The village where hundreds were duped into selling their kidneys
Adventurers attempting to scale Mount Everest can set eyes on three record-setting landmarks after they set off from the Nepalese capital of Kathmandu.
The first is the mountain’s peak, visible on a clear day from a plane as it makes its way towards the Himalayas.
The third is Lukla, known as the world’s most dangerous airport, where climbers land before heading to Everest Base Camp.
Such is the majesty of the Himalayas that they almost certainly miss the third: a tiny village around halfway between Kathmandu and Lukla.
Hokse, though, is known not to travellers but to health experts working to expose the grim practice of international organ trafficking.
Researchers believe roughly every other adult in the village of a few hundred inhabitants has sold one of their kidneys for money.
Agents are known to target poor people in rural places around the world, and Nepal has no shortage of either.
In Nepal, brokers representing wealthy foreign clients often befriend potential victims and trick them into parting with a kidney with promises of big payouts, lies about the health risks, and even false claims their kidney will regrow.
A 2015 study found that more than 300 Hokse villagers had sold their kidneys for as little as £160.
Most victims were trafficked to India, which shares a huge porous border with Nepal, and where many of the nearest clients are based.
Even the largest payouts of around £3,000 are a pittance considering the suffering people can experience if they can endure.
Humans are able to live normally with one kidney, but their lives are in much greater danger if they experience problems with the remaining organ.
Many locals in Hokse say people there have stopped selling their organs thanks to greater education about the risks and scepticism toward the lies peddled by brokers.
But its effects are now coming full circle in a tragic way for those who fell victim to the trade over the years.
Poverty has driven a surge of young Nepalese men leaving home to look for work in the Gulf states, particularly Saudi Arabia, the UAE and Qatar.
Reports indicate that those who sold a kidney are especially vulnerable to kidney failure there due to working in searing heat under gruelling conditions.
Jit Bahadur Gurung, 29, who spent three years working in Saudi Arabia, told Sky News: ‘I had to work in extreme heat – around 50 degrees [Celsius]. We didn’t have time to have lunch, go to the toilet or drink water.
‘I was overheating. Suddenly I felt my feet swelling and I couldn’t walk. Then I was told my kidney had failed.’
He survived the ordeal and returned to Nepal but now has to undergo blood dialysis three times to survive without a kidney.
In a bitter twist of irony, he is now in need of a kidney donation – but the donor legally has to be related to him and no one in his immediate family is a match.
A leading surgeon at Nepal’s main organ transplant clinic said he used to only perform transplants on the elderly but now deals with many young people.
Figures suggest around a third of all transplants in Nepal now involve overseas workers who have returned from abroad.
Patients exhibit a common pattern of having worked in high heat with little water and coming back with ‘completely failed kidneys’, Dr Pukar Shresth explained.
Even among vulnerable older people, cases of kidney problems often involve only partial failure of the organ, which can adapt and continue to function well after treatment.
Attracted by large-scale projects in cities like Dubai and Abu Dhabi, more than 160,000 Nepalese workers are estimated to have travelled to the UAE alone in the 12 months up to July 2023.
There are believed to be around 200,000 based in Saudi Arabia and 400,000 in Qatar.
Over a similar period, around a thousand Nepalese workers are known to have died in Gulf states and several hundred suffered life-changing injuries and illnesses.
It’s feared there could be many more due to gaps in record-keeping in those countries.
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