Selling kidneys for cash has been a decade-long global concern. But to most poor Vietnamese who regularly sell their blood at HCM City's hospitals, the illegal trade in kidneys was virtually unknown - until now.

The recent case of 22-year-old To Cong Luan, who sold one of his kidneys in China and is now in a critical condition, has served as a warning to the public about the high risks of such a surgical procedure.

Desperate for money to support his pregnant girlfriend, Luan, a second-year student at the No 2 Industrial Technical High School, had been a frequent visitor to HCM City's Hematology Blood Transfusion Centre to sell his blood.

When he learned that people could sell their kidneys for 70 million dong (US$4,375) in China, Luan crossed the northern border to Guangdong Province in December to have an operation.

Two months later, he was returned to Viet Nam in a vegetative state and later sent to HCM City-based Cho Ray Hospital, where doctors said several incisions on his abdomen indicated that the surgery in China had been improperly done. Luan is now severely brain-damaged and in a state of semi-consciousness, doctors have said.

"Our family has given up hope for his recovery. Since his life can now be counted in days only, we've decided to bring him back home," says 45-year-old To Cong Son, Luan's father, who has recently filed a lawsuit in Viet Nam against the people involved.

The young man was brought home on Tuesday to Phuoc Dan Town, Ninh Thuan Province, where his family now waits for a full police investigation.

Quest for cash

Luan first became acquainted with the organ trade when he met 57-year-old Nguyen Thi Thuy, a professional blood seller and owner of a small coffee shop, outside the 175 Hospital in HCM City.

There, Thuy knew a collegue whom she calls Tam, who was the point of contact for the kidney trade in China.

Thuy says that no one knew Tam's real name and that since the incident he cannot be found.

"Tam was very poor. I hadn't seen Tam for some time, but then one day he ran into me and showed off his new Yamaha Novou motorbike. Where did he get this sudden wealth?"

"Later, he and his wife showed me the still pink, vivid scars on their stomachs and told me that they had earned big money from selling kidneys to a man named Phong in China. They wanted me to spread the news to other people and introduce young people to them," Thuy told Viet Nam News in a recent interview.

Asked if that was why Luan came to her, she said: "Yes! Luan also wanted to go to China to sell his kidney. He came to find me and asked me to introduce him to Tam, who would get him papers and take him to China.

"Tam took him to China with five other people for surgery. Three of them had kidney removal surgery and returned home safely before Tet, except for Luan and another woman named Hien. Tam told me that Luan was fine and his weak health required a longer time to recover from surgery."

"The other people returning from this trip also told me the same story, so I didn't doubt them. I then introduced five more people to Tam for the following trip. They were all pre-paid 6-7 million dong ($375-$437) for departure from Viet Nam."

Phong, the buyer of Luan's kidney in China, paid her about 15 million dong ($937.5).

"I was given 5 million dong ($312.5) for one person to have a kidney removed. I gave 2 million dong ($125) to Luan's girlfriend," Thuy said.

When she discovered the truth, Thuy said she realised that Luan was in "a very critical situation and that they had cheated me. I was so horrified that I phoned Tam. I asked him and Phong to return the second group of five people safely without any kidney operation or else I would report everything to the Vietnamese police."

"I contacted the police, but failed to return Luan. Despite my efforts to make Phong keep him in Guangdong Province's Hospital in China for medical treatment, he and Luan's girlfriend secretly returned him in an unconscious state. I saw his bad condition when Luan's girlfriend brought him to my house. Immediately, I took him to Cho Ray Hospital and went straight to HCM City's Fifth Police Station to report my crime and seek help for Luan."

Asked if she felt guilty, she said: "My heart and soul dies when seeing his terrible scars and skeletal body."

"Some of them had sold their kidneys and all of them looked healthy and had a big sum of money as a reward. I didn't know that selling kidneys was illegal. I had never heard about such a thing on TV or newspapers. If I had known about it, I would have never had the nerve to do such an evil thing. I just gave Luan what he had asked for. I thought I was giving him a chance for a better life."

Stopping illegal organ trading

Viet Nam's Ministry of Health reports that an average of 5,000 to 6,000 kidney patients are on a waiting list. Last year, only 158 of them were able to have a kidney transplant.

"Undoubtedly, kidneys are the most sought after organ," says Professor Nguyen Nguyen Khoi, ex-head of the Ha Noi-based Bach Mai Hospital?s Kidney Disease Department and a senior consultant at Ha Noi Medical University.

According to the professor, Luan's was not a rare case. "Many people phone me, offering their own kidney and asking me for advice," Khoi said.

"They're all poor and desperate people. I don't know what to do except advise them on the risks they might encounter during the surgical process and later. If they want to go ahead, I tell them to call the 103 Hospital or 105 Hospital instead," he added.

Currently, under Vietnamese law, the selling of organs is a crime. However, a law that became effective in July last year that permits organ donations from the living and dead contains loopholes, many lawyers say.

"According to Vietnamese law, it's a crime here. However, as Luan was able to voluntarily exchange his kidney for money and his surgery took place in China, it's really hard for Viet Nam to impose any criminal proceedings against the buyers and the Chinese surgeons," said Tran Pham Thanh Loan, a lawyer for Sai Gon Law Company. (By THU HUONG/ The Viet Nam News/ ANN)