Transplant Tourism Pakistan: A First Person Account

By Anna Bennett

UPDATE:  Jan 31, 2009  We have been contacted by the author of the blog quoted below.  As it is illegal in Pakistan, the United Kingdom and the United States to purchase organs for transplant, in a compromise we have removed the archive of the original blog (which the author (now referred to as Bambi) deleted) and have redacted anything identifying the author.

Bambi's Journey is a blog about desperation. Bambi was desperate for a kidney, the hospital in Pakistan was desperate for foreign cash, and the donor, was desperate for money to ease the family's struggle with poverty.In the latest entry in the blog, Bambi has a new kidney, the transplant hospital has been paid, and we presume that the donor has returned to their life, one less kidney and with some compensation.

This is amazing to read.  Neither Bill nor I have ever read a first person account of a compensated foreign kidney transplant.  It elicits some powerful responses. For me, a recent deceased donor transplant recipient, it gives an account of the transplant process in a third world country with the added dimension of secrecy. The hospital advises:

...you keep a low profile and not interact with anyone from the outside, even if it is family. REDACTED

Bambi writes about the matching process and on arrival in Pakistan, had to wait a few days for the hospital to find a match. (I was on the UNOS list for 3.5 years) According to the blog:

They [the hospital] have almost 500 donors on their books. All REDACTED with O+ blood group, since this is a universal blood type and anyone can receive an organ from this blood group.

Also there seems to be many little hidden additional costs. I will need to pay more $ for donors that they will need to test to find a perfect match. They charge $250 for each new donor that they cross-match after the first 2 cross-matches, until they find the right match. They conveniently forgot to mention this vital information.

Bambi secretly tipped the donor 70,000 Pakistan Rupees (US $888.21):

Since it was so difficult to talk or connect with the donor, everything had to be done secretly. I was able to quickly tell REDACTED that I wanted to give REDACTED a gift, and if I could have a phone number or something from REDACTED. REDACTED told me that they did not have an address. I felt very sad hearing this. Later that day I was passed on a cell phone number by one of the nicer nurses. REDACTED Also it was a good opportunity to take photo's REDACTED. I also took that opportunity while no-one was around to tell REDACTED also that we wanted to give them some money as our gift of thank you and that they must not leave without seeing us before they left.

REDACTED

In keeping with the comparison, as a token of thanks, I sent a letter (to maintain anonymity via UNOS/OPTN) to my donor's family. 

Foreign Transplants are a controversial subject, and are widely written about from a pundit and medical perspective. From 11/07 edition of Transplant international : Official Journal of the European Society for Organ Transplantation A socioeconomic survey of kidney vendors in Pakistan:

In recent years, Pakistan has emerged as one of the largest centres for commerce and tourism in renal transplantation. Kidney vendors belong to Punjab in eastern Pakistan, the agricultural heartland, where 34% people live below poverty line. We report results of a socioeconomic and health survey of 239 kidney vendors. The mean age was 33.6 +/- 7.2 years (M:F 3.5:1). Mean nephrectomy period was 4.8 +/- 2.3 years. Ninety per cent of the vendors were illiterate. Sixty-nine per cent were bonded labourers who were virtual slaves to landlords, labourers 12%, housewives 8.5% and unemployed 11%. Monthly income was $US15.4 +/- 8.9 with 2-11 dependents per family. Majority (93%), vended for debt repayment with mean debt of $1311.4 +/- 819. The mean agreed sale price was $1737 +/- 262. However, they received $1377 +/- 196 after deduction for hospital and travel expenses. Postvending 88% had no economic improvement in their lives and 98% reported deterioration in general health status. Future vending was encouraged by 35% to pay off debts and freedom from bondage. This study gives a snapshot of kidney vendors from Pakistan. These impoverished people, many in bondage, are examples of modern day slavery. They will remain exploited until law against bondage is implemented and new laws are introduced to ban commerce and transplant tourism in Pakistan.

Rarely do we get a first hand account.  I am sorry that Bambi reached such a level of desperation that Bambi was compelled to travel to an underprivileged country for a transplant.  I thank Bambi for sharing her experience.  It is a window into organ trade that is illuminating and thought provoking.

Comments

[nickp]

What is this women doing in the UK after her transplant?

She has been living in the USA for 16 years so why has she not gone back to the USA?

She shouldn't have gone to buy a kidney in Pakistan if she couldn't afford the aftercare back in the USA.

The NHS is already overstretched and under funded. Why should UK taxpayers and the NHS have to pay for her aftercare and medications.

Ridiculous!

[Bill Peckham]

I assume she started dialysis in the US which would imply some sort of US insurance so I'm not sure. The posts so far leave a lot of unanswered questions.

Who is Micheal? It's not clear - he could be anything from a good friend (i don't think I have a friend who would accompany me on a weeks long, sketchy Pakistani transplant scheme) to someone involved in setting up the trip. She doesn't provide any information on how the trip was set up or how she came to manifest trust in the Lahore transplant industry or the total cost as paid to ... who?