The Intersection of Organ Trafficking and Bonded Labor in Pakistan

Pakistan’s brick kiln industry in particular is known for the peshgi system, which leaves workers forever trapped in debt – and vulnerable to coerced organ donations.

In February 2026, Muhammad Rafiq reported that his cousin in Rawalpindi, Pakistan had been kidnapped by an organ trafficking ring. He named an entire team of operatives, from abductors to medical personnel, who force individuals to have one of their kidneys removed and sold internationally. This case is the latest embodiment of a wider phenomenon in Pakistan surrounding the illicit organ trafficking industry, which continues to flourish despite the country’s existing legislation intended to curb the practice.

Primarily operating in Pakistan’s Punjab region, brokers coercively obtain organs to sell in a variety of ways, but one method in particular appears to be the most prevalent. Targeted victims tend to include impoverished workers who are often in desperate need of a loan to cover immediate expenses, such as medical bills, weddings and dowries, or, in some cases, to repay previous loans. Pakistan’s brick kiln industry in particular is known for offering what is known as a peshgi system, where workers can take an advance on future wages if they agree to work until the debt is paid off. These are unofficial and usually undocumented deals, with many debtors unable to verify the terms due to illiteracy. Some have reported that even when they know that terms have been drawn up in bad faith, they lack the confidence to challenge their bosses.

The debtors begin work at the brick kiln to pay off their loan, but the repayment terms are designed to keep them trapped in a continuous cycle of debt. One labor rights report published in 2025 found that a family of four who made 1,000 bricks in a day in Pakistan would be paid between 75-88 rupees each, which amounts to less than a dollar per person. With high interest rates on brick kiln loans, even when debtors pay toward their owed sum, their debt continues to grow. One girl’s family owed 200,000 rupees when she became a brickmaker at the age of 10. By the time she was 50, this debt had grown to 3.5 million rupees, despite her family working continuously to pay it off.

As it becomes clear that no amount of work will be sufficient to reduce, let alone fully repay, their debts, brick kiln owners begin to apply increasing pressure for loan repayments. They often provide indebted workers space to build mud huts near the kiln, and while this may seem like an appealing offer, it effectively places the whole family within the owner’s reach. Female family members are known to be subjected to sexual violence by kiln owners to increase pressure on debtors, demonstrating how such living arrangements enable exploitation. These types of threats are gradually increased over time to ensure the debtor enters a state of desperation and is punished psychologically.

It is at this point that the brick kiln owner will contact an organ broker and invite them to deliver a well-rehearsed speech that frames organ selling in attractive and heroic terms, with no mention of the serious health risks associated with the surgery. These appeals to heroism are likely intended to exploit the workers’ perceived failure as providers, implying that selling their kidney could restore a sense of masculinity by lifting their family out of debt. As debt is transferred intergenerationally after the debtor’s death, many choose to accept this morbid offer for the sake of their family. 

Some people in this situation are so desperate they even consider selling the organs of their own children, as was the case with one man who was then convinced by a local activist to refrain from doing so. The motivation for considering this option was to ensure the children could live their lives debt-free in the future.

These debtors undergo highly dangerous surgeries in unlicensed........

© The Diplomat