place for potential buyers to leave a message.
Americans are not just buyers; some may be sellers as well. Scheper-Hughes discovered "an older brother in the Los Angeles area offering to sell his younger brother's kidney online on Craigslist." The phenomenon has opened up a new form of trade, diffuse and fragmented, that has already increased the number of commercial transactions manifold and ushered in new kinds of abuse. And money is not the only inducement, says Monir Monir-uzzaman, an anthropologist at Michigan State University in East Lansing. In a study of the organ trade, he has found numerous ads that promise jobs, visas, and even citizenship in the developed world.
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Driving from Delhi to Gurgaon in June 2008, I glimpsed the soaring skyscrapers of Gurgaon's economic boom, but shanties closer to the ground spoiled the glossy view. Finally I entered the gated residential community where Kumar's hospital, sealed by the CBI, sat in a row of villas. It was enclosed by a wall and draped in bougainvillea vines whose pink flowers stirred in the muggy afternoon breeze. Peeking through the locked iron gate, I saw a stretcher left behind on the grounds. Having escaped from Mumbai and Jaipur, Kumar set up a clandestine facility here, putting up a sign advertising a lawyer's services. "The idea was to keep nosy neighbors away," CBI's Dwivedi said.
Kumar did not work alone. One of his main accomplices, the physician Upender Dublish, ran a hospital in Ballabgarh, an industrial town about two hours away. Bald and rotund, Dublish projects the resigned air of a man terribly wronged but too beaten to protest. At the Ambala courtroom, he told me with a pained look that he needed medical attention for a heart ailment. Dublish ran Kumar's supply chains, in which the more enterprising donors became middlemen themselves. The result was a pyramid scheme, which Scheper-Hughes says is common to kidney markets around the world. She has seen the pattern in Brazil and Moldova. "Middlemen will say to prospective donors, 'I lived through it and made money; you can too.'" An early recruit was Gyasuddin, whom I saw with Kumar in Ambala. He told me he sold his kidney for $1,000 and became a node in Kumar's network, earning about $110 "for every donor I could find." He brought dozens of donors to Kumar from his hometown, Meerut, an old city about forty miles from Delhi.
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Even as old charges from past arrests slogged through the legal system, Kumar's layers of protection grew. In 2004 he set up an in-house tissue-matching facility at the hospital to avoid dealing with external diagnostic labs, which he felt would draw the attention of law enforcement officials. But what really prevented exposure was corruption and lack of government oversight. In October 2003, a fifty-five-year-old Turkish patient named Mehmet Bayzit died at the hospital. Bayzit's relatives wanted the body flown back home, which meant that it had to be embalmed. There was a problem, though: embalming centers need a death certificate, which in turn requires a doctor's report.
The situation threatened to attract scrutiny of Kumar's operations. Dublish came to the rescue. He wrote a report on his Ballabgarh hospital letterhead, stating that Bayzit came to his hospital after experiencing chest pains on his way back from a trip to see the Taj Mahal. The report, citing cardiac arrest as the cause of death, enabled Dublish to obtain a death certificate from local municipal authorities. When two more Turkish patients died, in 2004 and 2005, Dublish used the same story as a cover-up. Indian authorities started an investigation only in 2006, when the Turkish embassy in Delhi, prodded by the patients' relatives, requested an inquiry. Still Kumar remained unscathed.
In fact, Kumar did not just evade the law; he turned to it for help. In his testimony to the CBI, he claimed that he received extortion threats from men working for Chota Shakeel, a Mumbai mobster. In 2007, after Kumar