Deep in debt, L. Manikandan*, a 36-year-old construction worker and father of three, made a desperate call to a relative, knowing well what he was getting into. That call set him off on a journey from his home town at Samandur in Namakkal district. The next few weeks took him to private hospitals in Salem, Vellore, Madurai, and finally, Tiruchi, where he gave up one of his kidneys, clinging to the hope of getting the promised sum of ₹5 lakh, an amount that would help him repay his mounting debt.

The decision wasn’t easy, but he knew others who had taken the road as the last resort. Manikandan was not the first in his family to do so as he claims his father had sold his kidney for ₹30,000 nearly 25 years ago. Now, lack of regular jobs and poor wages, coupled with crushing financial pressure, had driven him down the same path.