In Myanmar, a troubling and desperate underground trade of human kidneys has emerged, particularly in the wake of the country’s civil unrest and economic collapse following the 2021 military coup. As the conflict has torn through the country, many Myanmar villagers, burdened with crushing poverty and debt, have resorted to illegal kidney sales as a means of survival. One such villager, Zeya (a pseudonym), shared his harrowing story with BBC Burmese, revealing the extent of desperation that has led him and others to part with one of their vital organs in exchange for a monetary sum that promises to alleviate some of their most pressing financial burdens.
Zeya’s decision to sell his kidney was driven by an unrelenting need to provide for his family and settle his outstanding debts. Living in a small village far from Myanmar’s bustling capital of Yangon, he faced a grim reality. The prices of essential goods had soared as a result of the civil war, and Zeya could barely afford to feed his wife and children. With no house of his own and forced to live with his mother-in-law, Zeya became aware of others in his community who had also sold their kidneys to ease their financial strains. Inspired by their apparent health after the procedure, he decided to investigate further and take the same desperate step.
He soon made contact with a “broker” who facilitated the illegal transaction, promising to arrange everything from medical tests to surgery. While the sale of kidneys is illegal in both Myanmar and India, where many of these procedures are carried out, the broker was skilled at navigating the complex and often dangerous world of organ trading. Zeya was told that a potential recipient, a Burmese woman, had been found, and the two would travel to India for the operation. In India, the law requires that organ transplants between non-relatives are altruistic, and that the relationship between the donor and recipient be explained convincingly. To circumvent these laws, the broker forged documents, creating a false family connection between Zeya and the woman in need of the kidney.
Zeya recalls the disturbing process of having his name added to a fake family tree, which the broker presented to Indian authorities as proof of the supposed familial connection between him and the recipient. Once in India, Zeya underwent the necessary interviews with a panel of medical professionals, who were tasked with ensuring that he was donating his kidney voluntarily and without coercion. After passing the scrutiny, Zeya underwent the surgery at a large hospital in northern India, where he remembers being administered anesthesia before drifting into unconsciousness.
Though Zeya’s immediate recovery went smoothly, he endured significant pain post-surgery and was unable to move freely for some time. However, the money he received for his kidney—roughly 7.5 million Myanmar kyats, or between $1,700 and $2,700—was enough to pay off his debts and purchase a plot of land. This was a life-changing sum, but Zeya was left with lasting physical pain and the knowledge that he had participated in an illegal and morally dubious transaction.
Another individual, Myo Win (also a pseudonym), shared a similar tale with BBC Burmese. Like Zeya, Myo Win was struggling with medical bills for his wife and mounting debts. When approached by the same broker, he was offered the same sum of money but was told that the donation was a “charitable act” and that he was simply helping a relative in need. Myo Win, too, was told to memorize a false story about his connection to the recipient and was provided with fake documentation to support the narrative. The broker even arranged a fake call with Myo Win’s supposed mother to further convince the authorities that the organ donation was legitimate.
Both Zeya and Myo Win received part of their payment upfront, and the remaining sum was promised after the surgery. Although they both experienced physical discomfort and health complications following the procedure, they felt trapped by their financial circumstances. Myo Win, in particular, expressed regret but acknowledged that the financial pressures he faced left him with little choice. “I had to do it because I had already taken their money,” he said. “I had no job and no way out.”
The consequences of the military coup and the subsequent civil war have been devastating for Myanmar’s population. As unemployment rates soared and foreign investment fled the country, the standard of living plummeted. By 2023, half of the country’s population was living in poverty, compared to a quarter in 2017. This dire situation has driven many to seek desperate means of survival, and the illegal organ trade has become a way for some to escape crushing debt and poverty, even if it comes at a high personal cost.
However, the illegal organ trade is not unique to Myanmar. It has been documented in several other countries across Asia, including India, Pakistan, Nepal, Bangladesh, and Afghanistan, where poverty-stricken individuals are lured into selling their organs by brokers who exploit their desperation. The World Health Organization (WHO) has long warned of the dangers of the black market for organs, estimating that 5-10% of transplanted organs come from illicit sources. These illegal transactions not only exploit vulnerable individuals but also pose significant health risks, including complications during and after surgery, as well as the potential for lifelong health problems.
In India, where many of these transplants take place, concerns have been rising about the growing trend of illegal kidney sales. In one high-profile case last year, Indian police arrested seven people, including a doctor, who were accused of running a kidney racket that targeted impoverished individuals from Bangladesh. This case highlights the widespread nature of the issue and the challenges authorities face in regulating and controlling organ transplants, particularly those involving foreign nationals.
Despite the efforts of law enforcement, illegal kidney sales continue to thrive in countries where poverty and economic instability create an environment of desperation. The role of brokers in facilitating these transactions has made it more difficult for authorities to prevent or track such activities. In some cases, brokers even provide assurances that no legal repercussions will follow, feeding into the false sense of security that encourages people to take such drastic steps.
For individuals like Zeya and Myo Win, the decision to sell a kidney may have brought temporary relief from their financial woes, but it also leaves them with physical and emotional scars. Zeya, in particular, expressed that while he had no regrets about selling his kidney, the lingering pain and the ethical cost of his decision would stay with him for the rest of his life. “I have to restart working soon. If the side effects strike again, I have to deal with it,” he said, reflecting the ongoing consequences of his decision.
In Myanmar, the lack of effective law enforcement and the widespread poverty have made it difficult to stem the tide of illegal organ sales. Public health officials have raised concerns about the risks involved in such transactions, particularly the lack of post-operative care and the potential for complications. Dr. Thurein Hlaing Win, a public health campaigner in Myanmar, noted that the government’s failure to effectively address the issue means that many more people will continue to fall prey to this illegal trade.
Zeya’s story, along with the stories of others like him, underscores the dire consequences of economic collapse and political instability. It highlights the lengths to which individuals will go to survive in a country where hope for the future seems out of reach. While Zeya and Myo Win may have found temporary financial relief, the long-term consequences of their actions—both physical and moral—are significant. As Myanmar continues to grapple with the effects of war and poverty, it remains to be seen how the international community will address the growing crisis of illegal organ sales and the exploitation of vulnerable populations.