Will you brand him ‘Dr Horror’ when you want to save life?

Will you brand him ‘Dr Horror’ when you want to save life?

Natteri Adigal

10 February 2008, Sunday

MEDICAL SCIENCE has been making big advances recently and there is bright scope for medical tourism in India because of the availability of good doctors. One of the fields where India can make a significant contribution to humanity is organ transplantation. Indian doctors have the reputation for possessing the unbeatable combination of strong book knowledge, skillful hands, mastery in fast emerging techniques and professionalism. Substantial funds generated from the activity could go a long way in addressing primary healthcare needs of an impoverished population. But, doctors are leaving the country in droves due to hostile attitude and gross apathy on the part of the powers that be.

Kidney transplantation is one area that where lopsided policies of the myopic administration are acting against the interest of people. Thanks to path-breaking discoveries following cutting edge research, rejection of transplanted kidneys occurs in no more than 10-25 per cent of people (during the first 60 days). Rejection does not necessarily mean loss of the organ; it may just require additional treatment. Even when a transplant fails, perhaps after some 10-20 years, a patient may opt for a second transplant. The surgery itself takes hardly three hours.
Earlier, the donor and recipient needed to have compatible blood groups (ABO compatible) and a tissue match before transplantation. But, use of modern immuno-suppression and plasmapheresis techniques does away with this requirement. The FDA (Food and Drugs Authority of the US) has approved the Cedars-Sinai High Dose IVIG therapy in 2004 and there are several other projects on ABO-incompatible transplants going on.

It has also been established that recipients of kidneys from live donors do relatively well, in comparison to deceased donors. While cadaveric kidneys (taken from brain-dead or cardiac-dead donors) take seven-30 days to reach normal functioning levels, living donor kidneys require just three to five days. Harvesting of kidneys from donors too has undergone revolutionary changes. Formerly, the kidney was required to be removed by making an incision. But, laparoscopic surgery is being done nowadays, which reduces pain drastically and enables the donor to return to work almost immediately. It also has minimal effect on the outcome of the kidney. In short, kidney transplantation is becoming almost as simple as donating blood.

Anyone acquainted with a person suffering from end-stage kidney (renal) disease will realise the extreme pain associated. Usually, patients need to undergo dialysis, lasting three to four hours for up to three times a week. They, and their near and dear ones, spend a fortune and desperately search for a way out of the pain, without resorting to mercy killing.

On the other side, thanks to the criminal mismanagement of the country’s economy, there are any number willing donors – debt-ridden peasants and workers, pressurised by moneylenders – to whom selling a kidney is a way out of resorting to suicide. Under the moronic Indian law, live kidney transplants are allowed only if the organ is donated by a blood relative or spouse, or there is a swap agreement between two needy families. The government must also clear all transplants.

The law was enacted at a time when removal and implantation of kidney was not quite a safe preposition. Also, like many other laws of the ‘permit-license-quota’ raj, it only serves unscrupulous elements within and without the system. Out of the average Rs 80,000 paid for each kidney, brokers pocket a fat commission. It is even bigger a racket than the hypocrisy of the ban on professional blood donation, which lets hospitals to literally bleed relatives of surgery patients. Most touts pass on a portion of the cut to bigwigs. When quacks perform surgeries leading to complications, or when touts default on promised meager compensation, hapless victims have no one to complain to, the whole operation being illegal.

The infamous ‘Gurgaon kidney scam’ requires to be seen in the context of this ground reality. According to the impression being created by the mainstream media siding with authorities, police officials of Moradabad, Gurgaon and New Delhi are doing a great job in nabbing Dr Amit Kumar, variously dubbed by them as ‘Dr Horror’, ‘Kidney kingpin’, etc, for whom a Red Corner Interpol alert was issued.

People in Brampton, Canada, from where the ‘nephrologist-surgeon’ has been conducting his operations, are sceptic about the ‘global hunt’ launched for his arrest. A big chunk of the estimated 600 patients who received a transplanted kidney in his clinics were Indians settled in Canada. They paid anything between $ 15,000 and $ 20,000. The raid on a number of clinics and hospitals with connections with the Kumar brothers Amit and Jeevan is branded as a big ruckus aimed at harassing them to rake in more moolah: “Thanks to India’s leaders and bureaucrats, the country will never be free from corruption, and people will never learn to respect the rule of law!”

The Toronto Star has quoted Amit’s wife Poonam saying that her husband was just a doctor who wanted to help people in need. “My husband didn’t do anything wrong,” she declared. Moreover, what were the cops, and the Indian Medical Council, doing all these years when he was allowed to practice and is apparently flourishing ever since he was convicted in a ‘kidney scam’ in 1993?
CBC reported a wealthy Indo Canadian businessman as saying, “Do you think any Indo-Canadian will ever tell you that he underwent kidney transplant? It is as a dirty secret. Indians still attach stigma to these things. Why don’t they turn around and grill these Delhi cops who are now giving the impression of doing a great job?”

The question that needs a honest answer is: “If you had a dear relation with end-stage renal disease, who was cured by a clinic and saved from undergoing numerous painful dialysis procedures, will you call him Dr Horror?”

Moreover, the Indian police, who must have blown lakhs of rupees in the ’global hunt’ cannot take any credit for ‘nabbing’ him. It was a staff member of Hotel Wildlife Camp in Chitwan in southern Nepal, 60 km inside the Indian border who recognised Kumar from Indian television reports and alerted authorities. Police showed up at the hotel shortly after and arrested the ‘tourist’ for violating Nepal’s foreign exchange laws. He faces a maximum sentence of four years in prison if convicted of currency violations. Kathmandu SSP Upendra Kanta Aryal told reporters, “We may deport him to India, but that process will begin only after he is taken to court to face currency charges.”

At a chaotic press conference where he was led to by the police, the impressively dressed suspect repeatedly shouted, “I am just a doctor, not a kidney dealer. I have not committed any crime.” India’s CBI does not appear to have much basis for charging that he “lured or forced hundreds of poor into giving up their kidneys.” The grossly discredited organisation is supposed to have taken up the matter of Kumar’s handing over with Nepalese government through the Indian Embassy in Kathmandu.

According to Aryal, Nepal would also investigate if Kumar’s racket extended into Nepal. “If Nepali people who are victims come to inform us, then we will look at charging him with illegal human organ trafficking.” One case has already been filed for possession of illegal foreign currency – a bank draft for Rs 936,000 and cash of € 145,000 and $18,900. The other two cases relate to the Red Corner Notice issued by Interpol and to illegal human organ transplants under the Nepalese Act. He may get a maximum sentence of five years or Rs 5 lakh as fine, or both, if he had carried out any kidney transplants in Nepal.

Kumar was ostensibly in Nepal to discuss a hospital project in neighbpuring country and has already lined up local partners for it.

Nepal’sl Deputy Prime Minister of Ram Chandra Poudel has insisted that he will be first tried for any The so-called ‘Doctor Kidney’ has apparently maintained very good relations with his patients, who were influential and powerful. “The people whom Kumar served are well connected and they can shield him from the long arms of law as they would want to keep their identity under wraps,” says a person in the know. This gives an ominous meaning to the statement of Indian Minister of State (MoS) for home affairs Sriprakash Jaiswal, “We hope this process is completed quickly. The speed with which Nepalese police have caught him, we hope he is handed over to us soon.”

Given the Indian government’s dubious past record of treatment of economic offender Rajan Pillai of Brittania (He was murdered by cops of Tihar), it is likely that the ‘soon’ may be ‘several years’. Incidentally, there is no extradition treaty between the two countries, India and Nepal.

If anything, the buffoonery by the Indian cops and the government has only created a big setback to medical tourism to India apart from protecting the interests of touts, quacks and those governmental elements thriving in the guise of ‘moral objection’ to organ trade.

[Also see another article by this author, uploaded on Feb 2, 2008: Who are the culprits behind the kidney scam? http://merinews.com/catFull.jsp?articleID=129887]

http://www.merinews.com/catFull.jsp?articleID=130087