This article is more than 2 years old.

August 12, 2016 This article is more than 2 years old.

In India, kidney trafficking is big business.

This week, the police arrested five top doctors from Mumbai’s elite Dr L H Hiranandani Hospital, including its CEO and medical director, for their alleged involvement in a sophisticated organ-harvesting racket that extracted kidneys from poor villagers.

Acting on a tip-off from a worker at the hospital, the police first uncovered the racket in July after busting a suspicious transplant surgery wherein a woman was to donate her kidney to her husband. It was found that the woman was a poor villager from the state of Gujarat, with no relation to the man.

Under Indian law, only close relatives can donate their kidneys to patients in need. Buying and selling organs is strictly prohibited and punishable by prison sentences and fines of up to Rs25 lakh.

In a statement, the hospital said it has appointed Ernst & Young to conduct an audit to investigate transplant operations.

The scandal comes just weeks after the Gujarat police arrested Ayurvedic practitioner Santosh Raut, the alleged mastermind of a massive international network involved in over 1,000 illegal kidney transplants across India, Nepal, Myanmar, and Sri Lanka. His network is believed to be linked to the Hiranandani racket.

Incidentally, Raut, who has been arrested twice before, escaped from police custody this week.

In June, a similar racket was busted at the prestigious Indraprastha Apollo Hospital in New Delhi where agents allegedly forged documents to show that donors were related to the recipients. In reality, the donors were paid around Rs300,000 ($4500), with their kidneys then re-sold for a massive profit.

In India, unrelated persons can only donate kidneys if the procedure receives government approval to ensure that no money transaction is involved. The only other options for kidney donations are to source organs from brain-dead patients, with their families’ permission, or from cadavers. However, so far these choices have remained unpopular.

With around 200,000 Indians requiring kidney transplants every year, demand significantly exceeds supply. That’s contributed to a thriving black market where touts earn millions of rupees per transplant by charging a hefty sum from patients and paying donors, usually impoverished and debt-ridden villagers, a relatively tiny sum.

“In far flung villages in West Bengal and Bihar, most of the villagers live with one kidney and operations are performed locally,” Rishi Kant from NGO Shakti Vahini told the Hindustan Times. “It is a thriving market, with touts preying on (the) poor.”