their easy chairs waiting for their chance to influence policy.

The most obvious among them was Dr. K.C. Reddy of Devaki Hospital–who allowed a broker named Dhanalakshmi to operate for years outside his hospital and in the past has been a vocal proponent of live-donor donations. He was practically jovial. Though he wouldn’t say a word to me.

When the opening remarks were over the press was kicked out and the doctors began to discuss their recommendations in private.

It was like putting the inmates in charge of the prison. The very people who were implicated in creating the organ racket in the first place were allowed to chart the course for the future. Allowed to set the clock backwards and make it seem like all their illegal actions over the last dozen years were actually for the best.

So it was no shock when the results came in and the doctors had reached a consensus that 1) Live unrelated donor transplants should be legal and that people should be allowed to buy and sell kidneys on the market. 2) Foreigners should be allowed to buy organs in India, but need to seek approval from the committee 3) All of the committee’s authorization decisions should be final and not open to appeal 4) Members of the ethics board in charge of overseeing that the system is not abused cannot be held accountable for coercion between brokers over donors or forged documents. And, to put it in the speakers own words, “should not be harassed by the police or press”.

So lets just throw transparency out the window and start an open-air-organ bazaar in Nungabakkam why don’t we. If the committee’s statements get taken up by the government (which is a real possibility) then we can look forward to thousands of completely above the board organ thefts. There were no stipulations to properly look after the rights of the people donating kidneys (except for one proposal for 5-10 years of free health insurance) and no mention of brokers at all.

But some people, thankfully, were not completely taken in by the committee’s organ mafia. V.K. Subburaj said that there was still need for further debate, and that cadaver donations were still the only real option. The same went for members of the MOHAN Foundation, who have organized 200 cadaver donations in the last three years.

To top it off, no people from the press were permitted to ask questions or attend the closed door sessions with the gang of doctor-criminals discussing how to divide the spoils if the laws change.

At this point it is in the hands of K.K.S.S.R Ramachandran ,the health minister, a DMK appointee who’s claim to the ministerhood seems to rely on his loyalty to the party and an incident in his past when he was burned by acid during a political rally. I don’t know much about Ramachandran except that he has endorsed cadaver programs in the past and that he doesn’t speak much English. Though one quote that he said during the meeting (which was translated for me) ran a chill though my veins:

“If there was a situation today where I needed a kidney I am sure that my son wouldn’t offer up his own, instead he would say that he would pay any price for one.”

And the price today is the blood of the poor.

Before he left a reporter from the Hindu asked if he would prosecute hospitals that had preformed illegal transplants. He said he would when the investigation turned up evidence. So far, it seems, he hasn’t looked very hard.