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‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal

Kidney selling is a global phenomenon engraved by poverty and governance in low-income countries with the higher-income countries functioning as recipients and the lower-income countries as donors. Over the years, an increasing number of residents in a village near the capital city of Nepal have sol...

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Autores principales: Shrestha, Bijaya, Adhikari, Bipin, Shrestha, Manash, Poudel, Ankit, Shrestha, Binita, Sunuwar, Dev Ram, Mishra, Shiva Raj, Sringernyuang, Luechai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021627/
https://www.ncbi.nlm.nih.gov/pubmed/36962518
http://dx.doi.org/10.1371/journal.pgph.0000585
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author Shrestha, Bijaya
Adhikari, Bipin
Shrestha, Manash
Poudel, Ankit
Shrestha, Binita
Sunuwar, Dev Ram
Mishra, Shiva Raj
Sringernyuang, Luechai
author_facet Shrestha, Bijaya
Adhikari, Bipin
Shrestha, Manash
Poudel, Ankit
Shrestha, Binita
Sunuwar, Dev Ram
Mishra, Shiva Raj
Sringernyuang, Luechai
author_sort Shrestha, Bijaya
collection PubMed
description Kidney selling is a global phenomenon engraved by poverty and governance in low-income countries with the higher-income countries functioning as recipients and the lower-income countries as donors. Over the years, an increasing number of residents in a village near the capital city of Nepal have sold their kidneys. This study aims to explore the drivers of kidney selling and its consequences using ethnographic methods and multi-stakeholder consultations. An ethnographic approach was used in which the researcher lived and observed the residents’ life and carried out formal and informal interactions including in-depth interviews with key informants, community members and kidney sellers in Hokse village, Kavrepalanchok district. Participants in the village were interacted by researchers who resided in the village. In addition, remote interviews were conducted with multiple relevant stakeholders at various levels that included legal workers, government officers, non-government organization (NGO) workers, medical professionals, and policymaker. All formal interviews were audio-recorded for transcription in addition to field notes and underwent thematic analysis. The study identified processes, mechanisms, and drivers of kidney selling. Historically, diversion of a major highway from the village to another village was found to impact the livelihood, economy and access to the urban centres, ultimately increasing poverty and vulnerability for kidney selling. Existing and augmented deprivation of employment opportunities were shown to foster emigration of villagers to India, where they ultimately succumbed to brokers associated with kidney selling. Population in the village also maintained social cohesion through commune living, social conformity (that had a high impact on decision making), including behaviours that deepened their poverty. Behaviours such as alcoholism, trusting and following brokers based on the persuasion and decision of their peers, relatives, and neighbours who became the new member of the kidney brokerage also contributed to kidney selling. The other reasons that may have influenced high kidney selling were perceived to be a poor level of education, high demands of kidneys in the market and an easy source of cash through selling. In Hokse village, kidney selling stemmed from the interaction between the brokers and community members’ vulnerability (poverty and ignorance), mainly as the brokers raised false hopes of palliating the vulnerability. The decision-making of the villagers was influenced heavily by fellow kidney sellers, some of whom later joined the network of kidney brokers. Although sustained support in livelihood, development, and education are essential, an expanding network and influence of kidney brokers require urgent restrictive actions by the legal authority.
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spelling pubmed-100216272023-03-17 ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal Shrestha, Bijaya Adhikari, Bipin Shrestha, Manash Poudel, Ankit Shrestha, Binita Sunuwar, Dev Ram Mishra, Shiva Raj Sringernyuang, Luechai PLOS Glob Public Health Research Article Kidney selling is a global phenomenon engraved by poverty and governance in low-income countries with the higher-income countries functioning as recipients and the lower-income countries as donors. Over the years, an increasing number of residents in a village near the capital city of Nepal have sold their kidneys. This study aims to explore the drivers of kidney selling and its consequences using ethnographic methods and multi-stakeholder consultations. An ethnographic approach was used in which the researcher lived and observed the residents’ life and carried out formal and informal interactions including in-depth interviews with key informants, community members and kidney sellers in Hokse village, Kavrepalanchok district. Participants in the village were interacted by researchers who resided in the village. In addition, remote interviews were conducted with multiple relevant stakeholders at various levels that included legal workers, government officers, non-government organization (NGO) workers, medical professionals, and policymaker. All formal interviews were audio-recorded for transcription in addition to field notes and underwent thematic analysis. The study identified processes, mechanisms, and drivers of kidney selling. Historically, diversion of a major highway from the village to another village was found to impact the livelihood, economy and access to the urban centres, ultimately increasing poverty and vulnerability for kidney selling. Existing and augmented deprivation of employment opportunities were shown to foster emigration of villagers to India, where they ultimately succumbed to brokers associated with kidney selling. Population in the village also maintained social cohesion through commune living, social conformity (that had a high impact on decision making), including behaviours that deepened their poverty. Behaviours such as alcoholism, trusting and following brokers based on the persuasion and decision of their peers, relatives, and neighbours who became the new member of the kidney brokerage also contributed to kidney selling. The other reasons that may have influenced high kidney selling were perceived to be a poor level of education, high demands of kidneys in the market and an easy source of cash through selling. In Hokse village, kidney selling stemmed from the interaction between the brokers and community members’ vulnerability (poverty and ignorance), mainly as the brokers raised false hopes of palliating the vulnerability. The decision-making of the villagers was influenced heavily by fellow kidney sellers, some of whom later joined the network of kidney brokers. Although sustained support in livelihood, development, and education are essential, an expanding network and influence of kidney brokers require urgent restrictive actions by the legal authority. Public Library of Science 2022-10-14 /pmc/articles/PMC10021627/ /pubmed/36962518 http://dx.doi.org/10.1371/journal.pgph.0000585 Text en © 2022 Shrestha et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Shrestha, Bijaya
Adhikari, Bipin
Shrestha, Manash
Poudel, Ankit
Shrestha, Binita
Sunuwar, Dev Ram
Mishra, Shiva Raj
Sringernyuang, Luechai
‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title_full ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title_fullStr ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title_full_unstemmed ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title_short ‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: Findings from an ethnographic study of a village with one kidney in Central Nepal
title_sort ‘the broker also told me that i will not have problems after selling because we have two and we can survive on one kidney’: findings from an ethnographic study of a village with one kidney in central nepal
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021627/
https://www.ncbi.nlm.nih.gov/pubmed/36962518
http://dx.doi.org/10.1371/journal.pgph.0000585
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