More than half of Afghanistan’s population of 38 million suffers acute hunger. The country has descended into even further financial mayhem since the Taliban took over the country six months ago. The suffering of the people that was already dire after 20 years of war is spiralling into an ever-increasing humanitarian emergency.
To survive and feed their children, ever more Afghans are selling their kidneys.
Illegal organ trading existed prior to the Taliban takeover in August 2021, however, the black market has snowballed after millions disintegrated into poverty in response to international sanctions.
The dire consequences of the strong economic penalties, combined with one of the country’s worst droughts and the effects of Covid have shattered the country. On top of the widespread practice of selling organs in order to survive, parents have been reported as offering their daughters to childless couples or for marriage in return for money as they no longer have the means to feed them.
Kidney removal has become so prevalent in the western city of Herat, that a nearby village is known as the “one-kidney, village,” where dozens of residents have gone under the knife in a desperate attempt to avoid starvation and pay off debts.
Five brothers from one family each sold one of their kidneys in the last four years, in the belief it would save them from their lives of poverty.
However, this hasn’t been the case.
“We are still in debt and as poor as we were before,” said Ghulam Nebi, who now has a large scar from where his kidney was excised.
Many Afghans also suffer from ill-health after having a kidney removed. Normally donors and the recipients of kidney transplants go on to lead full, healthy and normal lives, but their wellbeing after the surgery is generally monitored and they have access to a healthy diet.
This is not the norm in Afghanistan. Mohammad Wakil Matin, a former surgeon at a hospital in the northern city of Mazar-i-Sharif confirmed that very few donors arranged follow up checks.
“There are no public health facilities to register kidney sellers and donors for regular examinations to check on implications for their health,” he said.
The donors also earn very little compensation for their kidneys.
The price of a life-saving kidney which once ranged from $3,500 to $4000 has dropped dramatically since the Taliban took over.
Nooruddin was one of eight people AFP spoke with who had sold a kidney to feed their families or pay off debt – some receiving as little as $1500.0. At the time saw no way to feed his children as he was jobless and had debts.
His decision has led to ill-health.
“I regret it now,” he said.
“I can no longer work. I’m in pain and I can’t lift anything heavy.”
After the money from his kidney ran out, the family now live of the money his 12-year-old son earns, who polishes shoes for 70 cents a day.
In Afghanistan the practice of kidney donation and the funds received for it are unregulated.
“There is no law…to control how the organs can be donated or sold, but the consent of the donor is necessary,” Matin explained.
Another surgeon, Mohammad Bassir Osmani who operates at one of two hospitals where the majority of Herat’s transplants are performed confirmed “consent” was the key.
“We take written consent and do a video recording from them – especially from the donor,” he said.
Osmani also added that hundreds of surgeries have been performed in Herat over the past five years.
“We have never investigated where the patient or donor comes from, or how. It’s not our job.”
Brokers match desperate Afghans with wealthy patients who travel to Herat from across the country and from other countries such as India and Pakistan in search of a life-saving kidney.
The recipient pays for both the hospital fees and the donor.
“I sold my kidney for 250,000 Afghanis (around $2,700) said a woman called Azyta. She shared that her family had so little food that two out of her three children had recently been treated for malnourishment.
“I had to do it. My husband isn’t working, we have debts,” she said.
Her husband is now planning on selling one of his kidneys.
“People have become poorer,” he said. “Many people are selling their kidneys out of desperation.”
Shakila sold her kidney for $1,500, shortly before the Taliban seized power. Already a mother of two at 19, she bypassed a broker by searching out a patient at a Herat hospital.
“We had no choice because of hunger,” she said.
Another mother of three Aziza is trying to sell her kidney. She has already met with a hospital staffer who is trying to match her with an appropriate donor.
“My children roam on the streets begging,” she told AFP.
“If I don’t sell my kidney, I will be forced to sell my one-year-old daughter.”