FRONTLINE/World [home]

Search FRONTLINE/World

FRONTLINE/World Rough Cut

Rough Cut: India: A Pound of Flesh
Background Facts and Related Links
Learn more about India's history and population growth and the effects of globalization on the country's health.

Country Background

With a total landmass of 3,287,590 square miles, India is slightly more than one-third the size of the United States. Located in southeast Asia, it is the birthplace of one of the world's oldest civilizations, the Indus Valley civilization, which emerged more than 5,000 years ago. Since then, India has witnessed several waves of foreign invaders, including the Aryan tribes in 1500 B.C., the Arabs in the eighth century, the Turks in the 12th century and European traders beginning in the 15th century.

In the early 1800s, the area that is now India became part of a British colony. Upon independence in August 1947, the British colony was divided along religious lines, and two nations were born -- the secular, but Hindu-dominated India and the Islamic Republic of Pakistan. Even though Hindi is India's national language, English remains the most important language for national, political and commercial communication.

New Delhi, India's capital, is home to 13.8 million people. Mumbai, formerly known as Bombay, is India's industrial and financial capital and also its largest city. Located in the central region of India's western coast, Mumbai has a population of approximately 18 million, making it the sixth-largest city in the world. India's cultural capital is Kolkata, formerly known as Calcutta.


With a population that has topped 1 billion, India has become the world's second-most-populous nation, after China. The country's population is growing at a rate of approximately 16 million people every year (43,836 a day).

Forty percent of the world's poor live in India, with 28 percent living below the poverty line. More than a third live on less than US$1 a day, and 80 percent live on less than US$2 a day.


India's economy is driven by traditional village farming, modern agriculture and a wide range of modern industries, including textiles, cement, mining and software development. Globalization trends have resulted in information technology companies taking advantage of India's middle class, a large and skilled workforce that has helped to define the world's understanding of outsourcing. Traditionally, Indian governments, unions and businessmen have valued self-sufficiency. As a result, India is home to what may be the widest range of anti-globalization groups in the world.

In 2005, India's per-capita income was US$3,300. The progress that "shining India" has been frequently commended for still hasn't touched many of the nearly 650,000 villages where more than two-thirds of the country's population lives.

Although some of the economic disparity is simply between urban and rural divides, the country continues to be dominated by the ancient Hindu caste system, which assigns each person a fixed place in the social hierarchy.


Rates of kidney disease are rising in India, where a third of the population is obese and more than half suffer from hypertension. The World Health Organization has predicted that India will become the "diabetes capital of the world" by 2025. Those who have diabetes are 30 times more likely to suffer from kidney disease than those who do not have diabetes.

Many attribute India's rising rate of diabetes to increasingly sedentary lifestyles and Westernized diets, which are higher in harmful fats and excess calories. In addition, researchers have recently found that in regions where low birth weight and malnutrition are common, weight gain is more dangerous and is more likely to lead to diabetes.

The Indian government has invested in luring foreigners to India for low-cost but world-class medical treatment -- this year the second India Medical Tourism Expo was held in London. The Indian health and tourism ministries both have special departments to promote health tourism. However, kidney failure is so high within the country that many of the transplants being done in India don't involve foreigners at all; much of the surgery is performed on Indians.

For years, India has gained the reputation as a "warehouse for kidneys" and become one of the largest centers for kidney availability. To try to help monitor the growing industry, the country passed the Transplantation of Human Organs Act in July 1994. The act stated that only donors directly related to the patient could donate an organ in normal circumstances. But a loophole in the law that allows donors not related to the patient to donate in extreme circumstances on "compassionate" grounds was quickly exploited. Under current law, anybody between the ages of 18 and 65 with no medical illness and two normal kidneys can donate. The donor is supposed to be cleared by a committee, but few hospitals perform a thorough check. The high demand for organs and lack of rigorous oversight has given India the dubious distinction of having probably the largest number of unrelated donor cases in the world.

Selling organs is illegal in many countries, but loopholes and lax regulation often prevail. Critics fear that the organ trade will continue as long as the rich have money to spend on their health and the poor are left with few options but to sell their internal organs.

A 2003 article in the Indian Journal of Medical Ethics reported that police inquiries unearthed multiple stories of poor and uneducated people trading their kidneys for money. For payments as little as a few hundred dollars, these people were able to build houses, feed their families and wed their daughters. In some cases, kidneys were removed without consent from people who had checked into hospitals for entirely unrelated ailments.

Critics of the Indian organ trade also believe that there is such rampant corruption because there is no law that allows for organs to be harvested from people pronounced brain-dead. Some fear that the situation could worsen if regulations aren't properly enforced.

The Indian Journal of Medical Ethics article also reported that 80,000 Indians were suffering from kidney failure in 2003 and that there were only 650 dialysis units available. In addition, 85 percent of doctors in India have no training in medical ethics.

SOURCES: Aljazeera, BBC News, CIA Factbook, The Financial Times, The Hindu, India Times, Indian Journal of Medical Ethics, TIME, The Tribune India, YaleGlobal Online.

Related Links


1994 Transplantation of Human Organs Act
Read the full text of India's law that stipulates who may be an organ donor and under what circumstances.

Organs Watch
This Berkeley California-based NGO specializes in studying the international market in human organs.

Diabetes In India
This Web site dedicated to the problem of diabetes in India features a dictionary of diabetes terms and articles for patients and doctors about how to cope with the illness.

United Network for Organ Sharing (UNOS)
UNOS is a nonprofit, scientific and educational organization that administers the United States' only Organ Procurement and Transplantation Network (OPTN), established by Congress in 1984. The site offers information about legal organ placement across the United States.

World Health Organization (WHO)
The World Health Organization, the United Nations' specialized agency for health, presents statistics on health in India.


Frontline is once of India's leading investigative magazines. Search its archives for extensive reporting on the illegal organ trade.

This Web portal gathers headlines from leading Indian media outlets and links to the day's top domestic and international news stories.