Global Affairs
‘I’ve already sold my daughters; now, my kidney’: winter in Afghanistan’s slums | Global development
The temperature is dropping to below zero in western Afghanistan and Delaram Rahmati is struggling to find food for her eight children.
Since leaving the family home in the country’s Badghis province four years ago, the Rahmatis have been living in a mud hut with a plastic roof in one of Herat city’s slums. Drought made their village unliveable and the land unworkable. Like an estimated 3.5 million Afghans who have been forced to leave their homes, the Rahmatis now live in a neighbourhood for internally displaced people (IDP).
There are no jobs. But the 50-year-old has hospital fees to pay for two of her sons, one of whom is paralysed and the other who has mental illness, as well as medicine for her husband.
“I was forced to sell two of my daughters, an eight- and six-year-old,” she says. Rahmati says she sold her daughters a few months ago for 100,000 afghani each (roughly £700), to families she doesn’t know. Her daughters will stay with her until they reach puberty and then be handed over to strangers.
It is not uncommon in Afghanistan to arrange the sale of a daughter into a future marriage but raise her at home until it is time for her to leave. However, as the country’s economic crisis deepens, families are reporting that they are handing children over at an increasingly young age because they cannot afford to feed them.
Yet, selling her daughters’ future was not the only agonising decision Rahmati was forced to make. “Because of debt and hunger I was forced to sell my kidney,” she tells Rukhshana Media from outside her home in the Herat slum.
Afghanistan is on the brink of “a humanitarian crisis and economic collapse”, according to the UN. The agency’s ambassador to Afghanistan has said it is “experiencing the worst humanitarian crisis of its contemporary history”. Drought, Covid-19 and the economic sanctions imposed after the Taliban seized power in August 2021 have had catastrophic consequences on the economy. Dramatic rises in inflation have resulted in soaring food prices.
The kidney trade has been growing in Afghanistan for some time. But since the Taliban took power, the price and conditions under which the illegal organ trade takes place has changed. The price of a kidney, which once ranged from $3,500 to $4,000 (£2,600 to £3,000), has dropped to less than $1,500 (£1,100). But the number of volunteers keeps rising.
Rahmati sold her right kidney for 150,000 afghani (£1,000). But her recovery from the operation has not been good and now, like her husband, she is also sick, with no money left to visit a doctor.
More than half of the country’s estimated 40 million population face “extreme levels of hunger, and nearly 9 million of them are at risk of famine”, according to the UN refugee agency, UNHCR. For a growing number of Afghans, selling a kidney is their only way to get money to eat.
“It has been months since we last ate rice. We hardly find bread and tea. Three nights a week, we can’t afford to eat dinner,” says Salahuddin Taheri, who lives in the same slum as the Rahmati family.
Taheri, a 27-year-old father of four, who scrapes together enough money for five loaves of bread each day by collecting and selling recycled rubbish, is looking for a buyer for his kidney. “I have been asking private hospitals in Herat for many days if they need any kidney. I even told them if they need it urgently, I can sell it below the market price, but I haven’t heard back,” Taheri says. “I need to feed my children, I have no other choice.”
In the past five years about 250 official kidney transplants have taken place in the hospitals in Herat province, with a very limited number being a family member donating their organ, says Asif Kabir, a public health official in the province. The cost of a kidney transplant is 400,000 afghani, plus the price of the kidney, according to Kabir.
But the true number of kidney operations may be far higher. A doctor working in one of the hospitals where most of the transplants take place, who spoke on the condition of anonymity, says: “Recently the number of people who want to sell their kidney has increased in Herat and most of them live in the displaced camps, in Herat’s slums. The customers also go to the displaced camps to find a cheap kidney.”
Sayed Ashraf Sadat, a civil society activist in Herat, was a member of a delegation assigned by president Ashraf Ghani to investigate the illegal kidney trade in May 2021.
“We found that the hospitals were not working according to the law. People are working inside and outside the country to encourage people to sell their kidneys. These people get them visas and send them to the other side of the border. There is more demand for kidney transplants outside Afghanistan. Countries like Iran need kidneys, and poor Afghans are forced to sell them.”
Sadat says the investigation he was part of identified two hospitals in Herat where kidney transplant operations take place; one of them said it had completed 194 operations and the other said 32, but more than 500 people were claiming to have sold their kidney, 100 from a single village in Herat. “This shows the kidneys were taken outside Afghanistan,” says Sadat.
“For example, a kidney is purchased for 300,000 afghani (£2,100) inside Afghanistan, and it is sold for more than £7,500 to £11,000 outside the country,” says Sadat.
“We found evidence that some are encouraged to sell their kidneys, taken outside the borders, and their kidneys are sold for 200,000 to 400,000 afghanis ,” says Sadat. “It seems that the doctors are involved in the illegal trade. But unfortunately, our investigation was stopped due to a worsening security situation.”
Two months have passed since Rahmati’s kidney operation, and the money has already gone to pay off medical debt. Her recovery from the operation continues to go badly.
“I am so sick. I couldn’t even walk because the wound has been infected. It is very painful,” she says, adding that the recipient of her kidney only paid for the operation fee, two nights in hospital and her first medicine bill.
On the day of the transplant, Rahmati was sick and the doctors refused to operate. “I couldn’t breathe properly, so the doctors took me down from the hospital bed, but I returned. I told them ‘I am happy with my own death, but I can’t tolerate seeing my children hungry and ill’,” she says.
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Global Affairs
Malawi aids Israel by sending agricultural workers during the Hamas war | International
On November 25, a group of 221 young workers from Malawi departed for Tel Aviv, from where they would disperse to work on Israeli farms. Israel’s Ministry of Agriculture and Rural Development said in early November that the war with Hamas has significantly affected the country’s agricultural sector after thousands of foreign workers left the country. Given the limited employment prospects in Malawi, which ranks as the fourth poorest country globally according to the World Bank, the African nation has forged a partnership with Israel to provide farmworkers.
“We’re thinking of initially sending around 5,000 people,” said Malawi’s Information Minister, Moses Kunkuyu in a recent BBC interview. Amid a foreign currency crisis, the people of Malawi are also grappling with soaring prices and rampant inflation. Malawi’s Labor Secretary Wezi Kayira says it has been exporting labor to countries like Israel for a long time since it creates jobs for the country’s youth and generates foreign exchange.
They pick us up on buses every morning and we go to work on nearby farms and fields. We are aware of the tough situation in Gaza, but we feel safe
Malawian farmworker in Israel
“A portion of their wages will cover living costs in Israel, while the remainder will be remitted to personal accounts here in Malawi to boost foreign exchange,” said Kayira in a statement shared with the media.
EL PAÍS chatted on WhatsApp with a young man from Malawi who has been working on a farm in northern Israel picking and packaging fruit. He prefers not to share personal details or where he is living in Israel. “They pick us up on buses every morning and we go to work on nearby farms and fields,” he said. “We are aware of the tough situation in Gaza, but we feel safe.” He said laborers from Malawi have arrived on three flights so far, with the most recent one on November 25. He estimates that around 350 Malawians have arrived as of now. “We’re spread out in different locations — some of us work on livestock farms, while others pick vegetables.” The young man tells this newspaper that he came to Israel to earn money so he can pursue his education. “The economic situation in my country is very difficult.”
The labor-export agreement follows Israel’s recent $60 million aid package to support Malawi’s economic recovery. The country’s growth has stagnated amid macroeconomic imbalances that continue to deteriorate, according to the International Monetary Fund (IMF).
Malawi President Lazarus Chakwera has been criticized for the potential risks the agreement imposes on Malawian citizens traveling to conflict zones, as well as the lack of transparency surrounding its negotiation. “Sending people to a war-torn country like Israel, where some countries are withdrawing their labor is unheard of,” Malawian opposition leader Kondwani Nankhumwa told the BBC’s Newsday program.
Habiba Osman, executive director of the Malawi Human Rights Commission, is concerned about the secrecy surrounding the agreement. “The government did not provide any prior information even though transparency is their obligation. We still lack information about this agreement between Israel and Malawi. Our aim is to ensure there are no human rights violations,” said Osman, who noted that another Israeli plane landed at Lilongwe International Airport airport on November 28 and is still there.
Sending people to a war-torn country like Israel, where some countries are withdrawing their labor is unheard of
Malawian opposition leader Kondwani Nankhumwa
Safe environments and decent wages
In addition to security concerns, opposition and humanitarian organizations worry about the working conditions for Malawian citizens in Israel. In 2015, Human Rights Watch reported abuses towards foreign agricultural workers in the country. However, Minister Kayira said, “The deployed youth will work at certified and approved locations, which are classified as fit and safe environments with medical insurance and repatriation arrangements for the youth involved.”
Malawians have expressed interest in working in Israel since the initiative became public, and government recruiters have fanned out across the country to explain the details and contract conditions. The Times of Malawi reported that a recruiter based in Lilongwe conducted a meeting at Chiwoko Primary School and told the job seekers “they were going to Israel for fruit picking and the treatment of plants and vegetables, mainly in greenhouses. The contract is for three years of working eight hours a day, and the salary will be $1,500 per month.”
Malawi and Israel established diplomatic relations in 1964, which have remained intact even after other African nations cut ties after the 1973 Yom Kippur War. In 2020, Malawi expressed its intention to become the first African country to open an embassy in Jerusalem, a significant diplomatic decision that has yet to be finalized. Most countries maintain their embassies in Tel Aviv, as they do not recognize Israel’s sovereignty over eastern Jerusalem, which it occupied in 1967. They believe the status of this holy city should be subject to negotiation for a just and peaceful resolution between Israelis and Palestinians. The United States relocated its embassy to Jerusalem in 2018 during the Trump administration.
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