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Philippines Tries to Reduce Sales of Kidneys for Transplant

In the Philippines, as in other impoverished parts of the world, selling a kidney may seem to offer an answer to financial hardship. But only the poorest of the poor resort to this, and their gains are often temporary. Douglas Bakshian reports from Manila, where he visited a district known as No-Kidney Island.

Reynaldo Yap has spent yet another uncomfortable night. After long hours working on a Manila dock, the scar on his side would not let him find the rest that he needed.

It has been a little more than one year since the 29-year-old sold his kidney. Even though he generally feels well, and can carry heavy loads, something seems different.

On cool days and nights he says he feels numb where the operation was, sometimes it hurts.

His story is only one of many in a place called Isla Walang Bato, or No-Kidney Island, in the Baseco section of Manila.

Running short of money and hope, Reynaldo decided to sell one of his kidneys to pay off a loan on a piece of land. He also bought some household appliances and sent money to his parents.

A broker arranged a deal under which Reynaldo received about $1,740 - a lot of money for a laborer making about $6 a day.

A Canadian received the organ. This is not unusual in the Philippines, where medical authorities estimate that in some large hospitals, more than 50 percent of all organs go to foreigners.

If a donor wants to make a private arrangement to sell a kidney, there is no law to stop him. However, it is illegal for a third party, or broker, to arrange the sale. To get around the law, the relationship is hidden, and it is difficult for the authorities to arrest violators.

Police Inspector Norberto Murillo works in Baseco.

"We hardly detect the brokers because [what] the brokers do is to accompany the donator to the doctors. So the brokers serve as a companion," he said. "And they don't put them as a broker, only a companion. It is only a secret agreement between the two of them."

How many residents of Baseco have sold their kidney over the years? Getting an accurate figure is difficult, although one University of the Philippines study estimates the number may be as high as three thousand.

According to Manila's National Kidney and Transplant Institute, or NKTI, there were just over 2,300 transplants in the Philippines between 2000 and 2005. It is not known how many of those kidneys were sold.

As with any major surgery, there are serious risks to removing a kidney. Donors can get infections or suffer other complications. And although most people can live healthy lives with only kidney, there is always a chance that donors may later develop kidney disease or other health problems.

A few years ago, the government began a program to educate poor kidney donors about the risks. This includes counseling for potential donors, twice-monthly transplant seminars at NKTI, brochures, and speeches around the country.

But Dr. Remedios de Belen-Uriarte, manager of the Philippine Organ Donation program in the Department of Health, says the effort has to be intensified because the commercial kidney traffic still goes on.

"We have to concentrate really on the indigent, or poor people, for them to know the consequences on their health, on their way of living after organ donation," said Belen-Uriarte.

A regulated approach to donations has been set up through the Kidney Foundation of the Philippines, a private organization. It offers a package of benefits worth about six thousand dollars to qualified donors. This includes free annual check-ups, life insurance, and cash. But the program is just over a year old, and its reach so far is limited.

That means the poor continue to take the risk. Many benefit little from the money they receive by selling part of their body. Baseco community councilor Rey Campenera says people frequently spend the money on short-term benefits.

"They don't know how to invest the money. They spend most of the money buying appliances, prettifying their house," he said. "But the problem is, after three or four months they have no more money so they go on selling those appliances they bought."

Baseco is not alone; there are other places in the Philippines where such activity goes on, and other developing nations as well.

Demand for transplants is massive. In the United States alone, the United Network for Organ Sharing says more than 95,000 people await transplants, mostly for kidneys. But only about 29,000 transplants were performed in 2006.

The World Health Organization says the international trade in organs is increasing, fueled by growing demand and unethical traffickers. According to the WHO, brokers may charge up to $200,000 to organize a transplant for wealthy patients.