Eleni Dagiasi flew from Athens to Delhi in January 2008 on a mission to save her life. With her husband, Leonidas, she took a taxi from the airport past sparkling multiplexes and office buildings to a guesthouse in the booming exurb of Gurgaon. A kitchen staff was on hand, the rooms had cable, and there was a recreation area with billiards, providing patients with creature comforts while kidney transplants were arranged. Over the next week, as her operation was scheduled, Dagiasi went to a makeshift hospital for dialysis. Then one night, while she was watching TV with her husband, a chef turned off the lights and urged everyone to leave. Shortly afterward, 10 policemen stormed in. “We were too stunned to react,” says Leonidas Dagiasis, a former fisherman who borrowed money from his employer to finance the trip. The couple and other guests were hauled off for questioning. The Gurgaon hospital, it turned out, was the hub of a thriving black market in kidneys. The organs were harvested from poor Indian workers, many of whom had been tricked or forced into selling the organ for as little as $300.
The mastermind, India’s Central Bureau of Investigation (CBI) charged, was Amit Kumar—a man who performed the surgeries with no more formal training than a degree in ayurveda, the ancient Indian system of medicine. In a career spanning two decades, Kumar had established one of the world’s largest kidney trafficking rings, with a supply chain that extended deep into the Indian countryside. Some of his clients were from India. Many came from Greece, Turkey, the Middle East, Canada, and the United States.
At parties in India and abroad, Kumar introduced himself as one of India’s foremost kidney surgeons, said Rajiv Dwivedi, a CBI investigator based in Delhi. The claim wasn’t entirely illegitimate: Investigators estimate that Kumar has performed hundreds of successful transplants, a practice so lucrative that he was able to finance Bollywood movies and had to fend off extortion threats from the Mumbai mafia. Two weeks after the police crackdown in Gurgaon, Kumar was arrested at a wildlife resort in Nepal and brought back to India, where he now awaits trial.
Kumar’s operation was a microcosm of the vast, shadowy underworld of transplant trafficking that extends from the favelas of São Paulo to the slums of Manila. The tentacles of the trade crisscross the globe, leaving no country untouched, not even the United States, as evidenced by the July 2009 arrest of a New York rabbi who has been charged with arranging illegal transplants in this country by bringing in poor Israelis to supply kidneys.
In June 2008 I traveled to India to get an inside view of Kumar’s ring and examine the perverse enterprise that fueled its rise. How did Kumar build his organ empire, and how was he able to run it for so long? The answers, I learned, lay in the grinding poverty and entrenched corruption of India, the desperation of patients on dialysis, and the transnational nature of the black market transplant business—which, though dominated by the kidney exchange, includes livers and hearts as well. The factors at play in India allow the kidney trade to thrive around the world, despite efforts by various governments to stamp it out.
