It was an intimidating offer, but one Sundar Singh Jatav couldn’t turn down: Sell your kidney and pull your family out of debt.

The 23-year-old needed the windfall, he told the Los Angeles Times. His family owed $10,000, his parents were ailing and his brothers had mental disabilities that kept them from working. Jatav’s $2.50-a-day job at a Mumbai video game shop wasn’t even enough to put a roof over his head.

Won over by a silver-tongued man who called himself Sandeep, Jatav agreed to go under the knife.

Doctors took his right kidney in late 2015. But Jatav never got paid.

Now, months after going public with his story, Jatav is at the center of one of the biggest crackdowns in recent memory on India’s thriving illegal organ trade.

Activists helped Jatav bring his case to police, who have arrested 14 people since July in a sophisticated kidney transplant ring, including several doctors and the chief executive of one of Mumbai’s leading hospitals, according to the Times.

Local press has dubbed it the Great Indian Kidney Racket — a network of shadowy criminals and health officials that dupes credulous and needy people into parting with their vital organs, often for little or no payment.

Organ trafficking in India and Asia generally is nothing new — Southeast Asia leads the world in organ trading, according to the United Nations — but the sheer scope of the most recent crackdown has brought extra attention. In July, when five doctors were arrested at the Hiranandani Hospital, along with the hospital’s medical director, the Times of India reported that it may have marked the first time the city’s senior doctors were arrested for unethical medical practices.

Experts blame India’s illicit kidney trade on a surge in renal diseases and a reluctance in some cultures to donate, even after death, as well as intense poverty, that creates a ready supply of donor-for-hire. On top of that, India lacks an official system for collecting donated organs; the few kidneys that are available come at prohibitively high costs.

How much donors are paid for their kidneys varies, but they’re often promised between $2,000 and $4,000, with some donors saying they gave up their organs for just a few hundred dollars, according to India’s Firstpost. Doctors, on the other hand, receive much more, as do their brokers or agents, who get paid a commission for finding donors.

The “organ trade in India like other problems such as child labor and prostitution has a societal issue to it,” said one 2009 study. “It relates to the exploitation of the poverty-stricken people by alluring them with financial gains that at times can be large and can meet their immediate short-term financial needs.

“The last decade has seen the struggle of the deceased donation program evolve in India. Simultaneously, it has witnessed the living donation program being marred with constant kidney scandals. In most instances, the donor accused the recipient or the middle man of having not compensated them with the promised sum,” said the study published in the Indian Journal of Urology.

In Jatav’s case, his employer linked him up with an agent, Sandeep, who promised to pay him enough money to take care of his family’s debt, in addition to finding him a new job and a new place to live.

“I trusted them,” Jatav told the Times. “I thought they were good people wanting to help me with my financial condition.”

Jatav gave up his kidney, but never saw a single rupee. Sandeep, it turned out, was actually Bhijendra Bisen, a convicted organ trafficker who once served 10 years in jail for a similar racket, according to the Hindustan Times. Bisen allegedly worked with a hospital employee to forge donation documents to make the donation appear legitimate, the Times reported.

After he began to suspect that he wouldn’t get his money, Jatav, who could barely read the documents, contacted an activist from the Indian National Congress party, who helped him alert authorities. In July, police arrested Bisen, along with a local merchant who was scheduled to receive Jatav’s kidney just two days later, according to the Times.

In the months that followed, Jatav’s tip led to a dozen more arrests. Most of the suspects in the alleged racket are free on bail, and a lawyer for the doctors accused of operating on Jatav denied any wrongdoing, the Times reported.

Suresh Gupta, the activist who helped Jatav, said Jatav’s case isn’t unique.

“They basically use the poor man,” he told the Los Angeles Times, “as a sacrificial lamb to prolong the life of the rich.”

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