On the back of the photograph the woman had written to Vajaya: 'Much love to you from your sponsor family in wintry Switzerland.' The word 'sponsor' seemed a mockery. If anything, it was Vajaya who had sponsored the Australian woman, by saving her life.
Vajaya had taken refuge in a Madras slum after a 10-year drought in Tamil Nadu withered her family's fields. Poor and desperate, she sold one of her kidneys to the Australian woman for pounds 377.
Most countries ban the sale of organs. India has gained notoriety as a spare human parts bazaar, a supplier of kidneys, corneas, blood, skin and skeletons. Parliament in June passed a bill cracking down on the organ traffic but it has yet to be enforced in many Indian states. Every year dozens of Britons, disheartened by the years- long queues for kidney transplants on the National Health, come to India for surgery. It is far cheaper and quickly arranged.
The slum where Vajaya lives with her drunken husband is called Villivakkam but everyone knows it as 'Kidney-vakkam'. More than 900 of the 4,500 inhabitants have sold a kidney. It is slightly better off than other Madras slums; some of the homes are of brick and the men ride bicycles.
Most donors are women. I asked Vajaya why. She nodded towards her snoring husband. 'We women are healthy. The men are drunkards,' she said. It seemed a relief to her that her husband was dead- drunk; that way he caused less damage. Although most of Villivakkam's dwellers cannot read or write, they are well-schooled about blood groups and tissue types and what the going rate is for a kidney. Prices vary from pounds 300 to pounds 350. The kidney recipient usually is charged pounds 14,000 for the surgery.
Huge profits go to the middle- men and the doctors. Dr Simran Nandy, a prominent Delhi surgeon responsible for pushing the new laws on organ transplants through parliament, said: 'It's like prostitution. It's an immoral trade in which the poor are forced to sell bits of their bodies to the rich.'
For the poor of Villivakkam, selling an organ, whether a kidney or a cornea, is their only chance of freedom from debt. 'Four girls in our village - educated girls with good prospects - wanted to marry. But their fathers did not have money for the dowry,' Vajaya said. 'So the girls sold their kidneys for the dowry and everyone was happy.' Donors must sign a document professing 'deep love and affection' for the unknown patient. This is to shield the doctors from later legal trouble from a repentant donor.
The price of a kidney is enough to pay off Villivakkam's money- lender, stage a wedding and buy a share in a motor-rickshaw. In the villagers' eyes, it is a fortune.
But Sakuntala, 35, a mother of three children, regrets having her organ removed. 'I have breathing problems and I can't work as hard as I used to. And the money went so quickly. It's all gone,' she said.
At one of Madras' most prestigious private clinics, the Willington Nursing Home, I asked where I could buy a kidney. The receptionist pointed to a medical supply room where a clerk was stacking boxes. In reply he scribbled down the name one of the clinic's specialists. 'Ring him at home in the evening,' the clerk said.
Posing as a foreign businessman in need of a kidney transplant, I spoke to the specialist, Dr Thiaga. He said the clinic had carried out 1,600 kidney transplants. As for the new laws making organ sales illegal, the doctor said, 'They're just trying to frighten us, that is all.' I asked about Aids. 'Don't worry,' he laughed. 'We are not like in Bombay.'
According to the Lancet, four Omanis recently contracted Aids from kidneys bought in Bombay, that were infected with the Aids virus. Back in Villivakkam, I asked Vajaya and several other women with long, welted scars curling round their midriffs, that were poorly disguised by their saris, if they had been given an Aids test before their operations. 'Now they do tests, but before they didn't,' said Sakuntala, whose kidney was removed three years ago. Word that a reporter was asking questions about selling organs reached Villavakkam's goondahs - hoodlums in the pay of the hospital middlemen. Scared, the women chased a photographer and me from their hut.Reuse content