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Medical tourism is a cover up for cheap kidney bazaar. The government of Pakistan has recently adopted a policy to promote medical tourism in the country. It has waived off duties and taxes on import of certain machinery and medicines in support of the tourism industry.
But can the country offer any type of medical excellence at economical rates to the foreign visitors? A research by TheNetwork reveals that the country has nothing to offer the world but cheap kidneys. Desperate to earn dollars, the government is ready to sell any thing to foreigners, even the kidneys of its poor population. The medical tourism is in fact a label for protecting and promoting trade in human organs.
Medical tourism is travelling to some country for some treatment, which is economical compared with one's home country. Many Asian governments are developing medical tourism as industry for the last few years and the experts estimate that it will become a 4 billion dollar industry by 2012 in Asia alone. There can be two attractions for a foreign patient to become a medical tourist in another country.
Firstly the health facilities being offered by the host country are economical yet meet international quality standards, secondly the tourism sector of the host country is developed and offers the patient additional attraction of spending vacations there. It does not need an argument to establish that Pakistan neither has world class health facilities nor does it have a developed infrastructure for tourism.
In fact whatever tourism industry the country had, has been in crisis since the 9/11 and the subsequent war on terror. Similarly the country's health care infrastructure is in appalling condition. Pakistan spends only 0.5 per cent of GDP on health and a considerable portion of the population is deprived of the basic health facilities.
This makes Pakistan a totally unattractive destination for medical tourists. However, Pakistan has some other kind of attractions for medical tourists; the kidney transplantation.
Pakistan is among handful of countries where human organ trade is not covered with any legislation and the extreme poverty forces people to sell even their organs. Organ trade is an affront to human dignity and is outlawed or strictly regulated in most of the countries.
Pakistan, in spite of introducing legislation to check the growing organ trade through law (the bill on human organ transplantation is pending with parliament for the last 15 years) has come up with special incentives for the transplant industry.
It has exempted from duty and taxes the import of plant, machinery, equipment's for 'kidney dialysis and transplantation' and exempted all duties on the imports of 'drugs used for kidney dialysis and kidney transplant'. These exemptions cost the government a revenue loss of Rs 230 million in the current fiscal only.
As the result foreigners are flocking to Pakistan to get a 'donated' or 'purchased' kidney transplanted by spending lesser energy and money on the process, which is otherwise very costly in their own countries.
It can take as low as Rs 300,000 ($5000) to a foreigner to spend on a renal transplant in Pakistan. The lion's share of this amount is pocketed by middlemen, doctors and transplant centers. The so-called 'donor' gets only Rs 50,000-100,000 for selling his or her kidney to an alien patient. In US a kidney transplant normally costs Rs 60 lakh ($100,000) and the patient has to himself seek a donor.
The buying and selling of kidneys commodities human organs. The people who resort to such unethical practices exploit the vulnerable and powerless members of society by treating them as means to an end. By legalising the transplantation under the beautiful cover of medical tourism, it seems, government has also acknowledged humans as commodities, the organs of whom can be sold and used to earn revenue, especially the foreign exchange.
KIDNEY BUSINESS IN PAKISTAN Every year, thousands of people suffering from irreversible kidney failure get a new lease of life by receiving the transplant of kidneys donated by some individuals. There are two kinds of transplantation; cadaver transplant and live human to human transplant.
In cadaver transplant the kidney of a person, who is medically proclaimed brain dead is transplanted to a patient. Most of the countries prefer this transplantation and provide it a legal cover as well.
In live transplant, according to legislation of various countries, only genetically related people or donors with blood relation to patient (like brother, sister, son, daughter) can donate their kidneys for their loved ones. The organ trade is legally outlawed in all but a handful of countries. Even the countries where unrelated donations are accepted follow a strict regulatory protocol, like Iran.
In Pakistan kidney transplantation was introduced in the mid-1980s and currently more than 2,000 transplants are undertaken each year. However, in our country the sense of selflessness that has traditionally motivated organ donation is being rapidly submerged in a tide of commercialism in which "body parts" are being sold in a market controlled by buyers.
As Pakistan has no legislation on the issue, the human organ trade is rampant and there is no dearth of medical professionals who tend to justify the trend citing that it helps the poor donors.
According to Dr Farhat Moazam of Centre of Biomedical Ethics and Culture, Pakistan is rapidly establishing itself as an international leader in this practice. She says that in the year 1991, 75 per cent of kidneys transplanted in Pakistan were donated by family members to their relatives.
In contrast, by 2003, 80 per cent of all transplanted kidneys in country were being obtained from unrelated donors. "Over half of the 2023 transplantation's performed in 2003 were undertaken on citizens of other countries, especially those from the Middle East.
In addition, more than 1,400 of all transplants were performed in private hospitals in Punjab, especially those located in Lahore and Rawalpindi. This burgeoning transplant tourism is no secret; the healthcare community and the government of Pakistan are well aware of the names of physicians and institutions involved in this practice.
Those who are in the dark have only to go to the Internet to view "transplant packages" being offered in newspapers around the world by hospitals located in the private sector in Punjab", Dr Moazzem suggests.
In these advertisements posted on the Internet, foreigners are given a "transplant package cost" that ranges from $1300 to $25,000, and includes the cost of a kidney labelled euphemistically as "donor cost".
"Based on rough calculations of the number of kidneys being transplanted each year in "foreigners" in this country it is easy to arrive at an estimate of a lucrative business of about $15 million annually for transplant physicians, surgeons, and their hospitals", she elaborates.
In recent past, newspapers have carried multiple stories about destitute individuals from villages in Punjab who have sold their kidneys to hospitals. Most of these 'donors' are brick kiln workers, caught in a vicious web of loans of kiln owners. They are often bounded labourers and put their body parts for sale to meet some urgent needs like marriage of sister or daughter or medical treatment of some severely ill family member.
(To be concluded)

Copyright Business Recorder, 2007

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