'I sell my kidney to get my own house and pay my debts'

"I just want make I get my own house and pay all my debts – dat na why I decide to sell my kidney," Zeya wey be farm worker for Myanmar tok.

Prices shoot go up afta one coup wey occur for 2021 cause civil war. Im bin find am hard to feed im young family and gbese bin full im head.

Dem bin all live for im mother-in-law house, for one village wia thatch house line up for roads wey dey few hours drive from di kontri biggest city, Yangon.

Zeya, wey we change im name to hide im identity, sabi some local pipo wey don sell one of dia kidneys. "Dem look healthy to me," e tok. So im begin ask around.

Im follow among di eight pipo for di area wey tell BBC Burmese say dem sell one kidney by travelling to India.

Illegal organ trading na problem across Asia, and Zeya story help torchlight how e dey take happun.

Arranging di deal

Buying or selling human organs dey illegal for both Myanmar and India, but im say, im soon find one man wey im call "broker".

Im say di man arrange medical tests and, few weeks later, tell am say dem don find one potential receiver – na Burmese woman - and say dem two fit travel go India for di surgery.

For India, if di donor and receiver no be close relatives, dem must to show say dem no dey donate am for selfish reason and explain di relationship between dem.

Zeya say di broker forge one document, wey every family for Myanmar must get, listing di details of family members.

"Di broker put my name for di receiver family tree," im explain.

Im say di broker make am look like say im dey donate to pesin wey im dey related to by marriage - "someone wey no be blood relative, but distant relative".

Den, im say, di broker carry am go meet di receiver for Yangon.

For dia, im say one man wey introduce imsef as doctor complete more paperwork and warn Zeya say im go pay plenty money if im say im no do again.

BBC bin contact dis man afterwards, wey say im part for di mata na to check weda or not di patient dey fit to do di procedure, not to check di relationship between donor and receiver.

Zeya say dem bin tell am say im go collect 7.5m Myanmar kyats.

Dis na somewia between $1,700 and $2,700 over di last few years - di unofficial exchange rate no stable since di coup.

Im say im fly go northern India for di operation and e happun for one big hospital.

All transplants wey involve pipo from foreign kontris for India must dey approved by one panel wey dem dey call authorisation committee, wey either di hospital or local goment establish.

Zeya say four pipo bin interview am, through one translator.

"Dem ask me if I dey willing to donate my kidney to her, not by force," im say.

Im say e explain give dem say di recipient na relative and di transplant dey approved.

Zeya remember di doctors as dem bin dey give am anaesthetic before im lost consciousness.

"No big issues happun afta di surgery, except say I bin no fit move without pain," im tok, come add say im stay for hospital for one week.

'Fake mama'

Anoda donor, Myo Win - also no be im real name - tell BBC say im too bin get to pretend say im dey related to one stranger.

"Di broker give me one paper, and I get to memorise wetin dem write inside," im tok, come add say dem tell am to say di pesin wey dey receive di kidney dey married to one of im relatives.

"Di pesin wey bin assess my case also call my mama, but di broker arrange one fake mama for di call," im tok.

E say di pesin wey ansa di call confam say im dey donate im kidney to one relative wit her permission.

Myo Win say dem bin offer am di same amount of money as Zeya, but dem describe am as "charitable donation", and im bin pay di broker about 10% of am.

Both men say dem bin give dem one third of di money up front.

Myo Win say dis bin dey im mind as im enta di operating theatre: "I make up my mind say I get to do am becos I don already collect dia money."

Im add say im bin "chose dis desperate way" as im bin dey struggle wit gbese and medical bills for im wife.

Unemployment don rise for Myanmar since di coup wey make foreign investors run.

For 2017, one quarter of di population bin dey live in poverty - but by 2023, di number don rise to half, according to UN development agency, UNDP.

Myo Win say di broker no tell am say selling im kidney dey illegal. "I for no do am if to say im tell me. I dey fear to go prison," im say.

Di BBC no go name any organisation or pipo so dat e go protect di identity, anonymity and safety of pipo wey we interview.

However, anoda man for Myanmar, wey also no want make dem call im name, tell BBC say im don help about 10 pipo buy or sell kidney through surgery for India.

Im say im bin refer pipo go one "agency" for Mandalay wey dey central Myanmar, wey im say make arrangements.

"But no worry about donors," im tok. "We get list of donors wey dey queue up to donate dia kidneys."

E too say dem dey fake di documents to label strangers as related by marriage.

Wen dem ask am weda im dey collect money for im help, im no ansa.

Arrests in India

Organ transplants don increase by more dan 50% worldwide since 2010, as dem dey do reach about 150,000 per year, according to World Health Organization (WHO).

But di supply of organs meet only about 10% of global need.

Trading in human body parts dey illegal for nearly all kontris and e dey hard to measure.

For 2007, WHO give estimate say 5-10% of organs wey dem transplant come from black market, but di numbers fit dey higher.

Documents dey of illegal kidney sales wey don occur in recent years sake of poverty across Asia, including Nepal, Pakistan, Indonesia, Afghanistan, India and Bangladesh.

For long time, India na centre for medical tourism and concern about selling of kidney don dey rise for dia sake of accounts for media reports and one recent police investigate.

Last July, India police say dem bin arrest seven pipo wey get connection wit one alleged kidney racket, including one India doctor and her assistant.

Police allege say di group dey arrange for poor Bangladesh pipo to sell dia kidneys, using fake documents to get approval for di transplants.

Dr Vijaya Rajakumari, wey bin dey work for di ogbonge Indraprastha Apollo Hospital for Delhi, bin allegedly do operations as visiting consultant for one different hospital, Yatharth, wey dey few kilometres away.

Her lawyer tell BBC say di allegations "dey entirely baseless and without evidence", say she only bin dey do surgeries wey authorisation committees approve and she dey always act according to di law. According to her bail order, dem no accuse her of preparing fake documents.

Yatharth Hospital tell BBC say all im cases, including di ones wey visiting consultants dey manage, "dey subject to our strong protocols to make sure say dem comply wit legal and ethical standards".

"We don further improve our processes to prevent dat kain tin from happening for future," di hospital tok.

Afta her arrest, Apollo Hospitals say Dr Rajakumari na freelance consultant wey dey work on fee-for-service basis and e don end all clinical engagements wit her.

Dem never carry Dr Rajakumari go court.

'No regrets'

Last April, one senior health ministry official write to Indian states warning of "rise" in transplants wey involve foreigners and call for better monitoring.

Under Indian law, foreigner wey wish to donate or receive organs must get dia documents, including di ones wey show di relationship between donor and recipient, and dia own kontri embassy for India go verify am.

Di BBC contact India heath ministry and di National Organ and Tissue Transplant Organization, as well as Myanmar military goment for comment, but no receive response.

One public health campaigner for Myanmar, Dr Thurein Hlaing Win, say: "Law enforcement no dey effective."

Im add say potential donors need to dey aware of di risks, including of bleeding during surgery and damage to oda organs, adding say dem also need proper follow-up.

Di last time wey BBC bin hear from Zeya na several months afta im surgery.

"I bin dey able to settle my debts and buy one plot of land," im tok.

But im say im bin no fit afford to build house and no fit construct one as im bin dey recover from di surgery.

E say im bin dey suffer from back pain.

"I have to restart work soon. If di side effects strike again, I get to deal with am. I no get regrets about am," im add.

E say im bin dey in touch wit di receiver for some time, and she tell am say she dey in good health wit im kidney.

Speaking on condition of anonymity, she tell BBC say she pay 100m kyats (between around $22,000 and $35,000 in recent years) in total.

She deny say dem forge documents, maintaining say Zeya na her relative.

Six months afta im surgery, Myo Win tell BBC say im pay off im debts, but not all.

"I no get work and one penny no remain," im say, come add say im dey experience some stomach problems since di surgery.

E say im no get regrets, but den e come add say: "I dey tell oda pipo make dem no do am. E no good."



Poor pipo selling dia kidney - like dis man for Afghanistan – dey documented for many Asian kontris





Di supply of donated organs dey meet only about 10% of di world demand, according to WHO