Global Health / Inspiration

Global Health Trafficking, Systems and Ethics

 

By Abhishek Dalal

Introduction:

The kidney transplantation waiting list far exceeds the number of donors, and there has been renewed discussion around the idea of selling kidneys. Meanwhile, kidney trafficking continues where the stolen organs are mostly transplanted to Westerners who are trying to survive. What may seem like a domestic issue is, indeed, interdependent with global poverty, health systems strengthening, and medical ethics.
It is against this backdrop that Mamta Jain Valderrama writes her novel A Girl in Traffick. This book belongs on the bookshelves of students, time-stretched executives, and healthcare providers alike. It brings to life many of the challenges in medicine and weaves together medical topics oft-considered to be distinct, allowing a Chief Medical Officer, for example, to gain traction with medical ethics.

The following is an interview with Mamta:
1. Your book presents both sides of buying and selling human organs, but certainly capture that stealing organs is immoral. What are your thoughts about a legal, regulated market for organ transplantation?
Perfect question! This is one of the reasons that I wrote this book and that is, I want my readers to give this question thought and for them to know that there are two sides in organ trafficking. There is a lot of discussion about the poor people who are duped into selling their organs but rarely, is there any talk about the people buying the organs, who are trying to survive. My own candid answer is an “I don’t know” and this question is highly controversial and an ethical enigma. I’m curious to see how Iran’s legal, domestic marketplace for organs evolves as a good case study.

2. Is there anything else you’d want readers to walk away with?
Another mission with this book is to raise awareness about organ trafficking. In our everyday vernacular, the term human trafficking is used to often mean sex trafficking and I would like to expand the scope and definition of the phrase ‘human trafficking’ to include organ trafficking.
Moreover, many people believe that organ trafficking is a myth, which I’ve noticed across my experiences in graduate school to working at the second largest dialysis provider in the US and with operations in India and elsewhere. It was surprising that there were no discussions about organ trafficking in even large organizations, and I realized that this issue needed a voice. Hence, I wrote my book as a thriller to reach a large audience and I believe raising awareness is the first step toward making change.

3. Lastly, a big theme of your book seems to be systems thinking and what do you think are appropriate next steps for organ trafficking?
Like all human trafficking, organ trafficking poses several legal and ethical challenges but the opportunity is not, unfortunately, to go into third world and stop criminals. In any case, most people are not empowered to take these steps. Moreover, organ trafficking wouldn’t occur if the demand were so great and therefore, the next step should involve reducing the kidney-donor shortage. It would be great to have an artificial implantable kidney and there’s a group at UCSF working on this; however, its fruition could take decades and the end-product may not be affordable. The other option is increased donations and there are many risks – it isn’t easy for somebody to say that they’re going to give one of their organs. Hence, the next step should involve education efforts and more so for deceased donation and for the prevention of kidney disease altogether. As an aside, health plans also have a role to play in covering the costs of organ donation, and more examination is needed on how they dis-incentivize organ donation!

Conclusion:

In her probing work, Mamta eloquently captures multiple sides of organ trafficking and the interdependencies at play. Part thriller and part travelogue, A Girl in Traffick is also a great novel and introduces many topics aside from medicine, including feminism and cross-cultural interactions, but without overly flowery prose – a perfect respite. Mamta is a healthcare strategist turned writer, and A Girl in Traffick is a well-needed book that spurs discussion about the role of organ trafficking alongside growing conversations about universal healthcare and improving quality.

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Abhishek Dalal is an undergraduate student of South and Southeast Asian Studies from UC Berkeley, with diverse experiences in patient safety, GME and organizational behavior.

Photo by nyayahealth.org, used under CC BY.

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