TIME Nepal

Nepal’s Impoverished Kidney Village, Where Organs Come Cheap

Man Bahadur Tamang, 51, who sold his kidney for 64,000 Nepalese rupees ($727) due to poverty, shows the incision scar from the operation, at his home in Kavre
Man Bahadur Tamang, 51, who sold his kidney for 64,000 Nepalese rupees ($727) due to poverty, shows the incision scar from the operation at his home in Kavre on Sept. 4, 2012. © Navesh Chitrakar / Reuters—REUTERS

In the mud-brick village of Hokshe, desperate Nepalese have been persuaded, or tricked, into selling a precious kidney for a pittance

In 2002, Kenam Tamang was duped into parting with a kidney by his own son-in-law. The ruse was a simple one, sweetened by the lure of work and a steady income – something he had been bereft of for too long. The two would leave their village of Hokshe in the Himalayan foothills east of Kathmandu, cut a line south and cross the border into India. Several days later, they would arrive in the southern coastal city of Chennai, ending a migratory passage that hundreds of thousands of Nepalese laborers had plied before them.

He hung around in Chennai for a month before being introduced to a group of Indian men — friends of his son-in-law who would arrange the work, he was told. “But one night, I heard them talking about kidney, but could not understand the whole conversation properly, which was in Hindi. And the next day, I was escorted to the hospital, where I was told that they are taking out my kidney.” Kenam, 48 at the time, turned to his son-in-law. “He said I will get a good amount for the kidney and there will not be any health complications. He even said that it would grow back.”

Hokshe is a cluster of mud-brick homes, flanked by fields of corn, sitting high up in the hills that circle Kathmandu. The arterial roads heading west from the village serve as tributaries that feed the capital with an ever fluid labor force made up of young and old, men and women, who see little point in staying at home to farm small patches of land for less than $2 a day. But the village carries a dark secret: of the 75 households in one ward alone, almost all have at least one member who has sold a kidney. Some, like Kenam, are duped into doing so; others are only too willing. From the days of the early ’90s, when the first villager was approached by brokers with the attractive offer of more than a year’s wages in return for an organ, the trade has taken on almost fad-like proportions.

Kumari Sapkota, 42, stands outside her home in Ward 3 of Hokshe. Her hands and clothes are caked in a chalky mud from working the field of corn below the house. If the money was right, she would willingly sell her kidney. Her only hesitancy is that all too often, the fee offered by brokers rarely gets delivered; either that, or sellers find that by the time they resume their lives in Hokshe, much of it has been spent on travel and medicine. That was the fate of Kenam. After being reassured by his son-in-law, he agreed to undergo the operation for $700. The cash was handed over in full, but three months later, as the bus wound its way back up the hill to Hokshe, only $100 was left. The two of them had spent the intervening time in Kathmandu, where the fee was whittled away. “Some money was used for dieting and medicine to be used soon after the operation, while my son-in-law spent money on alcohol,” he laments.

The story of Ganesh Bahadur Damai, 40, from nearby Jyamdi village, echoes Kenam’s search for better-paid work in India — that is, until he found himself drunk in a room in Bangalore with a group of strangers. “I was given an injection which made me unconscious for 24 hours. When I awoke, I was in a hospital bed. They had taken my kidney.” Three months later he arrived back in Kathmandu, where he was handed a mere $150, with which he bought a small plot of land. People living with one kidney should have its function assessed annually. But, he says, “I have no money to go for a health checkup.”

Stories like this don’t deter Kumari, nor the seemingly dozens of other villagers here who see opportunities in the organ trade. Her husband is a kidney down, as is the friend who works the field of corn with her. One man, Krishna, says his brother-in-law and two other relatives have sold theirs. He tried four times, but all were unsuccessful — on one occasion, the recipient of his kidney died just before he arrived for a pre-op checkup in Kathmandu. Frustrated, he won’t try again. But others are only too keen.

One 19-year-old mother is actively looking for a buyer, but recent crackdowns by Nepalese police have taken out many of the middlemen. “If you know someone [a broker], tell him to come here!” she says, laughing. Her reason is blunt, and a sharp reminder that the money they’ll receive isn’t for indulgence, but for far more pressing concerns. “I can get one lakh [$1,000] for a kidney. My son’s future will be secure.” As the conversation winds on, and more women come up from the field, it becomes clear that the international kidney trade that feeds clinics across the subcontinent and beyond has a bountiful source in Hokshe.

“Hokshe is an example of how people can [be exploited],” says Dr. Rishi Raj Kafle, executive director of the National Kidney Center in Kathmandu. “These villagers see people who haven’t died and think, Why not?”

Back in the village, the sharp whiff of locally brewed moonshine that comes off the breath of many locals — even those who, with one kidney, really shouldn’t be drinking very much at all — points also to a lack of understanding about the health implications. That isn’t surprising. Every villager TIME spoke to was illiterate and would struggle to learn about or comprehend the side effects of a nephrectomy, which can include high blood pressure and reduced function in, or even failure of, the remaining kidney.

The emergence of a legal donor system, in which relatives of patients who require a new kidney can trade theirs for $2,000 of government money, has reduced the numbers of Nepalese traveling to India for operations. Police have also clamped down on the rackets that prey on villages like Hokshe, and in May they arrested 15 traders in a sting operation. But Dr. Kafle fears there could be many more Hokshes across Nepal, even though the only people who seem to be making money are the traders. “I’ve not found a single person who sold their kidney who is rich,” he says.

TIME Thailand

Thailand’s Army Tightens Its Grip on Power

THAILAND-POLITICS-PROTEST-MILITARY
Members of the Thai security forces stand guard outside the Army auditorium in Bangkok where prominent figures including former Prime Minister Yingluck Shinawatra are reporting to the junta on May 23, 2014. CHRISTOPHE ARCHAMBAULT—AFP/Getty Images

A day after the army takes control, coup leader General Prayuth proclaims himself acting Prime Minister and scores of politicians and activists are barred from leaving the country, while users of social media are warned not to post any material critical of the coup. Some commentators fear a dramatic upsurge in violence if Red Shirts decide to strike back at the military's intervention

Thais awoke this morning to their first full day of military rule, with top political leaders detained and television stations taken off air following a coup yesterday led by the powerful army chief, General Prayuth Chan-ocha.

More politicians are expected to report to the army headquarters in Bangkok today, with the recently deposed Prime Minister Yingluck Shinawatra having already turned herself in, according to the BBC. They face possible arrest, while scores of politicians and activists have been banned from leaving the country. Commentators questioned the grounds for the coup in light of the fact that the ongoing political turmoil had been limited mainly to Bangkok. The U.S., a strong ally of Thailand, sharply criticized the army’s intervention, with Secretary of State John Kerry asserting that “there is no justification for this military coup.”

In downtown Bangkok yesterday evening, streets that would normally hum with activity late into the night began to empty as the 10 p.m. curfew approached. Television screens in restaurants and cafés across the country carried the emblem of the newly formed National Peace and Order Maintaining Council, headed by Prayuth, who has proclaimed himself acting Prime Minister. Patriotic songs played on a loop, breaking only for the army’s spokesperson to announce updates to the rules now governing the kingdom.

Among those was a warning that social-media users who criticized the coup could face prosecution, with hugely popular platforms like Facebook and Twitter threatened with closure in the event that they failed to deliver “accurate news to the people.” Thai-British academic and activist Giles Ji Unpakorn wrote on his Facebook page that the last time a crackdown on the flow of information occurred on this scale was when “the army raided bookshops and libraries in Thailand … on Oct. 6, 1976,” the date of the infamous massacre of student protesters by the army at Thammasat University, during a prior phase of military rule.

Critics of the coup have been placed in the crosshairs of the new rulers. Verapat Pariyawong, an expert on Thailand’s legal system, said he knew of people who had received “serious threats to their security,” but did not want to go public with them “in order to contain the fear to themselves — that is, they don’t want the public to also fear speaking out.” Verapat warned that an upsurge in attacks would likely follow. “[A coup] will always produce very detrimental effects because it deepens the conflict,” he said. Referring to a 2010 crackdown on a Red Shirt demonstration in central Bangkok in which 90 people died and 2,000 were injured, he added: “The situation is now worse than it was in 2010, because the preparedness of the Red Shirts to avenge the deaths of 2010 makes it much more uncertain what will happen next.”

Exactly how the course of events went in the lead up to the coup announcement yesterday remains unclear. Leaders from both the People’s Democratic Reform Committee (PDRC) — whose Yellow Shirt supporters had spent six months agitating for the removal of the Pheu Thai government — and the progovernment Red Shirts were summoned by Prayuth for a second day of negotiations at the Army Club in Bangkok. Shortly after, 14 people, including PDRC leader Suthep Thaungsuban, and Red Shirt leader Jutaporn Prompan, were detained and taken to a barracks next door. Television channels were seized, and Prayuth, flanked by senior military officials and the police chief — the new faces of power in Thailand — announced that the country had come under the control of the army. Troops guarding the entrance to the Army Club blocked journalists from entering, but at 6 p.m., TIME witnessed a convoy of army trucks packed with soldiers, and led by a machine-gun-mounted Humvee, entering the base via a side gate.

The economy, which has already slowed to a 2.8% growth following months of street protests, is expected to take a heavy knock. The tourism sector, which accounts for 10% of GDP, already lost nearly 400,000 arrivals in the first quarter of the year. Shovon Kibria, a Bangladeshi-American tourist, said his Bangkok-bound plane was forced to sit on the tarmac at Chittagong airport in Bangladesh for an hour yesterday, with the pilot announcing that martial law, imposed on Tuesday and considered a precursor to yesterday’s coup, had affected landing clearances at Suvarnabhumi Airport.

“I was aware of martial law being imposed but didn’t think that would affect me in any way, but hearing about the curfew completely changed our plans,” he said, adding that he and friends decided not to venture far from their hotel yesterday evening following the order to close all public transport in the country by 9 p.m.

Supporters of the PDRC, who have camped out in Bangkok since November last year cheered at the announcement yesterday, with many claiming a victory in the battle to topple the Pheu Thai government and rid Thailand of the rule of Thaksin Shinawatra, the exiled former Prime Minister who is considered chief controller of the Pheu Thai party and whose sister Yingluck is regarded as a proxy.

“They [the PDRC] know that the military is sympathetic to their cause — the movement against corruption and abuse of power by Thaksin,” said Kraisak Choonhavan, a former Democrat Party Senator who regularly took to the stage at PDRC rally sites.

Antipathy toward Thaksin is vitriolic among upper-middle-class Thais, yet he commands an overwhelming majority of support in the country. The opposition knows that elections scheduled for July would see his party claim a sweeping victory, so they have looked to the courts and Senate, traditionally seen as biased in favor of the Democrat Party, to topple the government.

“The PDRC probably think military rule is better than the barbaric capitalism under Thaksin,” Kraisak said. “The ideological ones among you will probably ask what the future of democracy in Thailand is under the military. But all the small details of Thaksin’s rule — the extra-judicial killings, the rice scheme — came under democracy. How does democracy produce such monsters?”

It is increasingly in Thailand’s legal system — the so-called juristocracy — that the machinations of politics plays out. The Constitutional Court, whose verdict on May 7 saw Yingluck removed from office, has long been considered favorable to the Thai establishment. “The Senate, too, now has to be watched very closely,” said Verapat. “The fact that the coup instigators opted to only temporarily suspend the constitution and specifically provide that the Senate continues to function suggests that the coup instigators may find some use in the Senate.” This may occur through asking Senators to nominate or endorse a temporary government or reform council, he added.

The streets of Bangkok today appear normal, and restaurants dished out the usual lunchtime fare to those who made it to work. Come 10 p.m., when street vendors pack up early and the lights of the ubiquitous 7-Eleven stores go out across the nation, Thais will once again be reminded that below the surface calm lies an almost uniquely dysfunctional political system that has seen the army annul a constitution that it wrote itself, and the country stagger from one coup to another, punctuated by mass street violence and the rule of the men in green.

“The worst part of all this is that it produces a generational problem,” says Verapat. “Young Thais have been and will continue to be indoctrinated that force is above all else, and that there’s really no use playing by the rules. They will grow up accustomed to such a culture, they will run the country, and the vicious cycle never ends.”

TIME Aviation

Malaysian Plane’s Unprecedented Disappearance Deepens Asian Tensions

Crew members from the Royal Malaysian Air Force look through windows of a Malaysian Air Force CN235 aircraft during a Search and Rescue operation to find the missing Malaysia Airlines flight MH370, in the Straits of Malacca, March 13, 2014.
Crew members from the Royal Malaysian Air Force look through windows of an aircraft during an operation to find Malaysia Airlines Flight 370 in the Strait of Malacca on March 13, 2014 Samsul Said—Reuters

Officials in several Asian countries are frustrated with Malaysia's handling of the hunt, with questions of why there’s so much contradictory information

Frustration at the sluggish rate at which the Malaysian government is releasing updates on the missing Malaysia Airlines plane has rapidly turned into suspicion — with China, echoed by voices in Vietnam and even inside Malaysia, demanding explanations as to why so much of the information released from Kuala Lumpur has been vague and contradictory.

It has been six days now since MH370, carrying 239 passengers, vanished over the ocean en route to Beijing from Kuala Lumpur. The absence of solid information released by Malaysia, which is leading the search, has been filled with bursts of wild conjecture from officials and media that have compounded the anxiety, confusion and grief of relatives and friends of those missing.

Air-force chief General Rodzali Daud was quoted in local media on Tuesday saying that the plane had changed course toward the Strait of Malacca, sparking rumors that it may not have crashed. Later, however, he denied making the statement, despite a high-ranking official confirming the report. Then on Wednesday, Defense Minister Hishammuddin Hussein said officials had detected radar signals that they thought might be from MH370, but that it had taken them four days to release the data.

Vietnam, one of the first countries to join the hunt for the plane, is among those growing increasingly frustrated by Malaysia’s messaging. Local and international media have spent the past three days lingering in airless rooms at the air-traffic-command center on Phu Quoc Island, southwest of Ho Chi Minh City, awaiting updates. But they have gleaned little. Vietnam has deployed planes and ships to aid the operation, and on Thursday morning scrambled four aircraft following the release of Chinese satellite images that appeared to show large chunks of debris floating in the South China Sea. Pilots returned having spotted nothing.

China’s subsequent admission that the images were released “by mistake” has added further strain to a search operation unprecedented in both size and its extent of multiparty cooperation. Beijing itself berated the Malaysian government over Kuala Lumpur’s perceived stalling, with China’s Foreign Ministry spokesman Qin Gang stressing on March 10 that Malaysian authorities should “step up their efforts and speed up their investigation.”

The Malaysian government has defended itself, with Defense Minister Hussein telling reporters on Wednesday that “it’s only confusion if you want it to be seen to be confusion.” But it is receiving growing domestic flak. “Malaysians have come to accept that their leaders don’t answer questions,” prominent lawyer Ambiga Sreenevasan told the New York Times yesterday. “When you are not seriously challenged in any meaningful way, of course you get complacent and comfortable.”

Pre-existing territorial disputes have added to the tension, with key parties in the search operation — including China, Vietnam, the Philippines and Malaysia — already embroiled in hotly contested claims over the South China Sea. Moreover, the fact that 154 of the 239 passengers were from either China or Taiwan presents an added urgency for Beijing. An editorial in the Chinese state-run Global Times said of Malaysia’s failure to issue regular and clear details: “Malaysia’s grave inconsistencies on this vital information cannot but be a devastating blow to the outside world’s confidence in its core role in search and rescue.”

For Vietnam, which has no nationals aboard the missing MH370, the question of cooperation with Malaysia appears a sensitive one. When TIME tried to approach a senior Vietnamese official involved in the search to ask about Malaysia’s sharing of information, an English-speaking member of staff stepped in and said, “It’s not a question we will answer.”

Speaking on condition of anonymity, however, a junior official from Ho Chi Minh City’s air-traffic-control department dispatched to Phu Quoc to aid the effort later expressed bewilderment at Kuala Lumpur’s methods.

“I asked [Malaysian officials] for information about the flight path two days ago, and the information only arrived this morning,” he said today. “It’s all very slow, and I don’t know why. Six days without finding something is too long. It’s very strange.”

Data automatically downloaded from the engine of MH370 has led U.S. analysts to claim that the plane may have continued flying for four hours after the radar went blank. The Wall Street Journal, which first reported on the new finding on Thursday morning, said investigators were exploring the possibility that someone aboard diverted the plane, “with the intention of using it later for another purpose.”

Malaysia’s Hussein dismissed the claims at a press conference this afternoon, saying that the government, as well as Boeing and Rolls-Royce, which designed engines for the Boeing 777 aircraft, believed the Journal’s report was inaccurate. That response is likely to be contested by U.S. analysts, who believe the new findings warrant an expansion of the search operation beyond the South China Sea. The U.S. dispatched a naval vessel to the Indian Ocean under the assumption the plane crashed somewhere there.

In the brain room of the Vietnamese operation, analysts huddle over a laptop, updating on a map the shifting demarcation of the search area. Two enlarged maps hang on the wall behind them, one showing flight paths of various airlines over southwest Vietnam, another marking in white the blocks of sea that were explored today, and in green those that will be explored tomorrow. The pencil lines change regularly, but new information on the plane’s whereabouts is scant.

On the nearby runway sits a small seaplane readied for Friday’s search. Vietnam has sent craft from airports across its southern provinces, while China has assigned 10 satellites to survey the seas and deployed nine ships and four helicopters. “As long as there is a glimmer of hope,” said Chinese Premier Li Keqiang at a press conference on Thursday, “we will not stop searching for the plane.”

TIME Burma

Burma’s Rohingya Are Now Being Forced to Live in Squalid Ghettos Watched by Guards

Rohingya men look out from behind a barbed-wire fence used as a barrier to restrict travel on Nov. 25, 2012, on the outskirts of Sittwe in Burma
Rohingya men look out from behind a barbed-wire fence used as a barrier to restrict travel on Nov. 25, 2012, on the outskirts of Sittwe in Burma Paula Bronstein—Getty Images

Increasingly, for most Rohingya, the only solution is to flee the country

The policeman manning the barbed-wire roadblock at the entrance to Bhumi quarter in Sittwe spells out the rules: if the Rohingya try to leave without a permit, they are apprehended and taken back to their homes. Asked if the Rakhine are treated the same, he smiles, embarrassed, and shakes his head. This neighborhood, in the capital of western Burma’s Rakhine state, is one of several Muslim-majority areas of the town that have been transformed into de facto open-air prisons, with the movement of inhabitants tightly restricted by armed guards.

The ghettos are among several developments to have occurred in Sittwe since violence broke out between Rakhine Buddhist and Rohingya Muslim communities in June 2012. Their populations are gradually thinning out: reports of a massacre of Rohingya in early January by Rakhine mobs and soldiers in Maungdaw in the north of the state quickly spread south, triggering panic among some residents of Bhumi and poorly guarded refugee camps nearby and causing them to up sticks and move to camps nearer the coast.

Those who have remained in the quarter look out dejectedly from doorways or wander listlessly through the quiet, dusty streets: only a year and a half ago they would travel into the town center to trade, shop, visit the doctor or take their children to school — those routine activities are now off-limits. Confined to 2 sq km, life has been whittled down to its most basic form.

“Every day I would go to the market to sell eggs,” says 65-year-old Abdul Rahim, who, having not left the quarter since the barricades first appeared in June 2012, relies on the slim earnings his son makes at a nearby shop. “Now I’m all the day sitting and thinking, and feeling unhappy.”

(MORE: Burma Accused of ‘Ethnic Cleansing’ of Rohingya Muslims)

If hospital treatment is required, inhabitants have to seek an exit permit from authorities; this is usually granted only in emergencies. U Khasin, 87 and suffering from high blood pressure and water retention in his legs, instead travels to a Muslim community clinic on the edge of the Thae Chaung refugee camp behind Bhumi quarter.

The policeman at the barricade shuffles nervously as he explains a policy he seems reluctant to enforce: were Rohingya to enter downtown Sittwe, he says, they would likely face attack from Rakhine.

Although the Rohingya have for generations lived in Burma — which is officially known as Myanmar — they are not included on the country’s official list of 135 ethnic groups on the specious grounds that they are land-grabbing interlopers from neighboring Bangladesh. They are denied citizenship and face severe restrictions on marriage, employment, health care, education and now daily movement. The U.N. has dubbed the community “virtually friendless.”

With no government-led efforts to rebuild intercommunal harmony, animosities have festered and hardened. Many Rakhine complain that the Rohingya’s desperation and poor education makes them a menace, and that their movements should be tightly controlled. Others say that it isn’t the Rohingya who have it tough but the Rakhine.

(MORE: Pushed from Burma, Stateless Rohingya Flee by Boat)

Khaing Kyaw Moe, a senior member of the Rakhine Nationalities Development Party, goes as far as to compare his people to the long-suffering Palestinians. He says the Rohingya are like the Israelis, “extending their buildings into Palestinian territory,” and warns that “if our government remains weak and the international community doesn’t begin to understand,” then Rakhine state will become as riddled with conflict as the West Bank. Comparing the fearful and isolated Rohingya to the mighty Israeli state is, of course, absurd — but then, prejudice almost always is.

The head of a school in Sittwe says the Rohingya should stay in camps until they are taught to be tolerant of other religions (the fear of many Rakhine is that the Rohingya are inclined toward Islamic extremism). He has cut contact with former Muslim friends, largely through fear that if the parents of his pupils discovered he still interacted with Muslims, they would pull their children out of school.

For the Rohingya, social exclusion and ghettoization are the final indignities. In the Thae Chaung camp, children walk around with no clothing beside open sewers, their bellies bloated in a telltale sign of malnourishment. Aid workers, journalists and diplomats have been visiting the camps for more than a year and a half but little has changed, save for their sagging tarpaulin shelters, which have become even more wretched and frayed.

New families have moved into shelters vacated not long ago by asylum seekers, who have taken to the sea on overloaded boats bound for Malaysia and beyond. Some of these new arrivals at the camp are not victims of direct violence, but rather of the fear that what happened in Maungdaw in early January could soon happen to them. They’ll soon be looking seaward to plan their own risky exits — and that suits the Rakhine just fine.

MORE: Horror at Sea: Adrift for Months, Starving Asylum Seekers Threw 98 Bodies Overboard

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