The one-kidney village

This news is so tragic that one would be shocked just hearing about it—such horrifying things do happen in this world! And that too in Bangladesh! Wars, conflicts, and bloodshed around the world cause human suffering. People die in wars, famines, floods, droughts, and various natural calamities—these too bring tears to human eyes. But if you hear that a village has been identified as a "one-kidney village", not only will you be shocked, you will also begin to question the very state of human civilisation.

You might not believe it at first—that for just Tk 3-3.5 lakh taka, people are selling one of the most vital organs of their body. A person can survive with one kidney, and many donate one to save a loved one’s life. It is not unknown to us that some sell a kidney simply out of poverty. But if, out of six thousand people in a village, one out of every thirty-five sells a kidney, that is not just unbelievable—it is news that makes one tremble.

Such a terrifying incident has taken place in the village of Baiguni in Kalaihat, Joypurhat, Bangladesh. This village is now known as the one-kidney village. Many people here make a living by selling their kidneys. The village is so poverty-stricken that its residents are compelled to sell their kidneys to survive. According to local sources, since 2015, kidney trafficking has become a major problem in the village.

One such kidney seller is Safiruddin (pseudonym), aged 45. In mid-2024, he went to India and sold his kidney for Tk 350,000. He had thought that with that money, he could lift his struggling family a little. He hoped to provide better food for his three children, maybe fix the house. Alas, the money is gone, and the house remains unrepaired. The price he received from selling his kidney is spent. But the real price he paid remains in the unbearable pain across his body. Now, the pain only serves as a memory that he has lost a vital organ of his body.

His health has deteriorated. He now works as a day labourer in a cold storage facility. Constant physical weakness and pain make it nearly impossible for him to do heavy work anymore. He told Al Jazeera, “I sold my kidney so my family could eat well and survive. I did it all for my wife and children.”

At the time, it had seemed to him like a smart decision. He hadn’t thought about what kind of complications might arise later or how terrible the consequences could be. The broker through whom the kidney was sold had also convinced him it was no big deal. It was, in fact, a great opportunity, not a danger!

The brokers took him to India with a medical visa. They arranged everything. Safiruddin doesn’t know to whom he donated his kidney. According to Indian law, organ donation is permitted only among close relatives or through special government approval. But the traffickers circumvent these rules by forging everything—family trees, hospital documents, even DNA test results.

Professor Moniruzzaman of Michigan State University, who has been researching organ trafficking in South Asia for a long time and is a member of the World Health Organization’s Task Force on Organ Transplantation, states: “Typically, the organ seller’s name is changed and a notarised certificate with a lawyer’s seal is produced to prove a false familial relationship between donor and recipient. Fake national ID cards are used to show that the donor is actually the recipient’s sister, daughter, or another relative. This is how organ donation is presented as an act of sympathy, while behind it lies the intricate deceit of trafficking networks.”

Safiruddin’s story is not unique. In the village of Baiguni in Kalai upazila of Joypurhat district, kidney selling is so common that the area is now known among locals as the "one-kidney village". With fewer than six thousand residents, this village and its surrounding areas have become a hub for kidney trafficking. A 2023 study published in the British Medical Journal Global Health revealed that one in every thirty-five adults in Kalai upazila has sold a kidney.

Kalai is one of the poorest regions in the country. Most donors here are young or middle-aged men who fall into the brokers' traps out of desperation for quick money. The study found that 83 percent of donors cited poverty as the main reason for selling a kidney. Some said they were forced into the decision due to debts, drug addiction, or gambling habits.

Safiruddin reported that the brokers took his passport before the surgery and never returned it. He didn’t even receive the medicines that he was supposed to take according to the doctor's advice.

After surgery, brokers often keep the donor’s passport and medical documents, leaving no evidence behind and depriving the donors of any future medical care. This puts them at severe health risks.

The kidneys collected in this manner are sold to wealthy patients in Bangladesh and India who want to bypass the lengthy legal procedures and strict regulations for transplants. In India, only 13,600 kidney transplants were conducted in 2023, while about 200,000 people are diagnosed with end-stage kidney disease every year.

Al Jazeera spoke with several kidney donors in Bangladesh. All of them said it was poverty that pushed them to sell a kidney. Behind this trade lies a harsh reality: poverty.

Another victim like Safiruddin is Jyotsna Begum, 45. After her husband's death in 2012, she struggled with her two daughters. She is from Binai village in Kalai upazila. To escape poverty, she first came to Dhaka to work in a garment factory. There, she met a man named Belal, and they married. After the marriage, they fell into the hands of a trafficking ring. In 2019, both husband and wife went to India and each sold a kidney. “It was the biggest mistake of my life,” said Jyotsna Begum. “The broker first said he would give five lakh, then said seven lakh; but after taking the kidney, he gave only three lakh.”

Belal also received three lakh for his kidney and, after getting the money, left Jyotsna Begum and married another woman. Now Jyotsna suffers constantly from physical and mental pain. She said, “I can’t do any heavy work. I survive on medication. I don’t even have money to buy medicine.”

Both Jyotsna Begum and Safiruddin cannot sleep at night. They lie in bed in pain, thinking about the grave mistake they made. Caught in the brokers’ traps, they lost a precious organ. The price they received is far less than the cost they now pay in unbearable suffering.

On the other side of the border in India, law enforcement agencies have taken strict action against kidney trafficking; but unless poverty in the region is eradicated, the helpless cannot be freed from this horrifying cycle.

Based on a report published in Al Jazeera