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Experts said more than 20million Nigerians had one stage of chronic kidney disease (CKD) or the other.
A consultant nephrologist at the Aminu Kano Teaching Hospital (AKTH), Prof. Aliyu Abdu, estimates about five per cent of all those with different stages of the disease have stage five, which is the stage of CKD at which kidney transplant may be required.
“We will be talking of around 1million Nigerians needing one form of kidney replacement therapy or another, including kidney transplant,” he said. This, he explained, is because many patients with kidney disease come to the hospital at a late stage.
Because deceased donation is not offered in Nigeria, a lack of regulation and transplant waiting list is driving many desperate renal patients to seek live kidneys from the black market. To do this, Daily Trust on Sunday found that they link up with kidney brokers who recruit local agents such as Yellow in Masaka, Abdulrahman and Habib in Mararaba to scout for vulnerable youths with financial needs.
Selling organs is illegal and unethical with many repercussions, said Prof Abdu, who explained that in the case of commercial donation, there is lack of proper preparation and investigation because the ultimate aim of the traffickers is to get the organ and not the wellbeing of the ‘donor.’
“And more so, after donation, the ‘donor’ is supposed to be followed up over time because he himself may be at risk of getting kidney disease in the future,” he said.
This newspaper documented at least six young men within Mararaba and Masaka and spoke with four of them, all below the age of 25 who have scars to show their kidneys have been surgically removed. They have all been approached by local agents with financial offers for their kidneys.
Many of the agents, including Yellow, Abdulrahman and Habib have equally sold a kidney each. The three agents had all worked for Mayor who introduced himself to Oluwatobi, as a staff of Alliance Hospital. The hospital, however, denied this claim and insisted that he is not on their payroll.
But the two minors, Yahaya and Oluwatobi, said Mayor had appeared familiar with many staff of the hospital.
“From my understanding, anytime some hospitals in Abuja need a kidney they will call their agents. Mayor will then call Habib or Abdulrahman and give them the requested blood type. When Abdulrahman finds a ‘donor’ he will negotiate the price and his percentage, then invite the ‘donor’ for a blood test. If it matches, Mayor will now coach the ‘donor’ on what to say,” Yahaya Musa said when asked about Mayor’s role.
Abbas Yusuf, who has met Mayor, said there were other kidney brokers, including women. “If anyone wants to sell their kidney they will call the agents and the agent will call kidney brokers like Mayor to arrange. If the person goes, he comes back with N1m and he will give the agent N100,000,” he said.
Three months of investigation led Daily Trust on Sunday to Mayor’s new phone number, which Truecaller identified as Emmanuel Olorunishola. He was said to have abandoned his old phone number, which he registered with the name, Mayor and fled to Lagos.
Exposing Abuja’s kidney trade
Driven by a surge in renal disease, the demand for kidney is rising all over the world, with less developed countries, including Nigeria, becoming the go-to market for foreigners in need of kidney transplant.
At least 1,353 kidney transplants have taken place in Nigeria from 2005 to date, according to the Global Observatory on Donation and Transplantation.
Information from a paper presented by the national president of the Transplant Association of Nigeria (TAN), Prof Fatiu Arogundade at the 2023 fifth biennial conference of transplantation in Nigeria shows that more than half of the kidney transplants conducted in Nigeria were done in a private facility in Abuja.
The paper, titled, ‘Organ Transplantation in Nigeria: The journey so far,’ captured only 16 transplant facilities and did not document Alliance Hospital. However, the hospital managing director, Dr Christopher Otabor, in March told journalists that the hospital had conducted 75 successful kidney transplants in the last three years, with a number of their patients flown in from outside the country.
Nigeria has no regulatory body that offers a licence for transplant centres as every centre is guided by medical ethics. This creates a loophole for the illegal trade where organs are sourced from poor Nigerians with financial troubles.
A source familiar with the ‘business’ told Daily Trust on Sunday that a kidney broker operating in the shadows negotiates a price with a renal patient. These patients, some foreigners, will pay about N5m to the broker for a kidney. With the help of local agents, the broker offers N1m to young boys for their kidneys. The agent gets 10 per cent from the ‘donor’ and another 10 per cent from the broker.
Another source told this reporter that because many private hospitals charge between N10m and N15m for a kidney transplant, they need the services of kidney brokers to boost profit.
“In 2022, my younger sister needed a kidney transplant and the private hospital treating her in Abuja told us that they could help us arrange for a kidney. But my sister’s son donated his kidney and despite this, we lost her a few months later,” said an Abuja resident who asked to remain anonymous.
Though Abbas, Aminu, Oluwatobi and Yahaya had admitted that they felt safe with the surgical procedure because it was carried out by licensed medical doctors, in ‘highly reputable’ private hospitals, consultant nephrologist, Prof Aliyu Abdu cautions that there are long term health repercussions for such illegal donations.
“In environments where commercial donation takes place, the ‘donors’ are at great health risks,” he said, adding that, “Most of them are full of psychological issues and regrets, especially when they realise that the motive for the donation was money and when they get the money and it is unable to solve their problems, they end up with regrets and some of them develop psychological issues and some become depressed.”
Going undercover as a kidney broker
To verify the information obtained from victims and sources, Daily Trust on Sunday went undercover, posing as a kidney broker and was linked to a kidney agent called Chiboy. His identity was verified as Joseph Paul Chimobi who claims to be 18 years and lives in Mararaba community. Sources in the ‘business’ said Chiboy was Mayor’s trusted agent and often called “Mayor’s boy.”
After weeks of planning, this reporter called Chiboy and requested for an 0+ blood type. At first, he was suspicious and wanted to know how this reporter got his number. When told she got it from a medical staff from one of the private hospitals in Abuja, he relaxed and said he could supply the needed blood group the next day. Chiboy then requested an immediate transfer of N5,000 as transport fare to bring the ‘donor’ from Mararaba to Abuja the next day. The money was paid into his Palmpay bank account.
He then insisted on negotiating price and stressed that the price for a kidney was now N2m. “The boys no dey gree for N1m again o, na even N2m them dey collect now,” he insisted in pidgin English.
After bargaining, Chiboy settled for N1.5m and reminded this reporter that his commission would be N150,000.
At 8am the following morning, Chiboy called to request for additional N5,000, saying the ‘donor’ was in Keffi, Nasarawa State and he had sent him N4,000 from the initial N5,000 to transport himself to Mararaba. Our reporter, however, insisted that they transport themselves to Abuja on the assurance that they would get a refund.
At 12:30pm on a Tuesday in October, Chiboy and a 38-year-old ‘donor’ met this reporter at an undisclosed location in Abuja, where it was agreed that the ‘donor’ would be physically assessed, as well as to conclude discussions on payment.
During the encounter, Chiboy laid back to allow the ‘donor’ do the bargaining. This reporter had earlier given specifications for a donor who had no history of drinking or smoking. However, the ‘donor,’ who is married with two children, confessed to being a mild drinker and said he had quit smoking. That provided the loophole for this reporter to re-bargain at a lower price.
The 38-year-old said he worked in a hotel before he was laid off and was now in desperate need of money to care for his family. He, however, insisted on N1.5m even when this reporter stood her ground that he had not met the agreed specifications and would have to revert to the renal patient.
When told that the patient was in Kano State but planning to find a suitable hospital for the surgery in Abuja, Chiboy immediately suggested the use of Alliance Hospital for the surgery. When asked why, he said, “Alliance dey fast, na there I dey work before. Their own na just one week stuff.” Asked why he left Alliance, he said: “Mayor no dey work again. You know, e get the time wey he come do some kind thing. He don stop, he dey Lagos now dey do company work.”
The ‘donor,’ who is a father of two, sounded desperate and said he understood what he was sacrificing but needed to do that for the future of his children.
During conversations, Chiboy confirmed that Mayor had offered between N1m and N1.3m to boys offering their kidneys for sale. He insisted that his price as an agent would be 10 per cent of the agreed amount.
“Mayor na N250,000 e dey pay me for one person. I dey carry like five boys for Mayor and e dey pay me N250,000 per person,” he said.
One hour into the meeting, it was time to go as this reporter assured Chiboy and the ‘donor that she will get in touch after settling the price with the patient.
Desperate for money, Chiboy offers more ‘donors’
A day after meeting Chiboy and the kidney ‘donor,’ this reporter informed Chiboy that the renal patient was offering N1m as the donor did not meet the specifications. The ‘donor’ tried to persuade this reporter to convince the patient to settle for N1.5m and said he had been offered N2m for his kidney in Minna, Niger State.
“It is just that I don’t want to travel to Minna for the surgery, but people are paying higher for this thing now,” he insisted. This reporter, however, assured him that the patient was adamant and may have found someone else.
However, in his desperation for money, Chiboy continued to offer more kidney donors willing to take N1m. During one of his numerous phone calls, he insisted he was bringing a ‘donor’ from Enugu and asked this reporter to provide the bus fare.
“Him don gree for N1m and he fit leave Enugui this night, arrive Abuja tomorrow, all you fit do na to pay the transport fare,” he insisted.
Even when he was told that the renal patient had finally found a ‘donor’ Chiboy continued to call and check in whether there was need for his service.
NAPTIP arrests Mayor after Daily Trust report
Few weeks after meeting Chiboy and the ‘donor,’ Daily Trust gathered that the National Agency for the Prohibition of Trafficking in Persons (NAPTIP) arrested Mayor. The arrest followed weeks of communication between this newspaper and NAPTIP officials based on information gathered from the field.
A senior officer with the agency confirmed that NAPTIP was building a case against Mayor and his accomplices.
Health ministry complicit in kidney commercialisation
Organ harvest and transplantation is enshrined in Nigeria’s National Health Act 2014, section 54 (3) (a) and (b) of the act states, that the National Tertiary Health Institutions Standard Committee shall prescribe criteria for the approval of organ transplant facilities and also procedural measures to be applied for such approvals.
Daily Trust on Sunday reports that this has not been done. The present National Health Institutions Standard Committee was inaugurated by a former Minister of Health, Dr Osagie Ehanire in 2021 for a four-year tenure and is chaired by Prof Abiodun Phillips.
However, sources from the ministry told Daily Trust on Sunday that the committee had not been active between 2021 and October 2023.
Prof. Abiodun Phillips told our reporter in a phone conversation that the committee had just been re-inaugurated by the present administration in November. He said they would work to change the scenario in the country’s tertiary health care system.
This newspaper reached out to the Ministry of Health for a copy of the criteria for the approval of organ transplantation, the procedural measures for such approval, the number of health facilities that have met those criteria, as well as their names and locations. However, the Director, Press and Public Relations of the Ministry, Patricia Deworitshe asked Daily Trust on Sunday to make the request in writing.
A Freedom of Information request on this was delivered to the office of the Coordinating Minister, Health and Social Welfare, Prof Ali Pate on September 5, 2023. However, there has been no response from the ministry despite weeks of follow ups. This reporter traced the letter to the Teaching Hospital Division of the Ministry and made two physical visits to the division, but the director made promises to reply to the letter. However, as at press time, the letter was not replied.
Sources within the ministry confided in Daily Trust on Sunday that the ministry had no policy for organ harvesting and transplantation despite the provision of the National Health Act.
“Hospitals are free to come up with their guidelines,” a source from the ministry said.
With no regulation governing organ harvest and transplantation in Nigeria, medical experts insist that health care providers must be guided by ethical principles, their religious beliefs and must have concern for other citizens, not just their patients.
Prof Abdu said, “There are laid down guidelines, both internationally and locally, governing organ transplantation. We have the WHO and a famous one, the Istanbul Declaration, which gathered people under the WHO. Different countries were represented, including Nigeria and developed a guideline governing organ transplantation worldwide.”
A very informative piece, kudos! |
