If you are thinking of paying a person you do not know, a total stranger from another corner of the world, to pull you from the queue of those patiently waiting for a deceased donor organ, or from the onus of asking a relative or close friend to rescue you from dialysis, you should know that you are entering a moral, social and political grey zone. Be aware of the collateral damage – to the families of kidney sellers and to the economically battered communities where kidney brokering and selling has destroyed trust and livelihoods and has broken homes. In hard-hit villages and slums from Latin America to Eastern Europe to Asia, the obligation to sell a kidney to save the family is being passed down from the father to his wife to oldest sons and even to underage children.
The kidney is not a ‘spare’ organ, despite what you may have heard from some surgeons or transplant brokers. If you were able to talk to kidney sellers the world over, you would find that even years after the operation, many are still suffering from its effects on their bodies, minds, social status, intimate relations and working lives. Medical journals do not report on the largely invisible long-term consequences of kidney selling, which include: decreased physical and mental wellbeing, weakness, chronic pain, depression and suicide, self-hatred, distorted body image (‘half-person’), anger, social rejection, stigma and isolation. There are new psycho-social syndromes that will never appear in the latest revision of the Diagnostic and Statistical Manual of Mental Disorders: phantom kidneys, kidney regret, kidney impotence, bodily emptiness (‘the body without organs’), chronic pain at the site of the surgical scar, burning, itching spaces, floating organs, ‘strangled’ kidney, and the attribution of all subsequent life troubles to the ‘missing organ’.
