TorontoSun.com - Canada - Global medical tourism feeds organ scams

TorontoSun.com - Canada - Global medical tourism feeds organ scams
"The good the bad and the ugly."

That's how Calgary-based Aruna Thurairajan defines the complexities of the organ transplant business.

She's the Canadian connection for Fortis Healthcare, a group of 12 state-of-the-art hospitals in India and involved in helping people get organ transplants in India, Pakistan, Philippines and other countries.

I recently interviewed Thurairajan about the major kidney transplant scam in India involving as many as 500 people who were allegedly duped by unscrupulous doctors, nurses and hospital staff who drugged these poor people and then removed their kidneys for transplants to wealthy patients, many from other countries.

Reports allege that the ring leader of this scam -- known by the Indian media as "Dr. Horror" and "Dr. Kidney" -- is Dr. Amit Kumar, who may be on the run in Canada. One report says his wife Poonam, 28, and two boys 5 and 4 years old, live in Brampton in a $610,000 home that Kumar bought last year.



"Kumar, who at present is in the centre of this kidney scam, was arrested in Mumbai some years ago," India's highly regarded journalist Surendera Nihal Singh told me.

"He was released on bail and jumped bail ... The city of Gurgaon is an obvious place for such operations because it is emerging as the hub of multinationals and since police haven't kept pace with the phenomenal expansion, implementation of regulations is lax.

"The corruption is rife and the bribes offered are considerable, so the Indian government is talking about relaxing the strict laws on kidney transplants in order to discourage black market trade."

The illegal kidney transplant racket started flourishing in India and elsewhere after the discovery of cyclosporine and other drugs that greatly reduce the risk of an organ being rejected by the body.

Under the Organ Transplantation Act of 1994, India prohibits sale of organs but cadaveric organs are allowed to relatives.

When asked whether such a scam is possible, Nihal Singh said "it's really a question of supply and demand.

"Those on the lookout for kidneys are desperate and since many of them, Indians and foreigners alike, are relatively wealthy and prepared to pay some $30,000 to $40,000, there are takers. Those who indulge in the trade resort to subterfuge and bribe the police to look the other way," Nihal Singh said.

"The TED Case studies regarding India's kidney trade, conducted a few years back, dubbed India as a 'warehouse for kidneys' or a 'great organ bazaar' and that the country has become the largest centre for kidney transplants in the world."

Thurairajan knows first hand that the kidney scam "is very much possible." But reports claiming people were threatened by hospital staff armed with handguns don't sound credible to her.

"But I know doctors and their agents have lured poor people, taken them to five-star hotels, which is a heaven for these poor people," she said. "Their food is drugged and kidneys removed."

A few years back, when Thurairajan worked for a nursing home in Bangalore, known as India's Silicon Valley, she would see "how some local physicians would bring poor people from neighbouring towns and villages promising them work, subject them to a complete medical check up as pre-requisite for work and after being sure they were healthy, would drug them and remove their kidneys and other organs."

Years ago the Bangalore Police busted "a massive racket involving kidneys of over 1,000 unsuspecting poor persons in which a number of prominent doctors were involved."

But doctors don't have to resort to criminal activity as there are many people willing to sell their kidneys in India, Thurairajan said.

Organ transplants has become "the good the bad and the ugly" because of "the global medical tourism," she said, and that's what she proclaimed loudly last December at the international Organ Donation Congress in Philadelphia, where she was among the speakers .

She also disagrees with reports that only rich people "from affluent countries go to developing or under-developed countries which provide these services as 98% of my patients have begged, borrowed, mortgaged or sold assets to get an organ transplant."

It is a criminal offence for any foreigner to go to India or Pakistan for an organ transplant. The sale of organs is not legal in these countries.

"But from time immemorial organs have been traded for cash," Thurairajan reminded me. "It is kind of an unwritten thing."

Pakistan put a strict ban on the sale of organs Sept. 4, 2007.

"And the World Health Organization is watching them closely," she said. The result is people from Pakistan are now going to India for kidney and liver transplants.

The sale of organs is legal in the Philippines and Colombia.

"In Colombia people don't want organs from people who are over 35 years of age. There are plenty of organs for sale there, same as in the Philippines," Thurairajan said, adding that's where she now sends her patients.

It's been reported during this recent scandal in India that some of the kidney recipients were from Greece. They were arrested and their passports were seized. Thurairajan believes such widely published reports will deeply hurt the organ business. But she conceded "regardless of this being illegal, the transplant business continues behind the curtains" and, sadly, it happens "with the connivance of large hospitals and feeder clinics from the villages."

It costs $20,000 U.S. to get a kidney transplant in China and other organs could go as high as $90,000, although it's illegal for foreigners to receive transplants there.

It could cost $55,000 U.S. for a kidney transplant in the Philippines, where it is legal.

Some people in Toronto have waited seven years for an organ match, according to Jeffrey Zaltzman, director of the renal-transplant program at St. Michael's Hospital.

He said he recently examined a patient with a scar on his abdomen -- the result of a kidney transplant in India, or so the patient thought.

He was surprised to discover through an ultra-sound there was no transplant kidney.