Tuesday, October 30, 2007

An Organ For A Dime

A Chennai doc's arrest shows the kidney trade continues to flourish in the city

Doctor Kingpin

* Conducted 471 kidney transplants in two Chennai hospitals in the last six years
* Charges Rs 15-Rs 20 lakh per operation. Is said to be worth Rs 100 crore. Owns three bungalows and three farmhouses in and around the city.
* Donors, most of them poor, gullible women, were lured by lakhs but paid only a few thousands

Chennai cops now admit that it is but a fraction of a well-organised racket involving a network of brokers, sub-brokers, and doctors, with gullible donors hoping to better their lot.

"They spoke so well," says a poor woman donor. "And they were doctors, after all. We trusted them."

Many believed the kidney racket flourished—and faded out—in Chennai in the '90s. Till the Mumbai Police arrested Dr Palani Ravichandran on October 16, and discovered that the trade was thriving. With his tally of 471 transplants in six years—most of them at Chennai's
Bharati Raja and St Thomas Mount hospitals—Ravichandran is believed to be the mastermind behind a racket which is worth several hundred crores.

Charging between Rs 15 lakh and Rs 25 lakh per surgery and paying donors only in the region of Rs 25,000-Rs 60,000, Dr Ravichandran's personal assets are worth Rs 100 crore. He reportedly owns three bungalows and three farmhouses in and around the city. Income tax raids at his residence in Mugalivakkam and clinic at St Thomas Mount yielded incriminating documents. The Mumbai crime branch has also seized documents that will throw light on the kidney transplants conducted by doctors at two Chennai hospitals.

Dr. Dread: Ravichandran, the brain behind the racket
The Mumbai police got wind of Ravichandran's antics after Jeetu Borkar, an unemployed youth from Chembur, suburban Mumbai, who donated a kidney, complained of being shortchanged. He was promised Rs 4 lakh but paid only Rs 25,000. The trail of investigation led the police to Dr Ravichandran, who was arrested along with four touts in the city. Investigations revealed that while the doctor was based in Chennai, he also facilitated and performed transplant surgeries in Mumbai.

Among the scores of women who parted with a kidney to buy a better life is Uma Devi, 26. Promised Rs 3 lakh by a broker and a "Dr" Ramesh of Arun Polyclinic in Vadapalani, she donated her kidney so her husband could have plastic surgery to fix the damage an acid attack caused to his face and chest nearly three years ago. But the doc reneged on the deal and she ended up with just Rs 63,000, a sari and a gold bracelet. She used the money to pay off her debts and later filed a police complaint saying she had been cheated.

Cheated is how every kidney donor (more women as there is always a risk of men having damaged their kidney due to drinking) is feeling, whether they parted with one of their organs a few years ago or in the recent past. It's also a reflection of how the law (the Transplantation of Human Organs Act, 1995, which makes donating your kidney for financial considerations or under pressure illegal) has been unable to stem the racket. In fact, the trade—and money to be earned thereof—has only grown in scale.

Uma Devi's case is quite instructive of the ingenious means the racketeers had devised to circumvent the law. Before she could offer herself as a donor, Uma was sent to Sri Lanka under an assumed identity—Govindamma—and a false Indian passport in April 2005. She returned a month later as Uma, on a Sri Lankan passport, and shown as a relative of Maheshwaran, a Lankan, who was undergoing dialysis at the Madras Medical Mission hospital. The idea was to show that Uma was her kidney recipient's relative in the medical report.

Unrelated kidney donors have to go through several screeings before they are cleared by the state government's organ authorisation committee.

Extreme circumstances compelled most donors to donate their kidneys, but all of them say they had no inkling that they would be conned. "They spoke to us so well," says Uma. "And they were doctors, after all. So, we trusted them." "I saw my neighbour go for blood and other tests," says Rajambal, another donor from Uma's neighbourhood. "She told me that a broker was going to give her money for her kidney. Since I had a daughter of marriageable age and no economic means to get her married, I decided to donate my kidney. I now feel I sold a part of my body rather cheaply."

The loot: Income tax men raid Ravichandran's Chennai house

How did things come to this pass? Scott Carney, a freelance journalist who has investigated the kidney racket in the state extensively, says a member of the TN Transplant Authorisation Committee had told him this: "We do everything in accordance with the letter of the law on paper, but we know that almost all of the documents we see are false. It is an open secret. It is either approve a transplant with forged documents, or a patient is going to die."

"The Directorate of Medical Services should investigate hospitals and the organ authorisation committee of the state health department," says superintendent of police K. Bhavaneswari of the Chennai crime branch. "We can book the accused only under sections of the ipc pertaining to forgery and cheating." The police have already sent a letter to the authorisation committee. "We have sent them a letter," says Abhay Shastri, senior inspector of the Mumbai crime branch who is investigating the case, "and are awaiting their reply. If they have given the permission, they will have some explaining to do."

Ravichandran apparently said he had "committed a mistake" during interrogation and that he was innocent. But Shastri refuses to believe this. "The entire nephrology department was under him," says he, "and he had hired an entire floor for the transplants." However, C. Natesan, managing director of the Bharathi Raja hospitals, has denied his hospital's involvement. "Dr Ravichandran," he says, "used to hire our operation theatre for surgeries and used to move his patients within a day or two. All consultations, tests and diagnoses were conducted at St Thomas Hospital with which he is associated."

But that, says eminent neurologist Dr G. Arjundas, "is like saying I rented out my house but I did not know bombs were being made in the kitchen. I am very, very angry. In our time, we let our work speak for us, but today some doctors think getting a BMW is what medicine is all about." The Hippocratic Oath? It went out with the 4th century BC.
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