Trafficking for the Purpose of Organ Removal in India: Exploring the Impact of Social, Economic, and Cultural Factors on Vulnerability and Protection

Background and Purpose:

Medical advances in organ transplantation have prolonged life and increased quality of life for many people worldwide, but often at the cost of others’ well-being. An increasing need for living kidney donation has created a global market for organ sales. Research indicates that desperate, impoverished individuals and specific communities internationally are susceptible to organ sales due to their poverty status. Existing studies have exclusively focused on the financial motivations of trafficked persons, and the physical, economic, and social consequences post-transplant.

This study fills a gap in knowledge because it examines a specific, rural community in a state in Northern India where trafficking for organs frequently occurs. The perspectives of individuals who were trafficked and those living in the community who were targeted for trafficking, but did not have an organ removed, were incorporated. This allowed for the examination of both vulnerability and protective factors related to trafficking of organs within the community.

Methods:

Utilizing data from 43 qualitative interviews with persons trafficked for organ removal (N=20) and persons not trafficked for organ removal (N=23), this study explores the specific vulnerability and protective factors that impact susceptibility to trafficking in persons for the removal of organs (TPRO) in a community in India. Interview guides were developed and pilot-tested with the assistance of local community leaders. Study participants were recruited in collaboration with a local organization. Following an oral consent process, interviews were conducted in two languages (Bangla and Santali) and were transcribed and translated in to English. Study data was coded using a grounded theory methodology and then further analyzed using Atlas.ti.

Findings:

Data analysis reveals that intrinsic and extrinsic vulnerability factors combine to make an individual susceptible to trafficking for an organ removal. Factors, such as gender and work availability, influence an individual’s vulnerability to trafficking. Vulnerability factors impact an individual’s position of vulnerability and this position is exploited to gain consent for organ removal. Findings from this study show that economic, cultural, and societal factors affect both protection from and susceptibility to trafficking. The living organ donation assessment process is examined as a potential protective factor. The lived experiences of trafficked persons, and the consequences suffered post-transplant, are also presented.

Conclusions and Implications:

Original theoretical concepts emerged from the exploration of the interaction of factors on susceptibility and the role of consent. As factors influence vulnerability and allow for the abuse of vulnerability in the form of trafficking, the consent provided by individuals for organ removal is irrelevant. Research findings are situated within the global understanding of the role of trafficking and consent. This research provides macro to micro level recommendations for the elimination of trafficking for organ removal through preventative programs and policies on the local, state, and Indian national level. Implications for social work education and practice, particularly related to the framing of human trafficking as a global human rights issue, are also presented.