Wealth, poverty propping up Pakistan’s illegal kidney trade

In this photograph taken on February 2, 2017, Maqsood Ahmed, who sold one of his kidneys, works at a wood workshop in Bhalwal in Sargodha District, in Pakistan's Punjab Province. Pakistan has long been an international hub for the illegal kidney trade, but authorities complain they have been unable to act against the practice due to ineffective policies and limited powers. Organ donation is legal so long as it is voluntary, given without duress or the exchange of money. But strict cultural and religious taboos mean there is a shortage of those willing to donate. (AFP)
Updated 27 June 2017
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Wealth, poverty propping up Pakistan’s illegal kidney trade

PAKISTAN: When Pakistani authorities burst into a makeshift hospital in Lahore this year, doctors were caught mid-way through two illegal kidney transplants, the local donors and Omani clients still unconscious on the tables.
The doctors were allowed to finish the operation then arrested, along with their assistants and the Omanis, in a raid Pakistani authorities say is a turning point in their battle against organ trafficking.
Pakistan has long been an international hub for the illegal kidney trade, but medical and local authorities complain they have been unable to act against the practice, frustrated by ineffective enforcement policies and what they perceive as a lack of political will to crack down.
Organ donation is legal so long as it is voluntary, given without duress or the exchange of money.
Pakistani clerics have ruled it Islamic, but a lack of awareness and the pervasive belief that it is taboo for Muslims mean there is a shortage of those willing to donate.
The limited supply, observers say, sees Pakistan’s wealthy routinely exploit its millions of poor with the help of an organ trade mafia.
Kidneys can be bought so cheaply that overseas buyers are also tapped in, largely from the Gulf, Africa and the United Kingdom.
In many countries such trafficking is confined to the shadows, in Pakistan — it is brazen.
Within minutes of an AFP reporter entering the lobby of an upmarket general hospital in the capital Islamabad, staff had helped him find a so-called “agent” who offered to get a donor and facilitate government approval for a kidney transplant, all for a tidy $23,000.
The government’s Human Organs Transplant Authority (HOTA) says it is toothless. If a donor claims they give their consent, “there is nothing else we can do,” says Dr. Suleman Ahmed, a HOTA monitoring officer.
But the April 30 raid in Lahore was the beginning of a new clampdown, suggests Jamil Ahmad Khan Mayo, a deputy director of the Federal Investigation Agency (FIA).
Enforcement of current laws was in the hands of provincial authorities — and thus restricted by provincial boundaries — until March of this year, when those limits were removed by the decision to assign the powerful FIA to such cases, he explains.
In the Lahore case, all 16 people arrested remain behind bars as the investigation continues. They face up to a decade in prison.
“By this raid we would like to send a strong message abroad that Pakistan is no longer a safe haven for (illegal) kidney transplantation,” Ahmad says.
Experts suggest there is a need to tackle the root causes of the rampant underground industry.
“This illegal trade benefits the rich and elites of the country,” says Mumtaz Ahmed, head of nephrology at the government-run Benazir Bhutto hospital in Rawalpindi.
Ahmed, a member of a government investigation commission on the kidney trade, claims that is why lawmakers are unwilling to enforce penalties. FIA officials have vowed they will be indiscriminate in their bid to end organ trafficking.

Some 25,000 people suffer kidney failure each year in Pakistan, but just 10 percent receive dialysis and a mere 2.3 percent are able to get a transplant, according to the Sindh Institute of Urology and Transplant (SIUT), a regional leader in kidney transplants headquartered in Karachi.
“Many people come to us in government hospitals and bring their family donors willing to donate kidneys,” says Ahmed.
“Then suddenly they shift to private hospitals when they learn that they can buy a kidney from there.”
The high demand creates a market that inhabitants of Pakistan’s vast rural areas see as an opportunity to drag themselves out of poverty.
Employed in factories, fields and brick kilns, they borrow money from employers for medical bills or to raise children, but are unable to repay their debt.
Instead they are forced to work it off in a never-ending cycle of bonded labor — one they hope to break with the income from selling their organs.
Bushra Bibi, stiff with the pain she has suffered since selling her kidney years ago, is one of them.
Crying softly, Bibi recounts how her father needed the money for medical treatment and to pay off a loan — so, 12 years ago, she sold her organ for 110,000 rupees ($1,000).
With her father-in-law in the same predicament, her husband followed suit. But their desperate move has left them in chronic pain, struggling to work and care for their five children, and as a result owing even more money than when they began.
“I can’t sweep, people talk about me when I can’t finish my work,” Bibi says, tears rolling down her cheeks.
The agony of giving birth after her kidney operation, she says, is “known to me only and my God.”
Bibi and her family live in the fertile Sargodha district of Punjab province, where Pakistan’s best oranges are produced.
It is also a region where so many families have been caught up in the kidney trade that resident Malik Zafar Iqbal says he has formed a union to fight for donors’ rights.
Showing AFP documents with hundreds of names listed, he says he has met with authorities, but not yet managed to achieve better conditions for members.
“I sold my kidney for 104,000 rupees. One hardly gets enough,” he says.


Massive blackout hits tens of millions in South America

A vendor waits for customers during a national blackout, in Buenos Aires, Argentina June 16, 2019. (REUTERS)
Updated 16 min 7 sec ago
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Massive blackout hits tens of millions in South America

  • The subsidies were a key part of the electricity policy of President Néstor Kirchner’s 2003-2007 administration and the presidency of Kirchner’s wife and successor, Cristina Fernández in 2007-2015

BUENOS AIRES, Argentina: A massive blackout left tens of millions of people without electricity in Argentina, Uruguay and Paraguay on Sunday in what the Argentine president called an “unprecedented” failure in the countries’ power grid.
Authorities were working frantically to restore power, and by the evening electricity had returned to 90 percent of the South American country, according to Argentine state news agency Telam. Power also had been restored to most of Uruguay’s 3 million people.
As the sun rose Sunday over the darkened country, Argentine voters were forced to cast ballots by the light of cell phones in gubernatorial elections. Public transportation was halted, shops closed and patients dependent on home medical equipment were urged to go to hospitals with generators.
“This is an unprecedented case that will be investigated thoroughly,” Argentine President Mauricio Macri said on Twitter.
Argentina’s power grid is generally known for being in a state of disrepair, with substations and cables that were insufficiently upgraded as power rates remained largely frozen for years.
The country’s energy secretary said the blackout occurred at about 7 a.m. local time when a key Argentine interconnection system collapsed. By mid-afternoon nearly half of Argentina’s 44 million people were still in the dark.
The Argentine energy company Edesur said on Twitter that the failure originated at an electricity transmission point between the power stations at the country’s Yacyretá dam and Salto Grande in the country’s northeast. But why it occurred was still unknown.
An Argentine independent energy expert said that systemic operational and design errors played a role in the power grid’s collapse.
“A localized failure like the one that occurred should be isolated by the same system,” said Raúl Bertero, president of the Center for the Study of Energy Regulatory Activity in Argentina. “The problem is known and technology and studies (exist) to avoid it.”
Energy Secretary Gustavo Lopetegui said workers were working to restore electricity nationwide by the end of the day.
“This is an extraordinary event that should have never happened,” he told a news conference. “It’s very serious.”
Uruguay’s energy company UTE said the failure in the Argentine system cut power to all of Uruguay for hours and blamed the collapse on a “flaw in the Argentine network.”
In Paraguay, power in rural communities in the south, near the border with Argentina and Uruguay, was also cut. The country’s National Energy Administration said service was restored by afternoon by redirecting energy from the Itaipu hydroelectric plant the country shares with neighboring Brazil.
In Argentina, only the southernmost province of Tierra del Fuego was unaffected by the outage because it is not connected to the main power grid.
Brazilian and Chilean officials said their countries had not been affected.
Many residents of Argentina and Uruguay said the size of the outage was unprecedented.
“I was just on my way to eat with a friend, but we had to cancel everything. There’s no subway, nothing is working,” said Lucas Acosta, a 24-year-old Buenos Aires resident. “What’s worse, today is Father’s Day. I’ve just talked to a neighbor and he told me his sons won’t be able to meet him.”
“I’ve never seen something like this,” said Silvio Ubermann, a taxi driver in the Argentine capital. “Never such a large blackout in the whole country.”
Several Argentine provinces had elections for governor on Sunday, which proceeded with voters using their phone screens and built-in flashlights to illuminate their ballots.
“This is the biggest blackout in history, I don’t remember anything like this in Uruguay,” said Valentina Giménez, a resident of the capital, Montevideo. She said her biggest concern was that electricity be restored in time to watch the national team play in the Copa America football tournament Sunday evening.
Since taking office, Argentine President Macri has said that gradual austerity measures were needed to revive the country’s struggling economy. He has cut red tape and tried to reduce the government’s budget deficit by ordering job cuts and reducing utility subsidies, which he maintained was necessary to recuperate lost revenue due to years-long mismanagement of the electricity sector.
According to the Argentine Institute for Social Development, an average family in Argentina still pays 20 times less for electricity than similar households in neighboring countries.
The subsidies were a key part of the electricity policy of President Néstor Kirchner’s 2003-2007 administration and the presidency of Kirchner’s wife and successor, Cristina Fernández in 2007-2015. Fernandez is now running for vice president in October elections.