{ONE}
AS SOON AS PANKAJ SHARMA saw five passengers in a cab, one of whom was on a saline drip, he had a hunch about what was happening. A constable at the Ranipur police station in Haridwar district, Sharma had overheard a conversation about some “illegal going-ons” at a nearby hospital when he had stopped by a roadside teashop the previous month. His team from the Uttarakhand police had then traced these rumours to the Century Gangotri Hospital in Mazri Grant, a village 30 kilometres from the state capital, Dehradun.
Late into the night of 10 September 2018, as buses and lorries zipped past them on the Dehradun–Delhi highway, Sharma and six other police officers frisked the five passengers. Two of the passengers had six-inch surgical scars above their waists. These seemed to be marks of a recent kidney transplant, but they would not say. Finally, as the police detained them, one of the passengers started crying and pleading that the police let them go. “We haven’t even been paid yet,” he said.
In the subsequent weeks, the police discovered that the Century Gangotri Hospital had been the site of nearly five hundred illegal kidney transplants between 2016 and 2017. People from poorer parts of India were lured, duped or coerced into selling one of their kidneys to patients with renal failure from India, the United States, Europe and West Asia. One of the passengers detained by Sharma and his colleagues, for instance, was a woman from West Bengal who needed money for her daughter’s medical treatment. Another was an unemployed youth from Gujarat, who had been conned with a job offer at the hospital.
The residents of Mazri Grant were shocked. They had always taken pride in their village’s quiet, peaceful temperament, several residents told me. Theirs was a sharp contrast to the neighbouring city of Muzaffarnagar, with its high crime rates. As a local schoolteacher put it, “In Mazri Grant, if you cause a street accident, people give first aid instead of beating you up.” But the two-storeyed hospital—clad in brick red and beige, lined with potted plants and ornamental grass—always did seem odd. It advertised itself as a “charitable” endeavour, but had bouncers at its doors. The staff of the Uttaranchal Dental and Medical Research Institute, in whose premises it was based, was forbidden from interacting with its counterparts at the hospital. Even the cafeteria was partitioned into two. And yet, the hospital seemed to be doing rather well. When I visited the institute last February, some of the students staying on the campus told me that they would often notice visitors coming in high-end cars late at night. Amit Kumar, for one, would usually turn up in a Mercedes.
When the police raided the hospital in the morning, Amit had already fled. His rental villa was deserted, his cell phone unreachable and hospital records missing. Police officers in Haridwar and Dehradun told me they formed search teams, tracked down his associates and alerted Interpol. Three days later, they found him at a five-star hotel in Panchkula in the neighbouring state of Haryana. Amit had just opened a packet of dates, a gift from a kidney-beneficiary from Oman. “How did you find me?” he asked as the police handcuffed him. He had made it easy, they said. Of the six cars he owned, he had chosen to flee in the most conspicuous one. The police had to only search the parking lots of five-star hotels for the Mercedes.
A few days later, the senior superintendent of police for Dehradun, Nivedita Kukreti Kumar, held a press conference to announce their prize catch. Amit, in a squeaky white shirt and dark trousers, maintained an almost statesmanlike composure in front of the clamouring media. He answered questions briefly, with a poker face. He said that he had been working since 1992, that his clients paid him between twenty-five and thirty-five lakh rupees per transplant and that his “donors” received four to five lakh rupees for their kidneys. He even claimed all his surgeries had been successful before the police chief fact-checked him: “What about those three Turks who’d died?” The investigators later told me that Amit had been just as soft-spoken and amiable in custody, only adamant about his messiah complex: “I did no wrong. I only saved lives.”
Also present at the press conference was Jeevan Kumar, Amit’s younger brother, who is a homoeopath. The two siblings had started their trade in the 1980s, a time when there was no legislation against commercial organ-transplants in India. The low-key venture had spawned a family enterprise over three decades, with Amit and Jeevan’s youngest brother Ganesh Raut, Amit’s wives Sunita Raut and Bulbul Kataria, his son Akshay Raut and Jeevan’s wife Pooja Singhal joining in for varying periods.
The siblings were arrested several times between 1992 and 2017. “All the money he used to earn through his illegal activities used to get exhausted every time he got arrested,” Kukreti Kumar said in an interview with the Hindustan Times. Every time the siblings were released, they would go to a new place, build a hospital and start another kidney racket.
“Amit is the most confident person I’ve met,” a former associate told me. “He’s crazy for money and has no fear of the law.” Another said that Amit considered his acts were good karma: “He believes in his own lies. He calls himself ‘Lord Amit.’” At the press conference, Jeevan was in no mood for introspection either. “The patients come to him and insist he does the surgery, that’s why he does it,” he said. “Today, all of you are gathered here, asking so many questions. In reality, there’s a problem in the law.”
The systemic failure in the regulation of organ trading in India that Jeevan appeared to be pointing to is a severe one. An estimated ten thousand illegal kidney transplants take place every year around the world—around one every hour—and nearly a fifth of these occur in India. To understand its trade, it is important to understand why the organ is so sought after.
The kidney functions to filter blood and discard the body’s waste through urine. It is often the first casualty for those suffering from severe diabetes and hypertension, both of which are rife in India. Across the world, demand for kidney transplants outstrips supply, so much so that China began harvesting kidneys from executed prisoners. While the so-called “red market” is usually more prominent in developing economies, such as India, Nepal and the Philippines, similar rackets are also found in wealthier nations. The only difference is the price: a kidney in Turkey can cost around ten thousand dollars, while in Bangladesh or Pakistan it could be as little as a thousand dollars. In India, a combination of poverty, corruption and poor regulatory infrastructure enables one of the biggest kidney markets in the world. Its scale is rampant enough that doctors from reputed public and private hospitals in Mumbai and Delhi, including Apollo and Hiranandani, have been booked for facilitating it.
If a patient is to take a legal recourse, she would be put on a list of those awaiting organ transplants in government-certified hospitals. An estimated two hundred thousand Indians join such lists annually. Their waiting period can stretch on for so long that nearly half die in the queue. The National Organ and Tissue Transplant Organisation, a government agency formed in 2014, has adopted a programme to promote organ donation off the dead. “Nearly 70 percent of the 150,000 people dying in road accidents every year are brain dead,” Dr Vimal Bhandari, the head of NOTTO, told me. “Even if a fraction of their organs are donated, the organ trade will be eliminated.” But even if the organ shortage is addressed, the country’s public-healthcare infrastructure can barely keep up with the demand for surgeries.
Those with renal failure are, thus, forced to undergo dialysis while waiting for transplants. It is an expensive procedure, requiring three- or four-hour sessions up to four times a week.
Many are, then, willing to bend the law. This tendency was acutely visible after the Indian government enforced the Transplantation of Human Organs Act, criminalising the commercial organ trade, in 1994. Nearly a hundred patients, who had travelled to Hyderabad to follow up on deals with donors, threatened to go on a hunger strike unless they were allowed to undergo transplants. An exasperated MS Dayal, then the union health secretary, had then wondered aloud, “How do we really prevail upon people determined to break the law?”
{TWO}
AMIT WAS NOT THE FIRST of his family to fall foul of the law. His father, Rameshwar Raut, a native of Akola in Maharashtra, had a shoot-at-sight order against him during the Indian liberation struggle. Amit’s brother Ganesh told me that their father, along with a team of rebels, was said to have derailed a train carrying soldiers of the British Raj, killing dozens. Once India became independent in 1947, Raut was officially recognised as a freedom fighter and appointed as a trustee of a local school. He married at the age of 40, and had four sons and a daughter. Santosh Raut, who later became the infamous Amit Kumar, was the eldest.
In a region known for its endemic poverty and farmer suicides, the Rauts were landowners, living in a lavish bungalow with plenty of servants. Amit graduated in ayurveda from a college in neighbouring Nagpur, in 1976. The same year, he joined the Podar Ayurvedic Hospital in Mumbai, where he was mostly assigned minor, uncomplicated surgeries, such as removing haemorrhoids. But his people skills found him many friends within the Mumbai medical fraternity. In 1984, as he set up the Kaushalya Nursing Home at his apartment near a popular shopping precinct in the suburbs, many of these friends became visiting surgeons at makeshift operation theatres.
It was a well-timed move. In the 1980s, a number of patients seeking treatment for kidney failure were coming in from West Asia, especially Saudi Arabia. Transplants were carried out frequently, if clandestinely, at several private hospitals in Mumbai. Most donors were poor and destitute, desperate to feed their family or pay off debts. Amit would find them through a network of “agents,” who lurked outside temples, under bridges and around slums, offering beggars, rickshaw-pullers and migrant labourers easy money, between three hundred and a thousand dollars. He also reached out to foreign consulates and taxi drivers at the international airport, offering them a handsome commission per client.
Soon, he bought a Mercedes—the first of many he was to buy—married a Mumbai-based homeopath, Sunita, and had a son, Akshay. “He had a very lavish lifestyle, filmy style,” Suma Raut, Ganesh’s wife, told me when I met her at her Mumbai apartment last April. “The most expensive cars, good house... and girls! The Arabs that used to come paid good money. He used to look like Jeetendra”—a Bollywood actor from the 1980s. The siblings then decided to realise their longstanding Bollywood aspirations and produced two B-grade murder-mysteries, Khooni Raat—Bloody Night—and Jurmi Zanjeer—Criminal Shackles. Amit starred in both, hamming away as an upright police officer out to nab the killer.
“He never deceived anybody back then,” a former colleague who had worked at the Kaushalya Nursing Home recalled to me over the phone. “The donors coming were desperate. Some wanted money for a dowry, others to fund a family member’s medical bills. Amit would sit them down, explain the risks, make them undergo various tests and operate only after.” His sincerity endeared him to both donors and recipients, as did his easy wit. “I once asked him, ‘What is the best experience of your life?’” an associate who worked with Amit for several years, recalled. “He said, the sound of urine dropping in the bag,” referring to moments after a successful surgery. “Tap tap tap.”
In 1987, the World Health Organisation classified organ trade as a violation of human rights and declared it illegal.
A 1992 report by the United Nations claimed that India conducted the largest number of transplants using children’s organs. Touts would often fleece willing donors, paying less than promised.
In August 1994, three such donors, who were migrant labourers in Mumbai, approached the crime branch of the police and complained of being short-changed in a deal conducted by Amit. The police raided the clinic, seized surgical equipment and detained Amit, his siblings Jeevan and Ganesh, and eight others on charges of cheating and criminal conspiracy. MN Singh, then joint commissioner for crime, recalled Amit’s most startling confession: that he had conducted over two hundred surgeries himself. “I asked him, ‘You’re not qualified, how could you do the surgeries?’ He said, ‘I’ve registered for an MS—Master of Surgery. I’ll complete it soon.’” (Amit did neither of these.) Singh asked him about the risks he would be taking until he did so. Amit admitted some people had died, but added that he had learnt over time, “by trial and error.”
Amit might not have had the requisite qualifications, but the visiting doctors at his facility did. One of them, a Mumbai-based surgeon named Yogesh Kothari, took Amit under his wing. Under his tutelage, Amit read up on nephrology, attended medical conferences and performed his first transplant surgery in 1994. Singh told me over the phone that when he arrested some of the people involved in Amit’s racket, “there were concerns that more reputed doctors would be caught.” He recalled a conversation with Pramod Navalkar, an influential legislator in the state of Maharashtra. “Take it easy now,” Navalkar allegedly told him, “we’re losing all our good doctors.”
Amit’s arrest was a wake-up call for the Indian government. According to the union health department, India’s illegal organ trade at the time was estimated to be worth close to Rs 60 crore. The parliament passed the Transplantation of Human Organs Act in 1994, which had provisions for punishing racketeers with imprisonment of up to five years and a fine up to Rs 20,000. But under the Indian federal system, health is a state subject. The racketeers could always move to states that had not adopted the Act.
That is exactly what Amit and Jeevan did. After spending five months in Mumbai’s Arthur Road prison, Amit jumped bail and the two siblings relocated to Jaipur in Rajasthan, which was yet to adopt the Act. “By now, he was a different person,” the former colleague said. Amit had grown accustomed to a certain lifestyle. “One can eat half a roti and live in dignity. But once a lion tastes meat, he can’t go eat grass.” In Jaipur, Amit hiked his fees and performed numerous surgeries for two more years. Soon, he had three more criminal complaints against him: two in Jaipur and one at Guntur in Andhra Pradesh. Busted again, he fled to Canada, leaving his wife, son and parents behind. He would later purchase a four-bedroom house in Brampton and introduce himself to his neighbours as a cardiovascular surgeon with clients across the world.
Around 1999, Amit returned to India and moved to Delhi. This time, he changed his name from Santosh Raut to Amit Kumar, married again and had two children with his second wife, Poonam. In Gurgaon, an upcoming satellite town of Delhi, he and Jeevan started Star Max Hospital, the front for their latest kidney racket. In order to avoid external leaks, Amit had set up a diagnostic centre within the hospital. The patients coming from abroad were put up in a three-star guest house, also owned by Amit. Both of these places were located in the rapidly gentrifying parts of Gurgaon, among a row of plush two-storeyed villas with guard dogs and eight-foot-tall boundary walls.
In 2000, a railway canteen owner in New Delhi overheard a conversation between a few of his customers—many of whom were touts and donors—who had been to Amit’s hospital, and informed the police about the racket. Amit was arrested, but secured bail within months and resumed his operations. According to an article in Discover magazine, the income-tax department found that Amit had not paid his taxes, and initiated legal action against him in 2006. Amit sent them a cheque amounting to $1.4 million. It bounced, but neither was he penalised, nor was his real source of income investigated. Three weeks before the racket was officially uncovered, the Delhi police arrested Amit’s associate Upender Aggarwal, a Meerut-based physician accused of supplying kidneys. Amit bribed the police with Rs 19.85 lakh and had his partner released.
In January 2008, a policeman from Meerut in the neighbouring state of Uttar Pradesh came across two men brawling on a busy street over a “stolen” kidney. Their arrest and interrogations led the Uttar Pradesh police to Amit’s hospital. It was, they realised, a kidney racket of industrial proportions. The case was soon transferred to the Central Bureau of Investigation. Amit, the CBI found, had a network of touts across India, had operated on hundreds of patients and made an estimated hundred crore rupees through the racket. Aggarwal later told them that Amit would boast of ties to politicians, bureaucrats and two former prime ministers of India. In the resulting media furore, VP Singh, who had served as the prime minister between 1989 to 1990, and had battled kidney problems since 1993, was compelled to hold a press conference to say that he had not been involved in Amit’s racket.
The Gurgaon scandal occurred at a time when India was building a reputation as a hub of medical tourism. Foreigners, especially those from the West, were increasingly flying to private hospitals in India, known for its high-quality healthcare at a fraction of cost, a trend that continues till date—the Indian medical tourism industry is estimated to be worth eight billion dollars by 2020. Amit had followed the same modus operandi: he advertised kidney transplants as packages that covered stay, airfare and cost of surgeries for twenty-five to thirty thousand dollars. The same surgery cost $400,000, with a waiting time of around two years, in the United States.
After a week-long search, the CBI traced Amit to a remote wildlife resort in Nepal. His deportation was immediate—Pranab Mukherjee, then the external affairs minister, made a call directly to Nepal’s prime minister, GP Koirala, to ensure it. In April 2008, the CBI filed a chargesheet against Amit, Jeevan, Aggarwal and six others, including a nurse, an anaesthesiologist and a driver. As in Mumbai in the previous decade, the high-profile politicians, ministers and bureaucrats rumoured to be involved were neither named, nor charged.
The CBI had submitted a list of 126 witnesses, including Amit’s former associates, patients and “donors” who had complained of being abducted and threatened out of their kidneys. Yet, some were apprehensive about whether he would get away again. “He knows the loopholes in the law,” Rakesh Maria—then the Mumbai police commissioner and part of the team that had arrested and interrogated him in 1994—said in an interview with India Today. “He will hire the best lawyers and continue with this racket. This is the only business he knows.”
The trial began. By then, the media had moved on. In 2009, the parliament introduced an amendment to the Transplantation Act, doubling the maximum jail term to 10 years and the fine by a hundred times, to Rs 20 lakh. To address the shortage of organs, it allowed patients to get kidneys from uncles, aunts, grandparents or long-term acquaintances wishing to donate “out of love and affection.” The same year, while he was still lodged in Ambala jail, Amit bribed the prison guards to allow him access to a mobile phone. He knew just whom to call.
{THREE}
BULBUL KATARIA REMEMBERS the day vividly. It was a late evening in May 2008. She was working in a Delhi bank when her mobile buzzed. “Remember me?” Amit asked.
It took her a few moments. She had not heard from him since he was arrested. “Didn’t you have a case against you?” Kataria asked tentatively.
“No,” Amit said. “I have been wronged.”
Kataria’s last encounter with Amit in January 2008—shortly before the scandal over the kidney racket in Gurgaon—had followed a two-hour interrogation by the CBI. They had suspected her of being Amit Kumar’s girlfriend. He was the one interested in her, she told them. She was not.
When we met at a restaurant in Panchkula last March, Kataria did not appear too keen to make small talk. But her face lit up when I mentioned Amit Kumar. “I am lucky to have known him, to have married him,” she said wistfully. “For me, he’s my mother, brother, father, sister, husband, boyfriend, my whole universe.”
They had first met through a mutual acquaintance in 2005, she said. Amit came across as a “hotshot doctor” who owned a hospital in Gurgaon, but also as a bit of a show-off. His eyes “bulged like sheep,” and he was almost bald. But then he had started calling her up “a hundred times a day.” At the time, she was working as a financial advisor at a bank in Delhi. For months, he would follow her to her workplace, send personalised bouquets and ply her with lavish gifts, once even a Honda City. Tired of rejecting his advances, she met with him a few times. They would drive in his Mercedes and share filter coffees at five-star hotels. At times, she recalled, she did enjoy their conversations. But later in the year, when he proposed marriage, her initial response was, “Will we even look good together? Have you looked at yourself?’”
Amit would call her often from jail. He had not conned anyone off their kidneys, he would say. The recipients were ready to pay and he made sure their donors always got paid. Besides, the CBI did not, at the time, have the legal mandate to probe him under the Transplantation Act. Those powers rested with a so-called “appropriate authority” appointed by the state government. “I felt sorry for him,” Bulbul told me. “He’d saved lives, after all. He didn’t murder anyone.”
In 2009, Amit invited Kataria to meet him at the prison. She obliged. By then, she said, she was also quite smitten by his wit, charm and repeated declarations of love: “He has magic with words. If you talk to him, you’ll fall in love with him.” His looks, a turn-off once, did not seem to matter anymore. “Then I saw him in the jail, suffering, tortured. Tragedy has a way of bringing people close. I thought, it was my duty to get him out.”
Even if she bribed the members of the judiciary to expedite the process, which she claimed to have done, the sheer scale of the evidence against Amit left little room for his acquittal. The only way out was if the witnesses rescinded on the statements, refused to identify Amit during the proceedings and insisted that the CBI had pressurised them to testify against him.
Amit’s accusers did have a history of going back on every word of their initial complaint without any cogent explanation. For instance, Sriniwasrao Mudana, a cook from Andhra Pradesh, had filed a complaint against Amit and his cronies at Mumbai’s Mahim police station in 2005, accusing them of not compensating him for his kidney. Yet, his testimony recorded at the Sewree sessions court in 2009, reads:
Nobody met me during my residence at Mahim, then during my time of sleeping on footpath. Nobody inquired with me whether I have got any house for residence and also have arrangement of food. Nobody told that if I want to earn amount then I have to donate my kidney. Nobody taken me [sic] to Dr Gujrathi for examination. No Sonography was taken by any Doctor of my person or any part of my body. It did not happen that I was provided particular dress in order to go to Delhi and that I was taken to Airport for going to Delhi. I was not operated at Delhi. … I do not know if I was admitted at Delhi and then was discharged on 19/4/2005. It is not true to say that at Delhi when I was being taken back to Mumbai, then I was demanded amount [sic] and the persons with me refused to pay amount and that I was abandoned in Delhi. It is not true that after returning to Mumbai, I lodged complaint in police station against the Doctors.
And so, Kataria told me, she spent Rs 6 crore to bribe the police, jail authorities, lawyers, victims and witnesses. Some received “salaries” every month, while others had goons threatening them. The money came from her uncle Raj Krishna, a real-estate mogul in Delhi, who had agreed to help out in exchange for Amit’s properties. She also hired criminal lawyers, paid intermediaries to bribe judges and “managed” bail in 11 cases across the country. She attended every hearing at the special CBI court to make sure everyone was keeping their word. Those she could not contact on the phone, she would corner outside the courthouse. “Amit would say, ‘Everyone is conspiring against me,’” Kataria told me in a follow-up interview. “You think I’ll spend money, take favours from my uncle, take cash, go to jail knowing that he’s a criminal?”
One morning in 2013, Kataria recalled, Amit called her to inform that the CBI had got hold of Babu Ram, a kidney donor from Meerut. Ram had initially testified against Amit, but rescinded his statement after receiving money from Kataria. She called him up immediately. He explained that the officers had detained him from his house and driven him to the CBI headquarters in Delhi, but Kataria asked him to sneak out and meet her outside the office in an hour. She got into her car, picked him up and set off for Kasauli, a hill station in Himachal Pradesh, nearly three hundred kilometres away. There, she asked him to call the detectives and say he could not make it back as he had found a job in the town.
Even as she was influencing witnesses, Kataria approached KP Singh, the director-general of police in Haryana at the time, requesting material comforts and unfettered access to Amit. This was not an unusual request. Many political bigwigs, from the businessman Subrato Roy to the former telecommunications minister A Raja—both accused of financial misappropriation worth millions of rupees—are known to have received air conditioners, domestic help, wireless internet and television sets in their private cells. KP Singh’s personal assistant, Kataria said, conveyed her requests down the chain of command to Sanjay Bangar, then the deputy superintendent for Ambala jail. For over a year, Kataria and Amit would meet in Bangar’s chambers after visiting hours, between four and five times a week. The authorities never frisked her, so she would carry in food, mobile phones, SIM cards, currency notes, “whatever he wanted.” At times, they were even physically intimate.
Sometime in 2012, Amit and his co-accused Upender Kumar had a falling out inside the prison. Following a heated argument, Kataria told me, Amit’s lackeys inside the prison beat Upender “within an inch of his life.” The latter retaliated by writing to the chief justice of the Punjab and Haryana high court, listing all the attempts being made to manipulate and subvert the investigation. Already, the letter said, Amit and Jeevan had bribed the police to not arrest them in the cases registered against them in Jaipur and Guntur. Their attempts seemed to be working: only five out of the 120 prosecution witnesses recorded had testified against Amit.
“It was like a bomb had gone off,” Kataria said. After investigating the allegations, the CBI registered a fresh complaint against her, Amit, Jeevan, their associate Laxman Negi, who had liased with the witnesses, and Bangar. Under fire, the prison authorities barred Kataria from the jail. By the end of the trial, only four witnesses testified against Amit. Among them was Babu Ram. Explaining his flip-flops, he admitted he was “cheated, terrorised and suppressed” by Amit and his henchmen.
In March 2013, the CBI court pronounced Amit, Upender and three others guilty. “The soul of our nation had been shaken,” the judge said. “[The five] committed inexcusable sin in the society while their responsibility was far greater than what one expects of a common man.” They were sentenced to seven years of rigorous imprisonment and fines up to six lakh rupees. Jeevan and four others were acquitted for insufficient evidence.
At the time of the verdict, Kataria was at Ajmer Sharif, a sufi shrine in Rajasthan, praying for a favourable outcome. “Amit called me up and told me what had happened. I was crying so hard, I couldn’t speak,” she said. But within weeks, she appealed against the verdict in the higher courts. The Supreme Court finally granted bail on the technicality Amit had initially pointed out: the CBI was not the appropriate authority to probe him. In February 2014, Amit walked out of jail, having served six years of his sentence. The couple married the following month.
“And then?” I asked.
“And then we lived happily ever after,” Kataria said, laughing dryly.
A year into the marriage, Amit started working at the Century Wellness Centre, a hospital Jeevan had set up in Gurgaon. He would return home at odd hours, sometimes with bloodstains on his clothes. When asked, he would say he had operated on piles or hernia or brain tumours. A suspicious Kataria, who had inserted a surveillance device in his cell phone, knew he was lying. But she did not have the courage to confront him. She had left her job, was accustomed to living in his 15-room villa in Gurgaon and also financially dependent on her husband. Besides, he still owed her uncle Rs 6 crore.
In March 2016, Amit abruptly stopped going to the hospital. He switched off his cell phone and asked Kataria to do the same. They moved to her in-laws’ mansion at Sainik Farms in Delhi. As Jeevan and their tout friend Javed joined them there, Kataria could sense something was wrong. Nobody would tell her what had happened. But within weeks, it was clear that the three men had abandoned the Century Wellness Centre and were planning to set up a new hospital in Dehradun.
Kataria was furious. Unlike Amit, his partners were upfront about their plans in Dehradun. “Javed once asked me, ‘May we do it? It gives Rs 70 lakh per surgery.’ I said, ‘I don’t even want 70 rupees.’ Why would I want to take the risk of my husband being put in jail?” But she recalled that Amit seemed to relish the chase. “Don ko pakadna mushkil hi nahi, namumkin hai”—Catching the Don is not just difficult, but impossible, he would joke, quoting a line from the eponymous Bollywood thriller. One morning nearly three months into their stay, Amit, Jeevan and Javed left the house without notice. Kataria only heard from them after two more months, once the Gujarat police arrested him for harvesting kidneys off some residents of Pandoli in Gujarat. Only recently, it had become infamous as “the village of kidney sellers.”
{FOUR}
ALTHOUGH PANDOLI MADE NATIONAL news in 2016, a “village of kidney sellers” is more commonly found than one would expect. An early instance can be traced to the 1990s, when Pallipalayam in Tamil Nadu was nicknamed Kidneypalayam after many of its unemployed residents were found to be selling kidneys. Since then, the 2004 tsunami survivors of Ernavur in Tamil Nadu, Bindol in West Bengal and several villages in Pakistan and Nepal have received the label. In each of these cases, there is the same pattern of poverty, institutional corruption and failed socioeconomic policy. But what made Pandoli unusual was as much politics as policy: it was part of Anand, the glossy “milk capital” of India, and of the state of Gujarat, whose thriving development indicators were hard-sold by the then chief minister Narendra Modi en route to the prime minister’s office five years ago.
In January 2016, Amir Malik, a 25-year-old cattle farmer from Pandoli, asked his neighbour Rafiq Vora to help pay off his debt. “Only Rs 20,000?” Malik recalled Vora replying, when I interviewed him last March. “I’ll give you Rs 30,000.” The two travelled to Delhi and met Javed, Amit’s long-term associate, at a hospital. Javed, Malik claimed later, made him sniff a bottle. When he opened his eyes next, Malik was in a hospital room with a bandaged belly. He eventually received Rs 2.3 lakh through a courier.
Vora asked for his share, and Malik lost his cool. The two had a loud spat outside Vora’s residence. The local police did not want to get involved. But when a local newspaper reported on it, the news went viral across the country. Forced to investigate, the police discovered that Malik was not the only one who had been conned.
In the next few days, as the national media was making a beeline to this tiny village, 13 other residents admitted to selling their kidneys. Nearly all of them were farm and construction labourers. Some had been to Delhi for surgeries, others to Sri Lanka. But most, said Gujarat’s health minister, had sold their kidneys for “mauj, shauk”—to keep up their gambling and alcoholism in what is officially a “dry state,” one which bans the consumption and sale of alcohol.
“Nothing has changed since,” Jagdish Solanki, Pandoli’s sarpanch, told me. The village’s fifteen thousand residents consist mostly of landless farmers and masons. After earning Rs 120 for a day’s work, many gather in clumps at a place of choice: an abandoned hut, near illicit breweries or next to a garbage dump at the town square. Some drink, paying Rs 10 for a 100-ml glass of low-grade liquor; others wager on a deck of cards. So rampant is the routine, the sanctum walls of the local Gayatrimata temple are papered with de-addiction posters with slogans such as, “Ask yourself what you want: health or destruction?”
In March last year, accompanied by one of Solanki’s colleagues as a translator, I travelled across Pandoli to talk to the victims of the kidney racket. It was far more difficult than I had anticipated. One refused to be interviewed, two ran away after seeing me from a distance. Others were visibly reluctant to open up. At one point, Solanki even suggested that I pretend to be a government official. Many victims, he said, were in need of welfare funds. In spite of the financial windfall post their kidney “donation,” their lives had only changed for the worse.
Malik bought buffaloes with part of his earnings, but most of them died. Poonam Solanki had tried to build a house but soon ran out of money. Narendra Solanki had to annul his marriage after his wife discovered the reason behind an incision on his abdomen. Sagar Thakur had bought an eight-seater autorickshaw, but had to return to farm labour after the vehicle met with an accident. Like the others, he cannot take the heavy load anymore, restricting his chances at employment. “But it’s all right,” he says. “For those few months, I ate well, I drank buffalo milk.”
By late March 2016, as the police found Pandoli’s link to the Century Wellness Clinic in Gurgaon, Amit was already hiding at his in-laws’ farmhouse. They arrested him three months later in July at a Delhi courthouse, where he was appearing for an old case. For a month, Amit was in the Gujarat police’s custody, then taken back to Gurgaon for an official inspection of his clinic. While returning in the first week of August, the train stopped at a signal in Ajmer, Rajasthan, around 2.30 am. By then, Amit’s police escort—inspector Harish Vora, and constables Sandeep Patil and Bhavesh Vora—had slept off. None of them expected their detainee to flee, Patil recalled later. After all, throughout his custody, Amit seemed soft-spoken and well-mannered. “You can never tell with the educated types,” Patil mused.
A departmental inquiry was launched to investigate if Amit had bribed the officers. The three policemen were suspended briefly and later transferred to Vadodara. The findings of the inquiry were never revealed. Patil denied being bribed; Harish Vora did not respond to requests for an interview. BD Jadeja, a deputy superintendent who was now in charge of the Pandoli racket investigations, said, “Inspector Vora’s work had qualified him for a President’s medal. He won’t put his reputation at stake for money.”
“These are cosmetic things,” Kataria told me when I spoke to her over the phone in April last year. Soon after she heard about Amit’s arrest by the Gujarat police, she flew to Anand to meet him in custody. He had abandoned her three months before, but now seemed to be in a conciliatory mood. He said he loved her, then said he had come to an arrangement with the police. He would sell one of his Gurgaon properties, pay Rs 3 crore to Harish Vora, and would be let off.
Amit asked her to help him with the endeavour, but Kataria told him she was not willing.
Nevertheless, one evening in Gurgaon, she tailed Amit’s police escort to the guest house of his old acquaintance. After waiting outside for over an hour, she saw another car pulling into the driveway. Two men exited carrying a suitcase. It seemed to be stacked with currency notes—“It was so heavy, both of them had to hold it from each end,” she told me. In the train journey the next night, Amit “slipped out” of his handcuffs. Within months, he had struck a deal with Arun Kumar Pandey, the owner of the Uttarakhand Dental and Medical Research Institute in Dehradun and an old acquaintance. Amit would perform kidney transplants in the hospital campus and pay the latter a commission per surgery along with a monthly lease of Rs 5 lakh.
It took another year to arrest Amit again. And a few hundred more transplants.
{FIVE}
SINCE THEIR ARREST last September, Amit and Jeevan have been in the Dehradun central jail, attending trials in courtrooms across India, both in person and via Skype. Amit’s son Akshay Raut, a co-accused in the Dehradun racket, continues to be on the run. His father, Rameshwar Raut, died after severe kidney-related complications last year. The whereabouts of his first wife, Sunita Raut, are not known. His second wife, Poonam Kumar, lives in Amit’s house in Brampton, Canada, and did not respond to my phone calls and texts. His third wife, Kataria, had offered last year to turn an approver in the ongoing trial of influencing witnesses in the Gurgaon scandal. She did it on Amit’s instructions, her application stated, to save her marriage. In December, she filed a first-information report against her husband for trying to sell off his properties seized by the CBI, the enforcement directorate and the income-tax department, by giving the power of attorney to one Rohit Sharma from Dehradun.
Jeevan’s wife, Pooja Singhal, who also has a criminal case against her in connection to her husband’s racket, was unwilling to engage beyond claiming her husband’s innocence. I had a brief telephonic conversation with her in April this year. “He’s the brother of this guy, that’s why there’s always one or the other problem,” she said. “I have two small kids. I have to take care of them. That’s my only priority for now. I hope you can understand.” I tried to ask her more questions but heard a man on the other end of the line say, “Everything that you say is going to come against you. Shut up and keep the phone down.” Pooja hung up.
Amit’s advocate Virendra Sharma, a criminal lawyer from Moradabad, told me that a lot of the investigators’ claims against Amit were lies. “The matter is sub-judice,” he said over the phone in December. “There shouldn’t be a media trial.” He dismissed allegations that Amit’s agents fleeced people off their kidneys, that Amit bribed policemen, trial witnesses or members of the judiciary to get off the hook, and that his illicit activities had earned him a fortune over the years. “We have full faith in the judiciary,” he said. “I’m sure Amit will get justice.”
Today, Amit Kumar is arguably India’s most notorious kidney racketeer. And yet, he is not the biggest—that would be T Rajkumar Rao, a tout from Kolkata who was arrested in 2016, alleged to have facilitated nearly fifteen thousand transplants over two decades. Where Amit built a pan-India network by turning donors into middlemen, somewhat like in a pyramid scheme, Rao embraced the anonymity of the internet. He would lurk on social-networking websites and online support groups, posing as a distressed relative, offering monetary compensation to willing donors.
A number of advocates of organ trade have now started insisting that the only way to outdo the black market is its legalisation. After all, they say, if women can get paid to host the eggs of other women and bear their children, why can men and women not be paid for selling their organs to save the lives of others?
In their 2008 paper, “Introducing incentives in the market for live and cadaveric organ donation,” the Nobel-winning economist Gary Becker and his Argentinian colleague Julio Jorge Elias proposed that those willing to donate organs should receive encouragement, post-operative treatments and a compensation of $15,000. (Other scholars have since revised the amount to between fifty to a hundred thousand dollars.) Others say that the donors also should be rehabilitated by giving skills training or business loans.
But while a developed economy such as the United States might be able to address the ethical and economic problems arising out of commercial transplantation, “it would be a disaster for the developing world,” Philip O’Connell, the president of The Transplantation Society—an international organisation affiliated with the World Health Organisation—said in a New York Times interview in 2015. He also warned that if the United States sets the precedent, other “less scrupulous and less regulated places” could become fertile ground for further exploitation of both donors and beneficiaries.
“Instances of illegal kidney transplants are reported across India,” Narayan Prasad, the honorary secretary of the Indian Society of Nephrology, told me. “But the government seems to be in denial. It has not been able to provide quality infrastructure for dialysis or adequate funds for therapy. Unlike the United States, there is no research happening to prevent kidney-related diseases in India. It is a given then that a few people try to exploit the situation. The government needs to pump money, make a strong policy, get rid of bribing, install people with high moral character in authorisation committees. Only then can such rackets be stopped.”
In 2006, one tout lurking around a dialysis centre in Delhi introduced himself to the parents of a patient, who is now a homemaker. I met her last April at her residence. She told me that she was 17 years old when she was a patient, and had been diagnosed at the age of 13 with nephrotic syndrome—a kidney ailment characterised by an excess secretion of protein in urine. Within months, her immune systems nosedived. She went from being an active dancer to a sluggish patient on steroids, undergoing dialysis thrice a week. The tout offered to introduce her to someone who would offer a transplant without the red-tape: Amit Kumar. “I knew it was illegal but I wasn’t in a position to think beyond my own situation,” she said.
At the time of her kidney transplant, her father had met the donor in person. He said he was willing. But the setup was unusual—she remembers a driver working at the hospital doubling up as her surgical assistant. After the 2008 Gurgaon kidney donation scandal was uncovered, the CBI summoned her father for questioning and made him a prosecution witness. Despite threats by Amit’s henchmen, the father–daughter duo testified against Amit. But till date, she is evasive about the ethical implications of being a beneficiary of the organ trade. “The government has made it illegal,” she told me. “It’s up to them to solve it.”
It has been ten years since her surgery, five since her courthouse testimony. She has not heard from her doctor or her benefactor. As a teenager, she could never join her family for summer getaways because of her dialysis schedules. Today, she is a mother of two and planning her second vacation to Europe. But the past, she said, has a way of catching up. “Even today, when I visit my nephrologist for check-ups, I hear some patients talk of Dr Amit.”
“My husband and I just look at each other,” she added, misty-eyed. “And we giggle.”