Inside the transplant tourist trade: The desperate men of One Kidney IslandBy DAVID DERBYSHIRE - More by this author » Last updated at 22:05pm on 3rd December 2007
They stand in line in the stinking slums, their shirts lifted and arms raised to reveal the 13-inch long scars carved into their sides.
Poor, desperate and mutilated - these are the human victims of the profitable trade in kidneys in the Philippines.
For a cash payment of £1,000 - a fantastic amount in a country where 15million people earn a dollar a day - each of these "volunteers" has donated an organ to a wealthy foreigner.
On "One Kidney Island" no one knows how many donors fail to survive the operations - or die painfully from infections weeks later.
But with internet adverts fuelling demand from affluent Japanese, American and British patients, business is flourishing.
Many of the donors have huge families to support.
Others, such as Jeffery Avila, are little more than boys "encouraged" by parents to sacrifice a body organ.
"I am worried but I haven't got a job yet and I want to help my family," said Jeffery, 16, clutching his blood group card.
"My cousin Nog Nog, who is 18, sold his kidney and he's fine. I am sure I'll be fine too, like all the other men in the village."
As he speaks outside his ramshackle home, his father puts his arm around him and reassures him that he will be okay.
But Jeffery doesn't look fine - he looks terrified.
Jeffery and his father come from Baseco in the poor South Port area of Manila.
The area is nicknamed the "kidney market" because more than 300 people in this slum of 16,000 have gone under the knife.
The cash-for-kidneys trade is flourishing all over the world.
But it thrives best in countries such as the Philippines where foreigners are allowed make a "donation" rather than a payment to the donor.
The customers pay around £40,000 for the operation in a private Manila hospital where conditions are clean and, for some, reasonably luxurious.
The transplants are "live", with the kidney taken from a donor in one operating theatre and given to a recipient moments later.
Many of the health tourists keep quiet about their trip to the Philippines - and few people back home know the details of their operation.
But the gap between what the recipient pays and what the donor gets has more than a whiff of exploitation.
The country's government has responded to criticism by setting up a programme to compensate and care for live donors.
Many of the operations are carried out at the National Kidney and Transplant Institute in Quezon City, a modern hospital which describes its facilities as state of the art.
Officially, donors are not paid - they just receive compensation and free healthcare. But despite this scheme, many still sell their kidneys to private hospitals via agents.
Jerry Villegas, 33, has a family of seven. H
He sold his kidney for 100,000 pesos - or £1,145 - to a Japanese man. After agent's fees, he got 90,000 pesos.
"My house had just burnt down in a fire," he said.
"There was nothing left, just the stone base. I had five kids and I was desperate to rebuild the place.
"I really needed the money but I wouldn't have done it if my house hadn't been destroyed.
"We had nothing left, so a kidney was the only thing I could sell."
The kidney trade is fiercely competitive. There are agents touring the slums promising cash in hand for a few nights in hospital and a few weeks of pain.
Juanlerio Avila, 38, is one who boasts he has taken hundreds of people to local hospitals and that 70 have gone on to donate a kidney.
His contact at the local hospital is a woman called Lynn.
"Lynn came to Baseco and asked me to recruit potential donors," he said.
"She makes sure I have credit in my phone. She calls once every couple of months.
"She will ask for me to arrange for donors of certain blood types.
"I round up some of the volunteers I have recruited and take them for a blood test."
The volunteers get 500 pesos (£5.72) for expenses, while Avila gets 700 pesos (£8) for each trip he makes, plus a 10,000 pesos (£115) donation fee.
"There are many willing donors around here. My neighbour wants to give his kidney, he's just waiting," he said.
Third party beneficiaries are illegal, so agents are on constant lookout for police.
The World Health Organisation issued guidelines to stop the exploitation of the poor in the early 1990s but the rules are not binding.
Manilla's slums show few signs that the trade is helping the locals.
Men who donated kidneys a few years before remain poor and dispossessed. The best donors can hope for is a brief respite.
Celedinio Pindengi, 32, donated his kidney five years ago for 85,000 pesos.
"You are a rich man for a while," he said. "I bought a small house in Sama Province, my home town."
The recipient was the Filipino wife of a Brazilian, who was 42.
"I feel better because my kidney saved her life. I still have that feeling even if I've spent all the money and I am poor again.
"I just wish my kidney would grow back. I would happily donate it again."
http://www.dailymail.co.uk/pages/live/articles/news/worldnews.html?in_article_id=499486&in_page_id=1811PHOTO: Line of despair: Donors in the slum of Baseco with scars from their operations
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