MUCH to the dismay of people with a conscience, the unlawful organ trade, which has brought such a bad name to Pakistan and its medical profession, is back with a bang. It was believed to have been checked when the Human Organ Transplantation Ordinance (HOTO) had been promulgated in September. Once again stories are rife of middlemen luring poverty-stricken men and women to sell their organs for a pittance and avaricious surgeons throwing their morals to the winds and using their skills to mint money by fleecing wealthy but desperately ill foreigners. Much to our ignominy the complaints are now coming in from abroad - from transplant surgeons and WHO. Small wonder, the director of SIUT, Dr Adib Rizvi, who had been at the forefront of the campaign for the adoption of HOTO, has strongly protested against the reported malpractice and demanded action against the wrongdoers. This reaction is understandable. The organ trade must be condemned on ethical and humanitarian grounds. For several decades, Pakistan remained one of the few countries where organ transplantation was introduced and expanded without any law to regulate it. As has been amply demonstrated, unregulated medical practice is also open to abuse of the worst kind. It was therefore a happy occasion when the concerted struggle by transplantation surgeons and civil society led to the adoption of HOTO which inter alia bans the trade in human organs. It appears that HOTO which took off with many a hiccup is in danger of meeting the same fate as many other good laws in Pakistan that have come to nought due to non-implementation. The lobbies that had resisted the law initially are strongly entrenched. Once the law was adopted they tried to sabotage the spirit of the ordinance by attempting to manipulate the process of registration of health facilities entitled to carry on transplantation surgery. Now some of them are flouting the law and are back in their unscrupulous business with a higher price tag. The government has so far turned a blind eye to the racket. This is inexcusable considering that trading in human organs is illegal under HOTO. It is important that the institutions that are indulging in this reprehensible activity should be identified and the surgeons named. Their registration must be cancelled by the PMDC. They do not deserve to be in this noble profession. It is also important to publicise the law so that transplant tourism is brought to an immediate end. To exploit the indigence of a person and the desperation of an ill person violates human dignity. It is also medically hazardous because a surgeon in a hurry to perform surgery surreptitiously is more likely to botch up his case and put two lives at risk. __
