Law, or the license to kill

Kailash has his mother willing to donate her kidney and save him. But administrative expediency distances him from his mother. On paper, she is nobody as far as he is concerned and his step-mother is his Biological mother as well. Precisely for this reason, plus an administration that just refuses to be humane, 27-Year Old Kailash Tamang from Belbari , Morang, is in what looks like a death bed. But he can still be saved if the administration listens to his villagers who have said during ‘sarjimeen’ (verification of facts through public hearing) that Kailash’s mother is different from his mother ‘on paper’. Doctors have certified that his kidney matches with his real or biological mother.

After falling ill, Kailash went to a basic health checkup in Belbari.  As his condition worsened, he received treatment at Nobel Hospital in Morang. Following doctors’ advice, they discovered a kidney problem, and soon after, they confirmed it had failed needing an urgent transplant.

Since Morang lacks facilities for kidney transplants, Kailash traveled to Kathmandu. This move unfolded many complexities in his life. He has now been in Kathmandu for a month under treatment at Kathmandu Medical College. Dr. Sunil Kumar Sharma, a Nepali Congress MP from Morang, who is a major stakeholder in both hospitals, arranged his transfer to Kathmandu, charging him nominal fees.

Sharma played a vital role in his treatment  and the hospital authorities are contemplating filing a legal case to ensure that some lapses in papers should not be the cause for his death,

However, due to documentation issues, no breakthrough has happened yet. Kailash is currently staying in Tinkune and receiving dialysis at the KMC.

What’s the Documentation Problem?

Kailash’s biological mother married another person soon after giving birth to him and moved to Udaypur.  His father also remarried, and Kailash’s stepmother—whom he calls “younger mother”—became his mother on all official records, including his birth certificate and citizenship.

In fact, there are no legal documents acknowledging his biological mother. Now, as he faces kidney failure, his only match is from his biological mother, and she is willing to donate to her son. However under Nepali law, kidneys cannot be donated without proof of kinship. Neither Kailash nor his mother has documentation to prove their biological relationship.

Official sources said,  a ‘sarjimeen’ conducted had the locals confirming that they are mother and son, and the administration there duly wrote to the authorities concerned in Kathmandu based on this, However, the kathmandu Chief District Officer has the sole authority or discretion to accept, reject or remain silent on the issue. The KMC which is willing to give treatment to Kailash is yet to receive a positive response from the CDO office. Kailash, on the other hand, is spending sleepless nights.

Administrative Hesitation

But the District Administration Office remains uncertain and unwilling to fully endorse the letter. Speaking to Deshasanchar, the Assistant Chief District Officer and official spokesperson of the District Administration Office explained: “According to the law, a committee must be formed for kidney transplantation. Only after five members endorse it, the procedure for transplant moves forward. These include the donor, the recipient, the operating surgeon, the hospital director, and finally a representative from the district administration office where the hospital is situated.” He further added, “In Kailash Tamang’s case, four of the required signatures have been obtained, but our district representative has yet to sign. The root cause, as communicated by our representative, is that Kailash’s mother has not yet provided any documentation or proof to establish her biological relationship to him. Due to this complication, and the possibility that siding with Morang’s letter could jeopardize our office’s duties and reputation, we decided to halt the process. We believe  moving ahead under such uncertain circumstances could create serious difficulties tomorrow.”

Under Nepal’s Human Body Organ Transplantation (Regulation and Prohibition) Act, 2055     (1998), the donation of a kidney is permitted only from “close relatives.” These include spouse, son, daughter, parents, stepparents, adopted children and parents, grandparents, grandchildren, siblings, uncles, aunts, nephews, nieces, and in laws such as father and mother in law, siblings in law, children in law, among others. For relationships established via marriage or adoption, the law mandates that the bond must have been continuously maintained for at least two years prior to transplantation. This strict definition aims to prevent illegal organ trade and ensure that donations originate from genuinely close familial connections.

Kailash is in a crisis because authorities are not willing to recognize his own mother, Geeta, as his mother—even though she is ready to donate her kidney to him.

Is the deathbed the final option?

Kailash’s life hangs in the balance. At the age of 27, he is keeping a foot into a rope where life and death has been a must choose path ahead. Who would have thought that his citizenship and birth certificate would carry such a significant impact on his destiny. He’s trapped in life’s vicious cycle, forced to depend on his mother or father’s actions—or fate’s whims—to decide whether he lives or dies.

Despite increasing awareness that Nepal sees roughly 3,000 new cases of kidney failure annually and more than 1,500 transplants. Since services began many still cannot find a donor due to legal constraints. Kailash’s situation highlights a critical gap—where a deserving young man stands at death’s door, not for medical reasons, but due to lapses on paperwork.

There is also a social stigma that discourages a son or his guardian from owning a mother who has remarried as the ‘real mother’. This starkly underlines how policy must evolve to prioritize human lives over bureaucratic technicalities. Whether the law or administration become humane and pro-life, or rigidly bureaucratic at the cost of human life is what the present day Nepal faces, interestingly when the country has a chief executive who has gone kidney transplant twice without having to go through the rigorous scrutiny which Kailash is facing.