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Women laugh as they take part in traditional finger painting. Patient wearing surgical mask. Street vendor pushing a cart of oranges. Reporter walking through Chennai slums.

Rough Cut
India: A Pound of Flesh
Selling kidneys to survive


Samantha Grant

Samantha Grant is a San Francisco-based documentary filmmaker who has reported for PBS, NPR and Current TV through her production company Gush Productions. In 2005, Grant worked in New York as an associate producer with director Jehane Noujaim (Control Room and on a film about the 2004 presidential race. Upon her return to San Francisco, Grant was hired as an associate producer for FRONTLINE/World while pursuing a master's degree in Journalism at U.C. Berkeley.

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Length: 14:21

When Samantha Grant headed to Chennai in southern India to explore the kidney trade, she had no idea if she would be able to find anyone who had sold an organ or who would be willing to talk about it on camera. As you'll see in this week's Rough Cut, "A Pound of Flesh," getting people to talk was no harder than getting them to sell their kidneys in the first place. As Grant describes in her reporter's diary, before organ commerce was outlawed, "would-be donors used to line up outside Indian hospitals waiting for the chance to sell."

Traveling between Bangalore, India's thriving technology center, and the slums to the south, Grant spoke to government officials, doctors, kidney brokers and donors to try to find out why so many people are still getting paid to give up their kidneys even though a law was passed 12 years ago to heavily regulate the practice. When Grant arrived in the slums of Chennai, about eight hours south by train from Bangalore, someone offered to sell her their kidney on the spot. "I was stunned," she says.

A New York Times Magazine article recently asked the question, "Why not let people sell their organs?" From an economic point of view, the article explains, demand for kidneys is far outrunning supply around the world. If people could legally sell, economists argue, more people with kidney disease might be saved, and the poor people willing to sell would have a chance to get badly needed funds.

As Grant reveals, the problem is especially acute in India, where demand for kidney transplants is increasing along with the country's growing numbers of diabetics, a health problem that has been directly linked to India's recent prosperity and rise in obesity. Those who can afford medical care are much more likely to receive a new organ, often because inside India's impoverished slums, many are desperate enough to sell a kidney for as little as a few hundred dollars.

One doctor Grant spoke with says it's the Indian government's responsibility to regulate to protect the poor. "Nature has given us two kidneys because the poor especially are prone to more infections and more renal problems," Dr. H. Sudarshan tells Grant. "They can't really afford to donate one kidney. It's a myth. They need two kidneys much more than any rich person." Others see it differently, including Dr. Ajit Huilgol, a transplant doctor who says he has performed more than 1,400 transplant surgeries. Huilgol believes a nonexploitative measure could be implemented in which there is "no middleman involved and the money that is promised to the donor is given directly to them."

Above all, Grant's story shows a vicious cycle among India's poorest -- particularly among women, the family members traditionally expected to sell their kidneys. Holding out her original donor card, one woman tells Grant that she has been waiting 17 years for the rest of the money promised her. Other donors complain of health problems following their transplant operations but remain too poor to seek medical help.

Joelle Jaffe
Associate Producer

You can listen to Samantha Grant's radio report on India's organ trade airing July 20 on Marketplace by visiting American Public Media's Web site.

Please Note: Comments/Reactions for this story are now closed.


Berkeley, CA
It is great to see you cover this issue before recent events in India. Hopefully, the Indian Government will take the issue more seriously due to the recent arrest of the doctor who was involved in the kidney trade. Hopefully they will develop stricter policy and actively monitor the industry.

Ravi Mor - Nagpur, Maharastra
Thank You mam for bringing in front such a sad situation prevailing in my own country, I hope with the joint efforts of Government, NGO's and gentle-hearted people of this country, this will be changed soon.

Akhila Ananth - Huntington Beach, CA
First of all, the assumption that India is above all a "spiritual" nation does not allow for people to understand what the "true" India is--not just a mass of colorful films or a line of impoverished shacks or a scene of idol worship but a complex mix of it all and more. Secondly, the black-market organ trade is horrific primarily because it indicates that people are in such destitute conditions that they are willing to sell pieces of their bodies. Where does this stop? How can a government accept body mutilation as a concession for its inability to take care of its citizens? Also, the money earned from an organ sale is not sustainable, so neither does a government-regulated organ trade approach the problem of poverty in terms of long-term solutions. I look forward to seeing the documentary and hope to see more issues like this one brought to the world's attention.

Louise Young - Naples, Florida
I'm so glad someone is finally talking about this issue.

Madurai, Tamil Nadu
Mr. Sadique Ahmad, I would be interested in discussing your views on eye donation further. If you would be so kind as to drop me a line at I would be most grateful.

Purnima Gurung - Chennai, Tamilnadu
Most of the western aspect of organ trade centers around sale of organ that focuses only on the kindey. Rather when the law states no organ or tissue can be sold and this includes , womb, sperms, cord blood( as this is also a live tisue) and using a womb for payment is more risky than donating a kidney. Most important is that when a law says don't sell an organ it also implies sale within the family. Many times brothers and sisters do sell their organs legally to their near ones and still it is illegal. Further forcing a family member to give away an organ just because he is a near relative is also against human rights. This is very common when a young wife is forced to give her organ to her husband because of family pressure but against her will.

makia gorham - D.C., washingotn
I think people should be free to make their own decisions but be paid for their generosity. Being poor and selling your kidney is a big mistake knowing that the wealthy will not give them the financial support they need. A good example is when the woman was going through a waiting period of 17 years and still hasn't received her money yet.

Capitalism could be to blame because it is an economic system based on private ownership and the investment of resources for profit. A Socialist economic system could change this practice because with a socialist economic system it would enable the people of southern India to achieve greater equality and give the workers greater control of the means of production.

People should be able to do whatever they want with their bodies. Although there are many great downfalls and the effects are tragic, these people CHOSE to donate their kidneys and that was a personal descion. Capitalism does not play a part in this situation. People need money so they do whatever it takes to get what they need.

People should be able to do whatever they want with their bodies. Although there are many great downfalls and the effects are tradgic, these people CHOSE to donate their kidneys and that was a personal descion. Capitalism does not play a part in this situation. People need money so they do whatever it takes to get what they need. Although it is someone's business to sell kidneys,they are actually giving out money for a good instead of recieving it.

Ayanna Brooks - Washington, D.C.
People should be able to do whatever they want with their bodies. Although there are many great downfalls and the effects are tradgic, these people CHOSE to donate their kidneys and that was a personal descion. Capitalism does not play a part in this situation. People need money, so they do whatever it takes to get what they need. Although it is someone's business to sell kidneys, they are actually giving out the money for the good instead of recieving it.

Cynthia Delgado - Washington, DC
Capitalism is to blame because they can do something about there being poor places in India. If those poor people from India weren't poor they probably wouldnt have to sell their kidneys. They would have wealthy jobs and wouldnt have to be doing those type of sacrifices at all. I think a socialist would change this whole practice. Everybody would be the same with no differences among themselves.


Brenda Balcarcel - Washington, DC
This situation made feel sad and mad at how the rich just think about themselves and how the poor can't do anything to change the situation. The capitalist system is to blame because the reality is people are greedy and don't care about anyone if it doesn't affect them. The capitalist system is just a vicious circle; the poor do the hard dangerous work while the rich benefit. Although it's true that they are giving up their kidney a will the situation there in forces them to do that. A socialist economic system would change this practice. If people have food, jobs,education, a home and thats all their allow to get then no one would sell their kidney.

Neelam Nawaz - NY, NY
Amazing, these days when there is a tremendous hype about India becoming a super power etc, this video is an eye opener to all the people who should take practical steps for the poverty reduction in India and not just showing to people that what ever you watch in your movies and on your channels is not true India. I pray for all these people that they are going through this for the sake of bread and butter.

Jayakumar Arockiasamy - Trichy, Tamil Nadu, India
In India, recently the kidney racket among the Tsunami survivors came into limelight. First, the brokers need to be punished severely. The poor sell their organs with a hope that it will pursue a little money for their immediate survival, but even then they are cheated. First, this should be banned otherwise the compensation to be paid truly.

Sadique Ahmad - New Delhi, India
Shocking. As a filmmaker, I think that media should play a vital role to educate and sensitize people about the meanness of organ trade. I have even more soaring experience as I made a film on eye donation here in New Delhi. For the sake of money, people are ready to donate their one eye.

P Kannan - Herndon, VA
We should legalize organ trade within rules and regulation. Current legal structure, poverty and illiteracy in India is going to be an issue for a very long time. The existing law of 1994 does not have teeth and the government officials are not going to enforce it either. It is far easier to bribe in India than elsewhere. Organ black market, crime and other social plague is curse of modern times. I read about unsuspecting inebriated people operated on in the US and left in a tub with a note saying; "do not get up. Call 911". Beware!!!

Vikram Kakapuri - Pune, Maharashtra
I think Ms Grant has done a great job by making this documentry. Health services in India are not the best. This is not the only issue which is haunting India. Government does not do anything to stop such organ trade, except for making laws. First of all we need politicians who are not selfish and think of the masses in India. Not sure if that will happen in my lifetime. Anyway, regarding this issue, I think Government must make organ donation legal. Another step that Government can take is to make arrangements for removal of organs from any person who dies of an accident. All organs which can be useful should be stored and later transplanted in patients who need them. This will definitely solve the problem of organ trafficing to some extent. I am also looking forward to the day when kidneys and other organs can be grown in labs and artificial organs will be available in the market at nominal cost so that patients will not have to wait and do anything illegal to get the best possible treatment. I do have faith in medical science and all the research scientists in the world working on making this a reality.

Vicky Young - Chino Valley, AZ
In 2004, I donated one of my kidneys to a beloved male friend. In the small Arizona town (under 10,000 people) where I live, there are at least three women kidney donors. My dissertation research, on the experience of living kidney donors, shows that women give kidneys more often than men in the United States and some European countries. Women are the givers of life in numerous ways. This is a critical worldwide social issue.

Rashmi Sarmah - Guwahati, Assam, India
This is a known fact in India but the story came as a reminder. It is a shameful and sad situation for us Indians but not much can be done if individuals are willing to donate their organs voluntarily.

Rashmi Sarmah - Guwahati, Assam India
This is a known fact in India but the story came as a reminder. It is a shameful and sad situation for us Indians but not much can be done if individuals are willing to donate their organs voluntarily.

Ron Marquis - Columbus, Ohio
You would think India, being such a spiritual country, would know that the "body" is just on loan from God and is not ours to do with as we please.

kanwar rajpal - attock, nwfp
This is the true India contrary to what they depict on screen in movies.

Manikantan Sorimuthu - Nagercoil, Tamilnadu
I welcome the New York magazine's question: why not let people sell their organ? It's mutual benefit for the donor and the receiver. The government has to regulate organ trade.

Deborah Hartman - Pittsburgh, PA
Hopefully, this story will encourage proponents of adding kidneys to the world commodities market to reexamine their position. While paying "cash for kidneys" may be viewed by some as a way to eliminate the critical shortage of kidneys available for transplantation, the fact is that thousands of viable organs are lost each year simply because potential donors did not discuss their wishes with family members.

Kate Bicknell - new york, New york
I heard about this on the radio and thought it was very interesting. Great work.

Justin Sweder - El Cerrito, CA
Very thorough and interesting. Complex issue. Excellent report.

Tucson, AZ
Please tell me when "A Pound of Flesh" will air on PBS station KUAT
Tucson AZ

FRONTLINE/World's editors respond:
No immediate plans for a TV broadcast of this story, but you can watch it here online. Our "Rough Cut" series of videos on our Web site allows us to present stories that otherwise might never be seen. We'd love to be on air more often, but right now Frontline does NOT air during the summer.