Herat (Afghanistan) (AFP) – Jobless, debt-ridden and struggling to feed his children, Nooruddin felt he had no choice but to sell a kidney – one of many Afghans willing to sacrifice an organ to save their family.
The practice has become so widespread in the western city of Herat that a nearby settlement is infamously nicknamed “a kidney village”.
“I had to do it for the sake of my children,” Nooruddin told AFP in the town, near the border with Iran.
“I had no other option.”
Afghanistan has been plunged into a financial crisis following the Taliban’s takeover six months ago, worsening an already dire humanitarian situation after decades of war.
The foreign aid that once supported the country is slow to return, with extremist Islamists also cut off from Afghan assets held abroad.
The ripple effect has particularly affected Afghans like Nooruddin, 32, who quit his factory job when his salary was cut to 3,000 Afghans (about $30) shortly after the Taliban returned, believing wrong that he would find something better.
But, with hundreds of thousands out of work across the country, nothing else was available.
In desperation, he sold a kidney as a short-term solution.
“I regret it now,” he said outside his home, where faded clothes hang from a tree and a sheet of plastic serves as windowpane.
“I can’t work anymore. I’m in pain and I can’t lift anything heavy.”
Her family now relies on her 12-year-old son to earn money, which shines shoes for 70 cents a day.
A kidney for $1,500
Noorudin was among eight people interviewed by AFP who had sold a kidney to feed their family or pay off a debt, some for as little as $1,500.
It is illegal to sell or buy organs in most developed countries, where donors are usually related to the recipient or are people acting out of altruism.
In Afghanistan, however, the practice is unregulated.
“There is no law (…) to control how organs can be donated or sold, but the consent of the donor is necessary,” said Professor Mohammad Wakil Matin, a former top surgeon in a hospital in the northern town of Mazar-i. – Sharif.
Mohamad Bassir Osmani, a surgeon at one of the two hospitals where the majority of transplants in Herat are performed, confirmed that “consent” was key.
“We take their written consent and video recording from them, especially the donor,” he said, adding that hundreds of surgeries had been performed in Herat over the past five years.
“We never tried to find out where the patient or the donor came from, or how. It’s not our job.”
The Taliban did not respond to AFP’s requests for comment on the practice, but Osmani said the country’s new rulers intended to crack down on the trade and were forming a committee to regulate it.
Afghans in desperate need of money are usually matched with brokers with wealthy patients, who travel to Herat from across the country – and sometimes even from India and Pakistan.
The recipient pays both the hospital costs and the donor.
Azyta’s family had so little to eat that two of her three children were recently treated for malnutrition.
She felt she had no choice but to sell an organ and openly met a broker who put her in touch with a receiver from the southern province of Nimroz.
“I sold my kidney for 250,000 Afghans (about $2,500),” she says from her small, damp room.
“I had to. My husband doesn’t work, we have debts,” she added.
Today, her husband, a day laborer, plans to do the same.
“People have become poorer,” he said. “A lot of people sell their kidneys out of desperation.”
“One Kidney Village”
On the outskirts of Herat is Sayshanba Bazaar, a village made up of hundreds of people displaced by years of conflict.
Known as the ‘one-kidney village’, dozens of residents sold their organs after word spread among families destitute of the money to be made.
From one family, five brothers have sold a kidney each for the past four years, thinking it would save them from poverty.
“We are still in debt and as poor as before,” said Ghulam Nebi, showing his scar.
In developed countries, donors and recipients generally lead full and normal lives, but their health after surgery is usually closely monitored and also depends on a balanced lifestyle and diet.
This luxury is often not available to poor Afghans who sell a kidney and still find themselves trapped in poverty – and sometimes in poor health.
Professor Matin said only some donors had organized follow-up checks.
“There are no public health facilities to register kidney vendors and donors for regular examinations to check the implications for their health,” he added.
Shakila, already a mother of two at 19, underwent the procedure shortly before the Taliban took over, bypassing a broker while searching for a patient at a hospital in Herat.
“We had no choice because of hunger,” she said, wearing makeup in black eyeliner with a scarf covering the rest of her face.
She sold her kidney for $1,500, most of which was used to pay off the family’s debt.
Meanwhile, Aziza, a mother of three, waits for her opportunity after meeting a hospital staff member who is trying to connect her with a donor.
“My children roam the streets begging,” she told AFP, tears in her eyes.
“If I don’t sell my kidney, I will have to sell my one-year-old daughter.”
© 2022 AFP