“It doesn’t feel right. If it were someone I knew, even an acquaintance, I’d do it without pay. I am sure that I wouldn’t feel this deep sorrow.”–Sohaila
Iran is the only nation in the world where a living person can legally sell their own kidney (you only need one, after all). Prospective donors come to a state-run charitable office to sign up. If you’re in the proper age range, pass some medical tests, and are willing to wait out the bureaucracy involved, you can sell your kidney. Nima Sarvestani’s documentary Iranian Kidney Bargain Sale follows both donors and recipients as they go through the process of kidney donation.
The people who do this aren’t doing it to raise money for vacations or clothes. Sohaila is taking care of her younger sisters. When she tried to get an official loan with a decent interest rate, the bankers told her that she should raise the money by becoming a prostitute. Now she needs quick money to pay off loan sharks. Mehrdad was laid off from his job on the subway. He’s trying to raise funds for his wife’s abortion because they can’t afford to start a family yet. films Mehrdad waiting outside the abortion clinic, head in hands, while in a voiceover he says that the abortion is necessary because “my child would become somebody like myself.”
The recipients are also badly off–Shiva has already had a kidney transplant, but it didn’t work. She is understandably sick of this process. Young Said is relying on a benefactor to help pay for his kidney.
The part of Iranian Kidney Bargain Sale that surprised me the most is that donation isn’t necessarily anonymous. The featured donors and recipients meet face-to-face. I don’t know whether this is common when the cameras are off, although the way the system works encourages bargaining. Officially, both the state and the recipient pay a set portion of the costs. However, it seems as if the donor can pull out of the deal at almost any point, so in practice the donor can pressure the recipient to contribute more. Both sides are desperate, after all. In one scene, Soheila and Said’s benefactor haggle over one of Sohaila’s body parts. It’s all done in the most polite way possible and both parties still need each other, so fortunately the operation still goes through, but the embarrassment and misery involved is terrible.
The contact between donor and recipient leads to bonding, too. Shiva, Mehrdad, and Mehrdad’s wife hang out together and joke a bit before the surgery. How much of this camaraderie is due to the pressure of the camera or arrangements made by the director, I don’t know.*
According to the documentary’s epilogue, both Shiva and Said are doing well with their new kidneys. However, the money isn’t enough to get the donors out of their financial troubles. Mehrdad’s attempt to set himself up in a taxi business failed when he got into an accident, and Sohaila is back in debt again. Selling their body parts hasn’t led to financial security.
The efficiency of the Iranian kidney sale model has started a debate on whether the model should be adopted in other nations (thanks, John Stossel). On one hand, it means that people who need kidneys aren’t forced to wait as long as they might have. It also is much less costly than buying a kidney through the blakc market. On the other hand, the sheer unhappiness of the people who sell suggests that were there any other way out that didn’t involve crime or selling other parts of their bodies, they would take it–the kidney market relies on desperation and (at least in Sohaila’s case) discrimination, not on some magical invisible hand that cleanly plucks organs out of some bodies and deposits them in others. The Iranian economy is also in terrible shape–would the kidney market be as good if the market everywhere else wasn’t so bad? Does Iran’s success in reducing waiting lists rely on miserable economic conditions?
(Sarvestani’s documentary was released in 2006: this Iranwire article provides a 2013 update on the world of kidney sales.)
* If this went on in America, I can’t even imagine the crazy, abdomen-carving fuckery that would go on. It would be a godsend to the news and true crime channels!