Gender Bias and Organ Transplantation in Nepal

Women in Nepal are less likely to receive proper, high quality medical care than their male relatives. Live-donor kidney transplantation provides a compelling example of such disparities, as 84% of recipients are male, 75% of donors are female and most kidneys are transferred from mother to son and from wife to husband. In the case of transplantation, women are not just denied healthcare, they are also responsible for the health of their male kin. Based on semi-structured ethnographic interviews with transplant patients, organ donors, dialysis patients and relatives, this paper elaborates on the social and economic factors that have created an extreme gender bias in transplantation. We argue that women, whose livelihoods largely depend on their husbands, donate kidneys out of self-protection and a sense of duty. Conversely, men receive kidneys but rarely donate them to women, because the health of men is a more productive economic investment than the health of women. We reject the notion that wives are directly coerced or pressured into donating kidneys to their husbands. Rather, we argue that female kidney donors make thoughtful, independent decisions that serve their best interests, and allow them to assert some control over their lives. It is, however, Nepal’s patriarchal society that both necessitates and limits such assertions of power