Profiting from Pakistanʹs poor

Muhammad Iqbal was once a bear of a man. Today, the former factory worker's state of health is so bad that he cannot even practice his favourite sport, "Kabaddi", an ancient Southeast Asian form of wrestling.

The 44-year-old Pakistani blames himself. In 2012, the father of eight made a decision that was to ruin his life: "I was deeply in debt," remembers Iqbal. "I was living in a village near Lahore and working at a brick factory. I had borrowed 135,000 Pakistani rupees from the kiln owner. I was working round the clock to pay back the loan, but with my meagre salary, I could barely make ends meet, let alone repay the loan. I was so desperate; I would have done anything to have more money in my pocket."

It was his cousin Ashraf who came up with the idea: Iqbal could sell one of his kidneys to make money. At first the idea would have shocked him. But the misery in which he had lived at that time forced him to think about it again. His cousin, who had sold his own kidney half a year earlier, finally persuaded him to take the step.

"Ashraf rolled up his shirt, showing me the operation marks after the removal of his kidney," Iqbal continued. "He told me I could easily live with one kidney and the operation is not very complicated," Iqbal said, adding that he was scared that he could lose his life during the surgery.

Once Iqbal gave his cousin the green light, Ashraf arranged a meeting with Faqir Hussain, a Lahore resident involved in kidney sale. "Hussain offered me 130,000 rupees (€1,544). When I demanded more money, he raised it to 160,000 rupees," Iqbal said. "First, I was taken to a place in Lahore where they conducted my blood tests and took my X-rays. I was told that it was necessary to make sure that I did not have any major disease," Iqbal added.

Detailed health check

He was then asked to come to Rawalpindi, the former seat of the Pakistani government, some 300 kilometres away: "I can't remember the exact date. But I'm sure that we took a bus from Lahore to Rawalpindi in winter 2012."

They arrived at dawn and were picked up by drivers who had "been waiting for them and taken them to a palatial building near the city centre. The clinic was owned by Faqir Hussain."

The gangs that organise the kidney business have a reputation for being particularly kind to the donors before an operation. Muhammad Iqbal also had this experience: "First we should take a shower, then they offered us something to eat."

After a few hours they started with the tests. "We were subjected to a whole series of medical examinations for eight days."

They stayed in Rawalpindi for a total of 15 days and were provided with food and accommodation. "Because the test results weren't clear for everyone, some were sent back home."

The hospitals where such operations are performed often hide under a false identity. In the case of Muhammad Iqbal, it was an eye clinic. "In the basement of this clinic there was an ultramodern ward where the kidney operations were performed. On the day of the operation I was taken to the hospital.

There I also met Pathal, the recipient of my kidney. He paid me a little more than the agreed price." Every single one of the doctors and nurses knew about it. "Some of them also expressed their sympathy to us.

The doctors – as well as the gang involved – had the best possible legal protection, according to Iqbal: "Before the operation, a doctor asked me to confirm in writing that I had freely decided to have the operation and that the hospital would not have to pay for any complications or damages that might result from the operation. This would also have applied if I had died during the operation."

An operation with catastrophic consequences

But that didn't happen – just one day after the operation, which took place under general anaesthesia, he took a bus home. As Iqbal quickly found out, it was only now that his ordeal began. "Of the almost 1,160 euros I had received for my kidney, I had to spend around 290 euros on medication alone. Actually I should have eaten a lot of beef, but I couldn't afford it. In order to repay my original debts, I still had to sell my rickshaw."

Today he is a broken man: Due to the health restrictions resulting from the operation, he had to give up his regular work in the brick factory. He could only accept casual labour, which had led to new debts.

"My two daughters, 13 and 12 years old, have to work as maids in Lahore so that we don't suffocate in the mountain of debt. They don't even earn ten euros a month and have to live in the house."

"Never," Iqbal admits with tears in his eyes, he would advise someone to take his way. "I implore the government to waive the debts and raise the minimum wage of the thousands of people affected who, like me, cannot get out of this downward financial spiral.

Because one thing is clear: nobody would sell his kidney voluntarily. Only the fight against poverty in the country is an effective method, says Iqbal, to "put a stop to these gangs of criminals."

Sattar Khan

© Deutsche Welle 2018