Wednesday, August 6, 2014

THE KIDNEY DILEMMA

Some thirty-five years ago, when organ transplants began to take root as a viable medical procedure that saves lives, the controversy also began. Before a regulated list came into being, donors and recipients were matched according to need, compatibility and availability. Thankfully, I was among the first to receive a liver thirty years ago, which brings me to the topic of this blog post.

Human beings are born with two kidneys, a right and a left one. They are located towards the back, on both sides of the spine, below the rib cage. Kidneys are a little larger than a fist. They perform all kinds of functions one of which is allowing us to urinate. A human can live very well with one kidney, I should know, I only have one…a transplanted one.

Kidney trafficking has become widespread, especially in poorer countries, and newly autonomous countries still struggling to take shape. It’s illegal to sell your kidney for profit; and yet it is done pretty much everywhere. The law of supply and demand. Poor countries, like the Philippines for instance, have a thriving, willing and able kidney donor population. A family living off of $800donationm  a year will gladly give up a kidney they don’t need for the price of two years wages or more.

In the slums outside of Manila, predominantly men sign up with organ brokers to become kidney donors for the price of a laptop. The money they’ll earn, $1600.00 to $2500, will allow them to move to the country, buy a house or a piece of land and start a business. Of course plenty blow the money within a year, but others find a way of lifting their families out of the abject conditions of the slums to slightly less abject conditions in the countryside.
Meanwhile, here in the US, kidney donation by law must be altruistic. And thus, the waiting lists are anywhere from four to six years. Something is wrong with the entire picture. In fact, illegal donors as well as the regulated kidney donor list are both out of touch with reality and defeat the purpose entirely. On one hand, the legal avenue isn’t viable. Worldwide 118 people an hour die while waiting for a kidney. On the other side of the spectrum, the poor donors aren't getting fair compensation.

In Turkey, Dr. Yusuf Somnvez performed countless illegal kidney transplants from a hospital in Kosovo called Medicus. Aiding him in this extensive network undertaking were Moshe Harel, the surgery logistic man, and Dr. Zachi Shapira a prominent kidney transplant surgeon. In an interview with Dr. Shapira who lives in Israel, he continues to question the validity of a law that, as it stands, means a death sentence to so many.

Meanwhile, in Canada Mary-Jo’s mother, who’s been on dialysis for 18 years, sits in a wheelchair, her arms distorted from so many needles. She’s fifty-three and looks like she’s eighty. Her muscles have deteriorated, her energy level is non-existent and her skin is that of an old lady. Mary Jo herself is on a kidney transplant list in Ontario and has been waiting for over eight years!

Dialysis is a temporary solution, but not an alternative to kidney failure. The best option today is transplantation. The demand in Western counMedicustries far outweighs western supplies. As things stand 10 to 15% of kidney transplants are illegal. Raul Fain was in need of a kidney. He chose the illegal route with Dr. Yusuf Somnvez. The pre and post care at Medicus in Kosovo, according to him, was flawless. His donor, Anna from Moldova, spent some time at the hospital as well. She was compensated with $12,000.00. She was happy to help someone out and to get much needed cash. The entire experience was smooth and professional both donor and recipient said.

However Interpol views this transaction as an international crime and has been chasing Dr. Somnvez and his aids for years. Raul Fain paid $120,000.00 for his surgery, which included bribing local police to warn the doctors when detectives for Interpol would show up and check Medicus’ activities. According to Dr. Shapira, they would put casts on all the patients (sometimes 7 or 8 were transplanted in a day) and when detectives checked, they only saw people recovering from "broken" arms and legs.

Interpol is facing an uphill battle. Organ trafficking will continue as long as poor people will need money, and wealthier people are willing to pay for life. Illegal donor lists in the Philippines (apx.$1600 per kidney), Egypt ($2000), India ($1000), Moldova ($12,000), China ($2500) continue to grow, and with it, the potential for mishaps. Like the broker in the Philippines said, “When the guy comes back from the hospital to the slums and waves his hand flashing all that cash, the others get jealous and are even more eager to become donors.”

Interpol doesn’t stand a chance. The system is broken. For it to work, it needs to acknowledge the needs of all parties. The moral issue, “Selling your kidney for cash is wrong,” doesn’t hold up. It’s asking the wrong question. The moral issue should be, “How do we help as many people as possible”? As things stand, the moral issue is immoral. Patients die waiting, and poor people living in squalor get taken advantage of. No wonder Dr. Shapira is considered a hero in Israel. He has saved over 3600 lives, many of which illegally. Does that make his actions less honorable? I think not. Just ask those he has saved.

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