In Nepal, the majority of kidney recipients are male (87%) while most kidney donors are female (76%), and in most cases, kidneys are given from wives to husbands and from mothers to sons. In an attempt to curb organ trafficking, Nepali law permits live renal donation only among close relatives, meaning donors have close personal relationships with their recipients, and one’s decision to donate a kidney is made in the context of one’s family, social and economic situation.
This paper examines the socio-cultural and familial context within which organ donation occurs, and focuses on how such factors have created an extreme gender bias in kidney donation. Interviews with kidney recipients, donors and their families illuminate the complex and intimate factors that influence the donation decision-making process, and how that process has disproportionately made women Nepal’s main organ donors.
Live organ donation in Nepal is clearly tied to gender. The Human Organ Transplant Center (HOTC), a government hospital and Nepal’s only dedicated transplant facility, and The Aarogya Foundation, an NGO that focuses on organ failure, have made reversing gender bias in organ donation a top priority. Despite this, no research to date has been done regarding how gender influences decisions to donate. Through ethnographic interviews with kidney recipients, donors and their families carried out at HOTC in Bhaktapur, and in partnership with The Aarogya Foundation, I attempt to fill this gap in the research.