Desperate measures

According to the World Health Organization (WH0), about 10,000 illegally purchased organ transplants take place each year globally. Kidneys made up 75 percent of the organ trade and the biggest organ trafficking rackets were operating in China, India and Pakistan.

In Pakistan, most of the illicit transplantation cases have been reported from the Punjab province. Pakistan's National Human Organs Transplantation Authority says that most illegal kidney transplant facilities are in the Punjab.

Researchers say there are more sellers of human organs in Pakistan than buyers. Many people from the Middle East and other countries go to Pakistan to buy kidneys and other human organs.

The Pakistani government passed a transplantation law in 2010 to control illegal human organ transplantation in the country, but health experts say illegal transplantations and organ trafficking are on the rise.

Pakistani health experts and civil society activists say the law is ineffective and the government has completely failed to enforce it.

Organized racketeering

Dr. Tipu Sultan, a health expert and civil society activist in Karachi, told DW that poverty was one of the main reasons behind the illegal trade in Pakistan, adding, however, that "it is not the only factor."

"There is a very strong racket of influential people from the medical sector as well as the government health departments who make money by selling human organs such as kidneys. Now we have reports that even liver is being transplanted and sold."

Sultan said he knew of villages in the Punjab where most people had illegally sold one of their kidneys. He said that the poor people in these villages were mostly illiterate and in need of money.

Dr. Farhat Muazzam of the Sindh Institute of Urology and Transplantation (SIUT) said that there was a big demand of illegal kidneys in Middle Eastern countries. Poor Pakistanis, she said, were fulfilling this demand.

Law enforcement

Pakistani health activists are campaigning for the proper implementation of the 2010 legislature restricting transplantations. In July, the Pakistani Supreme Court ordered all provincial governments to enforce the law and arrest those responsible. Activists say the government has not paid heed to the court's orders.

"Laws alone won't solve the problem," said Sultan. "The government and civil society also need to raise awareness about this issue. Then the issue is linked with the economic problems of the country. This needs to be tackled," he added.