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Kalai Upazila, Bangladesh - In a rural village tucked away in northern Bangladesh, a growing number of residents bear the same physical reminder: a scar from where their kidney used to be. Baiguni village, population just under 6,000, has become known by a chilling nickname-"the village of one kidney."
An explosive new report published in BMJ Global Health estimates that one in every 35 adults in this region has sold a kidney, making Kalai Upazila one of South Asia's most exploited hotspots in the illegal organ trade.
"The brokers took everything," said Safiruddin, a local resident who sold his kidney after being promised a way out of poverty. He never received the full payment. His passport was taken. Even the medication he needed after surgery was denied.
Safiruddin's story is not unique. Al Jazeera interviewed more than a dozen donors in the region-all victims of the same system: exploitative brokers, forged documents, and surgeries performed across the border in India.
The trade thrives on a brutal equation: poverty meets demand. With over 200,000 people in India requiring kidney transplants annually and only 13,600 performed legally in 2023, patients and middlemen alike turn to the black market.
"This is not just a regional issue-it's a global health crisis," says Dr. Moniruzzaman, professor at Michigan State University and a WHO Task Force member studying organ trafficking in South Asia.
Hospitals in India-like Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata-have been repeatedly mentioned in donor testimonies. Brokers often forge familial ties between donors and recipients to sidestep transplant regulations. Passports are seized, trails are erased, and donors are left with long-term medical complications and no legal recourse.
Josna Begum, a 45-year-old widow, was promised over $5,700 to sell her kidney. She received less than half that after the operation. The brokers, she says, fabricated documents to show she was related to the recipient.
"It was a mistake," she says. "But we were desperate."
Like many others, she was smuggled into India through the Benapole border, housed in temporary apartments, and operated on in private hospitals. She never met the recipient.
What makes this industry almost impossible to stop is the lack of enforcement and legal accountability. Brokers rarely face punishment. Hospitals often deny knowledge. Victims-poor, uneducated, and undocumented-are silenced by fear, illness, and shame.
"The kidney trade continues because it's profitable for everyone-except the donor," says Dr. Moniruzzaman.
South Asia's illegal organ trade is no longer a hidden problem. It's a documented, growing, transnational crisis-and global silence is no longer an option.
Until real accountability is enforced, villages like Baiguni will continue to pay the price-with their bodies.
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