Transplant hub?

Earlier this week Indian Police filed cases against six Sri Lankan doctors in relation to a kidney racket, on the charge of conducting an estimated 60 paid kidney transplants at local private hospitals. The issue opens up disturbing questions on loopholes in Sri Lanka’s legal system and the impunity enjoyed by doctors and the medical industry to conduct transplants, for years according to investigations, without fearing the law.   

In response a fresh committee was appointed by the Health Ministry and Health Minister Dr. Rajitha Senaratne insisted legal action would be taken, if necessary, once the report is submitted next week. The committee is also tasked with establishing a new process to gain approvals for foreigners to have transplants in Sri Lanka. Indian media this week reported on fresh arrests on the alleged kidney transplant racket. Reports also said that six Sri Lankan doctors attached to four private hospitals are involved in the racket. According to Indian Daily, The Hindu, all transplants had taken place in four Sri Lankan hospitals while all donors and recipients involved in the racket are from India.

However the Minister also emphasised no decision has yet been taken to press charges against the private hospitals allegedly involved in the illegal transplants. Under current Sri Lankan law organ transplant operations require prior approval from the health ministry but this process was allegedly completely sidestepped by medical professionals.       

This is the second time an investigation is being commissioned on the matter. In 2014, the Health Ministry commissioned an inspection of all private hospitals in the country following accounts of illegal kidney transplants being carried out in private hospitals reported in both Indian and local papers. 

However the investigations petered out with no legal action being taken against any of the private hospitals or doctors. There is real concern the current round of investigations will face the same fate. It is shocking that external investigations had to push the Health Ministry to launch a second round of investigations despite numerous media reports of organ smuggling in South Asia. The kidney racket could also be an unwelcome side effect of a highly unionised medical sector that has created a shield of legal impunity, reinforced by significant amounts of money and influence, to offset any legal steps that could be taken against them. The Indian investigation points to the top private hospitals in Sri Lanka and charges indicate even the top rungs of administration could allegedly be involved.  According to the World Health Organization’s (WHO) global organ transplant report, 106,879 organ transplants were performed worldwide in 2010. But this data doesn’t identify whether the organs were bought and sold. WHO conservatively estimates the proportion of traded or trafficked organs is up to 10%, or roughly 11,000 in 2010. But the true figure could be much higher. The Declaration of Istanbul on Organ Trafficking and Transplant Tourism was developed in 2008 in an attempt to curb international trade in organs and travel for commercial organ transplantation, known as “transplant tourism”. It provides ethical guidance for policy makers and doctors working in transplantation medicine.

WHO and supporters of the Declaration of Istanbul believe the best solution involves developing better systems of deceased organ donation, encouraging altruistic living kidney donation, preventing needs for transplantation by treating diseases that lead to organ failure such as diabetes and hepatitis as well as implementing laws that prohibit organ trading and trafficking. On this front Sri Lanka has much to learn and has to take legal action against erring doctors and hospitals if they are to maintain any credibility before the public.