家族養うため…腎臓売るアフガン人

【ＡＦＰ＝時事】仕事を失い、借金まみれになり、子どもを養うためには腎臓を売るしかない──こう思い詰めるアフガニスタン人が増えている。（写真はアフガニスタン・ヘラートで手術痕を見せる、腎臓を売った男性たち）
　昨年８月にイスラム主義組織タリバンが実権を握って以降、アフガニスタンは金融危機に陥り、数十年に及ぶ紛争で人道危機が悪化している。
　工場で働いていたヌルディンさんはタリバン復権直後に給与を大幅カットされたため、仕事を辞めた。もっと条件の良い職場があると思ったからだが、間違いだった。失業者を何十万人も抱えた国で、次の仕事は見つからなかった。
　切羽詰まったヌルディンさんは、手っ取り早い金策として腎臓の片方を売った。「今は後悔している」と話す。「もう働けない。痛いし、重い物は持てない」
　一家は今、１２歳の息子に家計を頼っている。靴磨きで稼げるのは、１日たった７０セント（約８０円）だ。

■一個１７万円
　ＡＦＰは、家族を養うためや借金返済のために腎臓を売ったという８人に話を聞いた。腎臓一つと引き換えに得た金額は、わずか１５００ドル（約１７万円）だったという人もいた。
　アフガニスタンには臓器売買に関する規制はない。北部マザリシャリフの病院で名の知られた外科医だったモハンマド・ワキル・マティン教授は、「法律がない」とした上で、臓器提供・売買には「ドナー（提供者）の同意が必要だ」と説明した。
　ヘラートで臓器移植の多くを手掛ける病院の外科に勤めるモハマド・バシル・オスマニ医師も、同意が重要だと指摘。ドナーから「書面と動画で同意を得ている」と語った。ただ、病院側が患者やドナーの身元や臓器提供の経緯を調査することはないという。
　金の工面に困った人は、ブローカーを介して裕福な患者と引き合わされる。患者は国内各地の他、インドやパキスタンからもやって来る。臓器移植にかかる費用とドナーへの謝礼金は、患者が支払う。
　３人の子どもに十分な食事を与えられず、うち２人が栄養失調と診断され治療を受けているというアジタさんは、２５万アフガニ（約３２万円）で腎臓を売ったという。今度は、日雇いで働く夫が腎臓を売ろうとしている。「人々は貧しくなった」「絶望の末に腎臓を売っている人も多い」と夫は話した。

■「片腎村」
　ヘラート郊外のサイシャンババザールは、長引く紛争で自宅を追われた人が集まってできた村だ。貧困にあえぐ住民の間に臓器が金になるといううわさが広がり、これまでに数十人が腎臓を売ったことから「片腎村」の名で知られる。
　ある一家では、兄弟５人が４年間に次々と腎臓を売った。貧しさから抜け出せると考えてのことだったが、「借金は残っているし、依然として生活は苦しい」とグラム・ネビさんは傷痕を見せて言った。
　先進国と異なり、腎臓を売っても貧しいままのアフガン人ドナーには術後のケアが提供されないことも少なくない。マティン教授によれば、ドナー登録をする機関も、ドナーの健康観察を担う公共医療施設もアフガニスタンには存在しない。
　臓器提供の機会を求めて病院を訪れたアジザさんは、「子どもたちは通りで物乞いをしている」「私が腎臓を売らなかったら、１歳の娘を売らなければならなくなる」と涙ながらに訴えた。【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2022/03/09-11:25）

Jobless, debt ridden, and struggling to feed his children, Nooruddin felt he had no choice but to sell a kidney -- one of a growing number of Afghans willing to sacrifice an organ to save their families.
The practice has become so widespread in the western city of Herat that a nearby settlement is bleakly nicknamed one kidney village.
I had to do it for the sake of my children, Nooruddin told AFP in the city, close to the border with Iran.
I didn't have any other option.
Afghanistan has been plunged into financial crisis following the Taliban takeover six months ago, worsening an already dire humanitarian situation after decades of war.
The foreign aid which once propped up the country has been slow to return, with the hardline Islamists also cut off from Afghan assets held abroad.
The trickle-down effect has particularly hurt Afghans like Nooruddin, 32, who quit his factory job when his salary was slashed to 3,000 Afghanis (about $30) soon after the Taliban's return, mistakenly believing he would find something better.
But, with hundreds of thousands unemployed across the country, nothing else was available.
In desperation, he sold a kidney as a short term fix.
I regret it now, he said outside his home, where faded clothes hang from a tree, and a plastic sheet serves as a window pane.
I can no longer work. I'm in pain and I cannot lift anything heavy.
His family now relies on their 12-year-old son for money, who polishes shoes for 70 cents a day.
- A kidney for $1,500 -
Noorudin was among eight people AFP spoke to who had sold a kidney to feed their families or pay off debt -- some for as little as $1,500.
It is illegal to sell or buy organs in most developed nations, where donors are usually related to the recipient or are people acting out of altruism.
In Afghanistan, however, the practice is unregulated.
There is no law... to control how the organs can be donated or sold, but the consent of the donor is necessary, said Professor Mohammad Wakil Matin, a former top surgeon at a hospital in the northern city of Mazar-i-Sharif.
Mohamad Bassir Osmani, a surgeon at one of two hospitals where the majority of Herat's transplants are performed, confirmed consent was the key.
We take written consent and a video recording from them -- especially from the donor, he said, adding hundreds of surgeries have been performed in Herat over the past five years.
We have never investigated where the patient or donor comes from, or how. It's not our job.
The Taliban did not respond to requests by AFP for comment on the practice, but Osmani said the country's new rulers have plans to clamp down on the trade and are forming a committee to regulate it.
Afghans desperate for money are usually matched by brokers with wealthy patients, who travel to Herat from across the country ?- and sometimes even from India and Pakistan.
The recipient pays both the hospital fees and the donor.
Azyta's family had so little food that two of her three children have recently been treated for malnourishment.
She felt she had no choice but to sell an organ, and openly met a broker who matched her with a recipient from the southern province of Nimroz.
I sold my kidney for 250,000 Afghanis (around $2,500), she said from her small damp room.
I had to do it. My husband isn't working, we have debts, she added.
Now her husband, a daily labourer, is planning on doing the same.
People have become poorer, he said. Many people are selling their kidneys out of desperation.
- 'One-kidney village' -
On the outskirts of Herat lies Sayshanba Bazaar, a village made up of hundreds of people displaced by years of conflict.
Known as one-kidney village, dozens of residents have sold their organs after word spread among destitute families of the money to be made.
From one family, five brothers sold a kidney each in the last four years, thinking it would save them from poverty.
We are still in debt and as poor as we were before, said Ghulam Nebi, showing off his scar.
In developed nations, donors and recipients usually go on to lead full and normal lives, but their after-surgery health is usually closely monitored -- and also dependent on a balanced lifestyle and diet.
That luxury is often not available to poor Afghans who sell a kidney and still find themselves trapped in poverty -- and sometimes in ill-health.
Professor Matin said only some donors arranged for follow-up checks.
There are no public health facilities to register kidney sellers and donors for regular examinations to check on implications for their health, he added.
Shakila, already a mother of two at 19, underwent the procedure shortly before the Taliban seized power, bypassing a broker by searching out a patient at a Herat hospital.
We had no choice because of hunger, she said, made up with black eyeliner with a scarf covering the rest of her face.
She sold her kidney for $1,500 -- most of which went to settle the family's debt.
Mother-of three Aziza, meanwhile, is waiting for her opportunity after meeting a hospital staffer who is trying to match her with a donor.
My children roam on the streets begging, she told AFP, tears welling.
If I don't sell my kidney, I will be forced to sell my one-year-old daughter.