Fighting the greed element - Zubeida Mustafa - Wednesday 4th May 2011

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THE love of money is the root of all evil. So we were told in the pre-capitalist age. Now we are told that the love of money is the root of all profit. And profit is king. This simple truth would explain why the bane of illicit organ trading is back with a bang. It’s the money, stupid, as a shrewd, cold-blooded entrepreneur would explain.
Pakistan is fast re-emerging as the most bustling kidney bazaar in the world. And Dr Adibul Hasan Rizvi, director of the Sindh Institute of Urology and Transplantation, is a disenchanted man today. He was the one who spearheaded the 15-year struggle to get the government to enact a law to regulate organ transplantation in Pakistan — and succeeded. At one stage he believed that he had won his battle against the organ mafia that was exploiting the needs of our poor and had our legislators in its grip when India banned organ trafficking in 1994.
That was when the Transplantation of Human Organs and Tissue Ordinance 2007 (passed by parliament later as an Act in 2010) created an infrastructural framework for organ transplantation that provided for ethical related transplant and deceased organ donation while banning unrelated commercial transplant.
It forbade organ transplantation in foreigners.As a result, the unethical activity disappeared. The law was welcomed as a perfect one by the World Health Organisation and recommended as a model for other countries. But to the disappointment of those who had championed the cause of ethics in medicine, organ trafficking has resurfaced and is symptomatic of what Dr Rizvi calls “rearguard action” that has historical precedents. Since the enactment of the law in March 2010, nearly 450 cases of commercial transplantations are reported to have taken place.
Of these, at least two patients, both foreigners, are known to have died of complications resulting from surgery that was clandestinely and improperly performed. Their deaths were reported to the surgeons here by their fellow professionals abroad. Although the racket has still to reach the pre-2007 proportions, it has graver dimensions this time.
Firstly, a law is supposed to be in place today unlike the years when the field was unregulated and gave a free rein to all kinds of operators. It is something to worry about if we are reverting to the kidney tourism of yesteryear in spite of the transplantation law, the existence of a monitoring authority and the threat of punishment involving 10 years imprisonment and a fine of Rs1m,
This time the health authorities are culpable. They have not responded to the complaints made by the medical professionals and the Supreme Court that had taken suo motu notice of the cases. It is symptomatic of the collapse of our system and the failure to police it. The two hospitals that have been identified by various patients, the Adil Hospital in Lahore and the Kidney Centre in Rawalpindi, seem to be indifferent to the disrepute they are bringing to Pakistan. Two years ago, when they were dragged before the Supreme Court they had promised not to indulge in these misdeeds again, and were therefore let off the hook.
At the press conference he called last week, Dr Adib Rizvi squarely placed the blame on the doctors who motivate agents to find desperate people and show them the kidney trade as a means to escape their mounting burden of debt and poverty. If these surgeons had contained their cupidity and remembered the Hippocratic Oath, no agent could have carried on with this vile trade. While on one side is the greed-induced commercialism of some black sheep in the medical profession, on the other is the oppression of the poor by the feudals and their growing impoverishment in an economy that makes the rich richer and the poor poorer.
In some research done by The Support, a group led by MNA Kishwar Zehra who visited many villages in Punjab, the donors now find themselves worse off. They have not managed to pull themselves out of their debt — having received paltry sums and not what they were promised — and they are in poor health since they did not receive the post-operative healthcare and drugs they should normally have been provided. The bulk of the Rs3,400,000 the patient had to cough up was pocketed by the doctors — obviously tax-free.
What needs to be noted is that kidney trafficking flourishes in Punjab. If it is simply a case of the poor selling their organs in desperation, one can well ask if there aren’t any poor people in Sindh. The fact is that the SIUT stands like a bastion of ethics in medicine which drives the organ vendors away.
On Saturday, Dr Adibul Hasan Rizvi received the Jinnah Award for 2008. His services to humanity were eulogised in his citation. He deserves the award not just for founding the SIUT. His most outstanding quality is his immense capacity to respect the dignity of every human being irrespective of his socio-economic status.
He insists that healthcare is the birthright of every person who should be provided all treatment free of charge because it is demeaning to ask the indigent to prove his poverty to qualify for ‘subsidised treatment’. Small wonder the kidney thieves consider him a threat to their trade. SIUT is designed to prove to the world that welfarism did not die when the Berlin Wall fell. n
The writer is the author of Tyranny of Language in Education: The Problem and its Solution.

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