The organ trade is alive and well in Indonesia. It is being facilitated locally for international buyers and Singapore is a destination of choice. The beauty of Singapore is that it is close, it is clean, the hospitals are good, and doctors are turning a blind eye in some instances to the more intricate technicalities such as whether the donor and the recipient are truly related.
This story (based on a story in the Straits Times 27 July 2008) comes out of Galang which is about 70 kms from Medan in North Sumatera. It seems that there is no shortage of willing sellers who see their organs as tickets to some degree of financial independence and a better life for them and their families. The going rate for a kidney at the moment is about IDR 250 million which is about AUD 28,000. The going rate for a portion of your liver is about IDR 300 million.
To be clear the buying and selling of organs in Singapore is illegal. However, where the donor and the recipient of the organ are related then there is no ethical problem in the donor offering up their organs for transplant. A couple of Indonesians have been jailed and fined in Singapore for attempting to part with their organs for a fee. The laws in Indonesia also prohibit the trade of organs and hospitals are supposed to refuse surgery where it seems that there are commercial factors at play.
This is a case of simple math or economics. If you are earning IDR 5, 10, 15, or 20 thousand per day, then the idea of a IDR 250 million pay day for parting with a kidney might seem to be an attractive option for short term gain.
A case on point is that of Salimudin who sold 7.5cm of his liver for IDR 300 million. The process was one contingent on lies in that Salimudin was flown to Singapore and made two false declarations; one at the Indonesian Embassy and the second at the hospital in front of 10 doctors. Now that the formalities were over and everyone was satisfied that Salimudin was related to the recipient known as Samsul, the operation was carried out.
The IDR 300 million has allowed Salimudin to buy a 5,000sqm palm tree plantation and a house. By Salimudin's account everything is peaches as he and his family are better off than they were before and it only cost him 7.5cms of his liver. Life though is not that good that he would not consider selling a kidney.
Is this the first step into a brave new world where we breed people for organs?