WE have officially entered the ‘Visit Pakistan’ year. No doubt government spokesmen will dutifully extol the delights of the Land of the Pure as a tourist destination. But although healthy foreigners might not fill our hotels, those with failing kidneys will continue to arrive in large numbers.

The way things are going, “transplant tourism” is going to be a growth industry in Pakistan for a long time to come. Last year, an estimated 2,000 operations were performed, with foreigners shelling out around $15,000 (or Rs 900,000) each. Out of this, impoverished donors received a maximum of $1,500, with the hospitals getting the lion’s share. Thus, nearly two billion rupees a year are being spent on these dubious operations in which rich clients, greedy doctors and shady hospitals join hands to exploit the poor.

Indeed, in certain areas, the medical fallout of this pernicious practice is reaching epidemic proportions. According to the Guardian, “most adults of Sultanpura, northern Punjab, have donated a kidney.... It is one of dozens of villages that provide the human stock for Pakistan’s burgeoning cash-for-kidneys trade.”

Apart from the demand for healthy kidneys, what is driving this ghoulish trade is the lack of any laws on the subject in Pakistan. For years, Dr Adeebul Hasan Rizvi, head of the Sindh Institute of Urology and Transplantation (SIUT), has been lobbying for the creation of a legal framework to regulate organ transplants. Time after time, he has tried to convince members of successive assemblies to push through the necessary legislation, all to no avail. Now, tired after all his attempts, he acknowledges the power of those involved in the trade: “There is just too much money involved.”

Those benefiting from the current lack of regulation argue that a law permitting the transplant of organs from cadavers, even with the permission of the family, is somehow “un-Islamic”. And yet nine Muslim countries, including Saudi Arabia and Iran, have laws that ban the sale of organs, while permitting transplants of organs that have been freely donated.

What such a law would do is to protect people like Nazar Mohammad, a rickshaw driver in Sultanpura. Talking to CNN, he said: “No one does this for fun. We have all sold our kidneys to pay off a debt so that we can save our families from indentured servitude. There is nothing here, not even water. The landowners keep us oppressed.” He went on to say that more than 20 of his relatives, both men and women, had sold their kidneys.

And yet, despite the evidence that giving up a kidney can have hugely damaging effects on the donor’s health, you can visit a number of websites where such procedures are advertised. At www.masoodhospital.com we learn that “The transplant team at Masood Hospital consists of some of the most experienced doctors in the field.... The most important fact to be considered is that patients are in absolutely safe hands.”

Perhaps the patients are, but what about the donors? In India, a study found that the health of 86 per cent of kidney donors had declined after their operations. The sale of organs was banned in India 10 years ago, and this is one reason the trade is now booming in Pakistan. In fact, ours is one of the few countries in the world where no laws regulate transplants.

Although a bill was drafted as long ago as 1992, no government has pushed it through, ostensibly fearing a backlash from fundamentalists. However, given the fact that even a conservative country like Saudi Arabia regulates transplantation, it is clear that the doctors making millions through the trade are using religious sentiment to block any legislation that would upset the status quo.

To be fair, the health ministry has been calling for a law to halt this trade. In a summary sent last year to the cabinet, it was pointed out that “Incidents of kidney selling by the poor is on the rise. Patients from certain developed countries visit Pakistan buy organs for transplantation at local kidney centres.” Nearly a year later, there has been no movement on the ministry’s proposal for legislation.

Despite the government’s fears of opposition from religious quarters, as long ago as 1981, an Islamic Code of Medical Ethics was worked out, and which recommended: “The donation of body fluids or organs such as blood transfusion to the bleeding or a kidney transplant to the patient with bilateral irreparable renal damage is ‘fardh kifaya’, a duty that donors fulfil on behalf of the society and if the living are able to donate, the dead are even more so.... This is indeed charity.”

This unambiguous and humane interpretation of Islamic doctrine should surely put to rest any reservations in the minds of our politicians. And yet, legislation remains stalled. Clearly, it is greed, and not faith, that is enhancing Pakistan’s reputation as a “kidney bazaar”.

Doctors who make a very good living out of transplants justify their actions by claiming that they are saving lives, while at the same time enabling poor donors to make some money. To hear them talk, it would seem they are saints who only perform these operations out of the goodness of their hearts. The reality is very different: the very fact that hospitals charge around $15,000 for the procedure, while giving donors only a tenth of this amount, indicates the level of exploitation.

Those involved in this racket are aware that if the government were to pass a law permitting transplants from cadavers, as well as from brain-dead people, while banning their sale and purchase, this lucrative business would end. As this is the law in most countries, including many Muslim ones, they are trying to use every trick in the book to block legislation.

And while this behind-the-scenes lobbying takes place, thousands of poor Pakistanis are being tempted to sell their organs to benefit rich foreigners and unscrupulous surgeons.

A law would not just protect the poor, it would make more organs available for transplants. Currently, only the rich can afford the operation because kidneys are unavailable. The poor simply die. Surely it is high time that we acted to protect our most vulnerable citizens from a handful of vultures. If foreigners want to visit our shores, we should welcome them, but not to raid the body parts of the poor of Pakistan.