How to Go Undercover in Bangladesh’s Organ Black Market

During season 3 of VICE on HBO, correspondent Vikram Gandhi looked at the harsh business of buying black market kidneys in Bangladesh. If you're a patient suffering from kidney failure in the US, one growing trend is the purchase of kidneys from abroad, where there are fewer obstacles in the way of a simple money-for-organ transaction.

But as we saw in the episode above, organs typically only flow up the world's social hierarchy. Some of the world's poorest people are willing go under the knife, in exchange for a cash windfall. But despite the fact that humans only need one kidney to live, the removal operation can permanently harm the donors—if "donor" is even the right word in cases like these.

So to get people to reveal the details of a messy process that saves lives on one hand, ruins lives on another, and involves money changing hands every step of the way, Gandhi and producer Alex Braverman had to perform some sleight of hand. With a little bit of undercover work, brokers and potential kidney providers will reveal how the black market system works, and how one can become the lucky recipient of a new kidney, if the price is right.

I asked segment producer Alex Braverman to lift the curtain a little on the investigative process, and apart from a few trade secrets, he was happy to oblige.

VICE: So why'd you have to trick people in order to get to the bottom of this?
Alex Braverman: People are not supposed to be selling their kidneys in Bangladesh. In order to prevent exactly what is happening there from happening, a law was implemented to basically make it so that family members could donate to someone else in their family who was the proper blood match. So anyone that's purchasing a kidney or selling a kidney to a stranger is breaking the law. To hear how the system works from a broker—some of them were comfortable talking about it and others weren't—we had to either let someone lie to us, or record it in a hidden way.

How'd you figure out who to talk to?
In the show, we go and talk to a young girl in her 20s, and she's someone that Dr. Zaman helped us find who was about to get a kidney from someone, and she was in Dhaka. She asks in the piece Should I tell them about the broker? and her parents are like No no no. But eventually, through her father, we got the name of a broker.

The guy in Dhaka seemed kind of like a big shot. What's his part in all this?
First there's a kind of broker that can help you make all the arrangements you need—a sort of big picture person—and that's who we met in the hotel room in Dhaka. The first guy is hustling. He wants you to follow through with the transaction, so he puts you at ease, and lets you know that you or your family member will receive a kidney, and it's gonna work out fine.

Did you have to sneak him into the hotel?
He wasn't doing anything wrong by talking to us, but he had no idea he was being filmed. We told him "When you get to the hotel, call this room from the lobby when you get there." It was just Vikram who went down to the lobby to grab him. He didn't want to talk about it in the lobby, so he just came right up.

How'd that conversation go?
He was probably in the hotel with us for 30 minutes at the most. Vikram had a bunch of questions that he wanted to ask. First he laid out his situation: that he was in from the [US], and he said "This is very difficult in the States, there's a list, I don't know if I can wait that long because of the deterioration of my wife's health." It seemed like the broker had heard it all before, and he never hesitated to answer those questions. That's just what he does and has done a number of times. There are places where you can do this kind of thing that are closer to the US than Bangladesh, but he didn't seem to be disturbed by that fact at all.

Where were you during this conversation?
I was in the next room over with the sound guy and the crew, listening. I wasn't shocked by what he was saying—I'd flown halfway around the world because I'd been told it worked that way, and I was discovering that it worked exactly how it had been described. There's something a little bit mundane about it, but it's a bit of a relief to know that you're going to be able to tell this story, even though obviously it's sad to see people being taken advantage of.

How was the conversation with the second kidney broker different?
That was more exciting to me than the hotel, because the guys in Dhaka seem like they're just providing a service for those that can pay for it, while the guys working with people who can't pay their loans seemed more predatory, and like a bigger part of the story.

Was it easy to get him in the room, like it was with that first guy?
He was very skeptical to meet with us—for good reason, but Vikram can be very convincing. I hesitate to call the broker sleazy, because of the language barrier, but I will say this: He was at one point desperate enough to sell one of his kidneys, and he knows what these people are going through. He showed us his scar. He was having health complications—and yet he is actively recruiting new people to go through that same process so that he can make some money. Although it's also so they can make some money, so it's not simple. Are they having second thoughts about this when they see him limping and struggling to get around and having a distended belly?

And how'd you get him on camera?
We were staying in a guest house in the north of the country and came up with a story that we felt legitimized us and invited him over to discuss it and had some hidden cameras set up. We were monitoring it from adjacent rooms. We had a place where we wanted him to sit. I don't want to give away all the trade secrets because we continue to shoot with hidden cameras when we need to but essentially there was one area in the room where we wanted him to sit because that's where our cameras would have picked him up. So we just made sure that was the only seat that was available.

And how was the conversation?
He just came over, and we had the meeting, and then ate lunch with him afterwards because we were in a guest house and asked him if he was hungry and he sat down and ate with us. Every meal in Bangladesh involves a lot of rice, lentils, bread. I think we had stewed fish a number of times, chicken. The food was really good, actually.

How'd you get him to bring in the donor?
We wanted to see what the process of negotiating a price would be. So the broker called the person willing to sell their kidney and he came over. I never actually saw him face to face cause I was in another room, but Vikram met with him again. He went through the story of why we were there, and made sure that this man understood that we wanted to purchase his kidney, and was he willing to sell it. Then the issue of price came up. I think this is in the final piece where he asked for a certain number and Vikram talked him down and they agreed upon it and shook hands. The guy was crying. He was emotional.

Was he crying because it was a life-changing amount of money?
Yeah, he was crying because of the amount of money and he was also crying because he was scared.

Did you feel bad that this guy wasn't getting his payday?
I did. At the same time, we felt equally as bad for those who we had met who had entered similar arrangements and did go through with the surgery and still were not paid. That's something that happens as well where they're promised $6,000 or $8,000 for their kidney and then in the end they get maybe one or two and the broker's like, "Sorry, that's how much you're getting."

Was shooting it as emotionally taxing as it seems like it would be?
The whole time we were there we just thought, "Wow this is one of the darkest shoots any of us have ever been on."It was a journey. We didn't know what our everyday was gonna look like. We flew out there with the information that we had and just tried to meet the right people that could make this story happen, and ultimately it did end up happening, which is exhilarating but also incredibly depressing.

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