“Hai . ravi from kakinada . age 30. o positive…. 8 lacks money ergent… plss cont. 99xxxxxx9” says one post on the website.“Guys could you please help me to get geniune buyer… o+ve blood group… if anybody interested contact me on this no +9192xxxxxxx3… i am in serious debt trouble...” That’s Nagarjuna, from Hyderabad.Suresh is even more direct. “I’m AB- donor. Age 24. Required amount 10 L. Call me 997xxxxx0”The “wares” they are plying online are not something you would find on your average ecommerce website: for, these men are looking to sell their kidneys to anyone who will pay them lakhs, through the website www.ineedakidneynow.org.While this particular website, which falsely claims it will not post requests asking for payment, has over thousands of posts, it is not the only online platform facilitating the buying and selling of kidneys. On a Facebook page “Kidney donor, dialysis nd transplant india”, what seem to be genuine posts by individuals seeking kidney donors have many replying that they want to sell their kidney.Another offers package deals for donors and recipients from India, wanting to get the procedure done in Sri Lanka The buying and selling of kidneys is strictly prohibited by law in India, under The Transplantation of Human Organs Act, 1994 and invites harsh penalties, including a prison sentence of one to three years and a penalty of up to Rs 25 lakh. But that evidently is no deterrent to individuals, driven to such desperation that they are willing to trade a part of their body, like they would a car or any other asset. And unlike the impoverished victims exploited by middlemen in the black-market kidney rackets, at least some of these aspiring sellers are educated.S Shivsundar, who says he is from Telangana, is one of them.The 68-year-old retired as an administrative officer in a government department and works in a private firm. “I need Rs 10 lakh.Some loans have come in, but I am still falling short. My children are not in a position to help,” he says over the phone, in English. He is not worried about the legal or medical risks. “There are many people living with one kidney,” he says confidently.Sanjay Shastri, a 42-year-old from Nashik, also needs Rs 10 lakh to settle his “financial problem”, for which he is willing to sell one of his kidneys. “My company has collapsed, so I need the money,” says Shastri, who has not told his wife about his decision. So far, the calls he has received have been from brokers, asking him to make a security deposit of Rs 20,000 and Rs 15,000 before the operation, presumably another ploy to hoodwink the gullible. But Shastri will have none of it. “I will sell only to genuine buyers.” On email, another prospective seller, R Reddy mentions an option of loaning him Rs 1 crore, interest-free, for 12 months in return for one of his kidneys, which would be “an help for an help”.While the sellers are individuals, most of the buyers seem to be brokers. Emails sent on the pretext of being a donor get replies that they are willing to pay Rs 4 lakh, on average, and that a passport is mandatory — without sending a scanned copy, negotiations will not proceed.Even if you are genuinely trying to find a donor, you might need to deal with those who expect remuneration.Ashutosh Khatri from Ahmedabad, who had posted on a Facebook group that he needed a kidney for his father-in-law, said the only responses he got were from people who wanted to sell their organ for Rs 5 lakh to Rs 50 lakh. “I know that this is totally against the law,” he says.Unable to find a donor, his father-in-law passed away two weeks ago.ET Magazine tried to contact ineedakidneynow.org through the administrator’s email ID given on the website but questions sent remained unanswered.That people like Shivsundar and Shastri are hopeful they might find buyers willing to pay them lakhs of rupees and, more importantly, break the law, is also one more indication of the shortage in kidney donations in India. Dr Sunil Shroff , transplant surgeon at Madras Medical Mission and the founder of the NGO MOHAN (Multi Organ Harvesting Aid Network) Foundation, estimates the current demand for kidneys to be 200,000 across the country. But with the majority of those with kidney failure unable to even consult a doctor, the actual demand would be less, he says. Even then, the gap between demand and supply has created an active black market. And as with other transactions that have moved online, the internet offers a new frontier for the buying and selling of organs, too. “There are many websites advertising this, where people put their numbers and other details.There is no kind of monitoring,” says Dr Shroff.The shortage in donated organs is due to many reasons, according to Dr Sudarshan Ballal director at Manipal Institute of Nephrology and Urology , who says only 5% of the 1,00,000-1,50,000 transplants that are needed actually take place.“You might not find a donor with a matching blood group among your relatives and, even if you do, they might not always be willing to donate. And the rate of cadaver donations in India is very low,” he says. Last month, a 33-year-old from Varanasi died waiting for a transplant, even though he had received funds from the Prime Minister’s Office.In India, there are strict laws about donating a kidney to someone who is not related to you, framed to prevent exploitation.The donor and recipient need to prove to a state authorisation committee that there is no financial transaction involved and that the two individuals know each other well. While this might make the process of donation complex, the system has been circumvented regularly by middlemen in India, as investigative journalist Scott Carney found. In his 2011 book The Red Market: On the Trail of the World’s Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers, Carney describes how impoverished donors in Chennai are coached by brokers. The committee members are paid off so that the hearing is reduced to a “mutually understood pantomime between organ sellers and buyers”. Papers are also forged by middlemen to show the donor and recipient are related as in a recent case in Bengaluru , which came to light when the seller tipped off the police after being cheated of her payment.Of late, donors and recipients have been going to get the procedure done in Sri Lanka, says Dr Ballal, who has seen many of his patients choose this option. “Rules are a lot more liberal there. If you can take a donor along, you can get the procedure done without too many questions being asked,” he says.This spurt in “transplantation tourism” could also be why agents trawling online forums for donors seek out passportholders.Rethinking the Model The shortage of kidneys and long waiting lists are hardly confined to India. In the US, the wait can be as long as 10 years, according to a recent report. Perhaps the only country that has eliminated this waiting list is Iran , which is also the only country where the government facilitates payments to donors.But the model, launched when the country was reeling under sanctions and could no longer afford to send citizens abroad, is controversial. Apart from the ethics of selling parts of your body, there is also criticism that there is no long-term followup of the donors’ health and that donors are overwhelmingly poor. The Declaration of Istanbul adopted in 2008 and endorsed by over 100 countries, for instance, explicitly calls on countries to prohibit the sale and purchase of human organs “because transplant commercialism targets impoverished and otherwise vulnerable donors… and leads inexorably to inequity and injustice”.Yet, there now seems to be a global debate on whether we should be rethinking the model of promoting donations by depending solely on the altruism of donors. In The New York Times, a recent two-part series pointed out that while nobody is following Iran just yet, “many are starting to remove financial disincentives that make donating a kidney an activity only for those with disposable income”.These include health insurance and reimbursement for salary lost during the time of the procedure.Dr Shroff says rather than looking at the Iran model, one could increase the availability of kidneys by promoting cadaver donations, which would then make the black market, online and offline, redundant. “Selling your organ can never be a long-term solution for anything,” he says. Carney agrees. In an email, he says, “The reason people sell their kidneys in India is because they are desperately poor, not because they want to be altruistic. A society that makes poor people look at their bodies as bank accounts is a truly sick one indeed.”ET Magazine meets a “willing” donor of a kidney for Rs 10 lakhI look at each passing man and wonder if it’s him. The stocky man in a tight-fitting red t-shirt stretched across his belly that proudly proclaims “No love, no tension”, another in trousers and shirt tucked out, talking into his cell phone. But both, who bear a faint resemblance to the profile photo in the email, walk by, without a glance. Finally, a young man in a striped white shirt and jeans pauses in front of the restaurant in Basavangudi in south Bangalore, and smiles diffidently.I had mailed Kumaraswamy (not his real name) three days ago from an ID from ineedakidneynow.org, the website that claims to be run by “The Good samaritan” connecting those in need of a kidney with willing donors, and stating “We will not post any request that asks for financial payment.” But that’s a blatant lie. There are myriad posts, offering to buy and sell for lakhs of rupees. Kumaraswamy himself had posted: "My self Kumar staying in Bengaluru india. My contact no. Is xxxxxxxxx580. I want to donate my kindey. i need 1000000 money urgently. I am not having passport my blood group is o+”Over coffee, Kumar, who is just 23, says he wants to sell his kidney because his family has “money problems”. A few days ago, he had typed the words “I want to sell my kidney for money” in Google search, which had led him to the forum. Wasn’t he afraid of the risks involved? That he might be cheated? “Yes, but I need the money,” he says. The previous day, the results for the CPT exams had come and the BCom dropout had failed, for the fourth time. His father had died a year ago and the family had borrowed Rs 3 lakh from a moneylender two years ago for their father’s cancer treatment, which had now ballooned to Rs 5 lakh. But didn’t he say he needed Rs 10 lakh? “Yes, that I just asked,” he says, with a shy smile. Kumar says he had not been able to complete his graduation, though he had 70% in his pre-university, because of the problems at home. The family has two acres of coconut trees in the village but, without water, the crops failed.Two others had also contacted him. One man, claiming to be from Mumbai, had told him he would be paid Rs 10 lakh, with 15% before the surgery and the rest after. But first Kumar had to deposit Rs 10,000 as hospital registration fee. The other had asked him to pay Rs 5,000 as registration fees.He says he had not told his friends or his family about his plan to sell his kidney, and did not know anyone who had done so either. The moneylender had given them a month for repayment but Kumar is unclear what would happen if the family defaulted, because his brother, who works as a coolie in their village near Tumkur in Karnataka, had negotiated the terms. They might have to give up the two acres of land, he says.(Names of some of the potential donors have been changed to protect their identities)