Under crushing financial strain, Kumar Budathoki sold one of his kidneys to organ traffickers for USD 5,000, a sum he hoped would help set him up for a lifetime free of money problems.
Instead, he got a lifetime of health problems and only a fraction of the money promised to him by a shady broker in Hokshe, a village of tiny farms and mud huts that has been the center of the illegal organ trade in Nepal for more than a decade.
Only about 4,000 people live here, yet at least 121 of them have sold their kidneys, said Krishna Pyari Nakarmi, who has been leading the campaign against the kidney trade in Hokshe.
In Hokshe, traffickers have operated with surprising impunity. Nearly every resident seems to know someone who sold a kidney on the black market.
Dr Rishi Kumar Kafle of the National Kidney Center in Katmandu said while there is illegal organ trafficking elsewhere in Nepal, he knows of no place where it has been as pervasive as it is in Hokshe. Over the years, the village earned the nickname "the kidney bank."
Budathoki gave up his kidney nearly 15 years ago. He said the broker downplayed the risks of the surgery.
"The broker told me that I had two kidneys and I only needed one, the other one was a spare that was useless for me. Until then I didn't even know what kidney was and why or how many I needed," he said.
Once he got to India, Budathoki could not understand the doctors because they spoke to him in Tamil and Hindi. He speaks only Nepali.
"I never understood what the doctors and people in India were talking about so all I did was nod and sign papers," Budathoki said.
The donors traveled to India because transplants generally were impossible in Nepal. Until 2008 the surgery was illegal; after that, only close relatives were allowed to donate, and even they had to pass through strict government screening. Budathoki said the kidney broker promised to pay him $5,000 but only handed over USD 1,000.
"I was promised I would get the full amount after the surgery," he said. "But I was already escorted back (to Nepal) before I could heal properly. I was too weak to argue or fight back and never saw the broker again."
Years of campaigning by social workers, along with more recent monitoring by police, have curbed trafficking significantly. Kedar Neupane, chief government administrator of Kavre district, said there have been no cases of kidney sales in 18 months.
Police arrested 10 traffickers last year. Three of them including Prem Bajgai, considered the kingpin of the trade, are in jail. The others are out on bail and awaiting trial.
But the temptation remains. Thousands of kidney patients in India and even Nepal are ready to offer big money for organs.
