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Living with the American liver

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Prolonged Statelessness: A Slow Poison

Keeping citizenship and census pending for generations has been deeply ingrained in the system. Civil liberty is not guaranteed by the fledgling democracy of the Kingdom. After one generation of stateless people is bred, it multiplies, and that gives the authority of Home Ministry reason to criminalize these generations of being illegal immigrants who entered through porous border.

Undoubtedly, the third country resettlement program has added joys to majority of the Bhutanese refugees resettled in various developed countries. As resettled refugees enrich themselves in the country of resettlement, many of their friends and relatives back in camps in Nepal still fear to opt for the resettlement package.

Veteran DK Karki, who demonstrated his political caliber in the early stage of camp settlement in Nepal as an active cadre of the Bhutan People’s Party was never willing to leave camp to settle in western countries.

When most of his contemporary friends involved in the party-politics in exile vanished one after the other grasping such opportunities in various occasions, Karki remained rigid with the opinion that Nepal would be the best place to fight against the Bhutanese suppression.

“I got several opportunities to leave Nepal and get settled in western countries. But, I chose to remain in camps,” Karki says.

But, the year 2009 became worst for him when he was first diagnosed of complications in his liver by the AMDA Hospital that treats refugee patients in UN-monitored camps of Jhapa and Morang of Nepal.

Following a series of treatments at the AMDA Hospital and Life Line Hospital, Karki also spent months in the Indian city of Siliguri fighting against his liver cirrhosis. His friends and relatives financially supported him for his expensive treatment.

When he got discharged, he changed his mind and decided to resettle in America for getting better treatments as AMDA Nepal informed him that his treatment was beyond its criteria considering the cost.

And, accordingly he was processed under an emergency status for resettlement. When his family waited at the International

Karki in the hospital following his liver transplantation/Sanita Guragain

Organization for Migration( IOM) transit camp in Kathamndu, he was admitted in the Norvic Hospital for weeks.

48-year-old Karki, who waited at Beldangi-I camp for 18 years to return to Bhutan with dignity and honor was eventually resettled in St. Louis of Missouri in July last year.

A private doctor from the IOM escorted Karki from Kathmandu to America. Upon landing in Missouri, he was directly admitted to the Barnes Jewish Hospital.

Last December, a team of doctors at the Barnes Jewish Hospital undertook a liver transplantation surgery that lasted for almost six hours, according to his family.

“Now he is in a stable condition and has already gained weight of 52 pounds (approximately 20kg) ,” mentions one of his family members. According to the Karki family, the hospital has not yet disclosed the details of the person who donated the organ.

Karki, who has been recuperating says he has no proper words to thank the liver donor and the hospital team that have renewed his life.

“I have no words to thank everyone who helped me to come to this stage”, adds Karki with tears in his eyes.

“He is a lucky person to get his liver transplanted within a six months of his entry into the United States,” says Dr Lakshmi Prasad Dhakal, President of the Bhutanese Community in the Netherlands.

He adds, “In the Netherlands, the waiting time for this type of surgery is minimum a year, provided a patient fulfills transplantation requirements. In addition, a patient needs to prove through blood test, an alcohol abstinence of minimum six months”.

According to Dr Dhakal, life long medications to prevent rejection of a transplanted liver is recommended to all patients who undergo such medical conditions, otherwise, the immune system, the defense mechanism of the body recognizes the transplanted liver as “foreign to the body” and tries to expel it.

Most commonly, the technique is orthotopic transplantation, in which a donor liver replaces a native liver.

As of today, Dr Dhakal highlights that liver transplantation is the only option for an end-stage liver disease accompanied by failure of liver functions.

As his resettlement proceeded, Karki kept his hope high that he would be getting better treatments in the United States. However, he never thought that he would one day undergo liver transplantation.

“I never thought that I would live so long. The transplantation was out of my imagination since I knew no patients like me could manage the cost,” he says.

It is not that all end-stage liver patients can manage the operation cost although it varies from countries to countries.

Karki says he has been getting better each day with new liver in his body/Sanita Guragain

“Surgery in India and Nepal, if a compatible organ donor is found, costs less than 100,000 rupees; in USA only surgical costs would climb around 300,000 dollars and in Europe the cost is nearly two times than that of USA,” says Dr Dhakal.

But, Karki is certainly a select few to get the proper diagnosis and treatment on time. He is also lucky enough to have all of his expenses borne by his Medicaid, the health insurance provided to the refugees by the government. The U.S. government has defined this facility as “a government health program that is available to qualified people for a limited time after their arrival in the U.S.”

“However, bitter part of this procedure is the follow up cost that increases every year,” says Dr Dhakal. As per him, in Nepal this cost would be not less than Rs 15,000 annually.

“Born in Bhutan, spent my youth in Nepal, now I am living with a donated liver in America,” says Karki in the hope to live longer with the transplanted liver.

With inputs from Sanita Guragain, Missouri, USA.


  1. feel really good when i go through the news , hope other victims like mr karki, will get a good treatment and safe their life.I hope Bhutanese in America are happy being treated good at hospitl.like the same, i have experience with my grandfther if he were in nepal we wouldn’t be ble to save his life,He had big surgery of four hour,but now he is doing well.hope mr karki will recover soon and have happy life in days to come.

  2. Nice to see DK daju getting better after lever transplantation. I wish him good wishes for his early recovery. I hope our jolly dk daju will be soon back with his humours.

    Kazi bhai- Many many thanks for informing us about DK daju’s situation. I had just heard that he was resettled to US but after that i lost track of him. You deserves my appreciations for this great write up.

    Ram Karki

  3. BNS, your claim as free and independent media is a sham. A free media is one that provides space for everyone to express their opinion both for for and against, with exception to use of profane languages. Your moderator seem to approve all posts that are against the government of Bhutan and disapprove posts that are against your so-called leaders. That’s not how free media should function. You are losing your credibility.

  4. Lotus Flower Ji:

    I have criticized Bhutan News Service in my comments many times in the past, and I was surprisingly pleased to see my comments were published without being edited by Bhutan News Service.
    I am a living proof that BNS does allow its readers to express their mind freely.
    I also noticed that Bhutan News Service is now doing much better and does not allow any reader to use profane language, insult, harass or intimidate commentators by some incautious readers.
    It is simply not true that BNS approves only those posts that are against the Government of Bhutan. As a matter of fact, BNS sometimes publishes the opinion of Bhutan Government also.
    However, BNS needs to allow pro-Bhutan Government point of view equally. At present, it seems like BNS publishes only 20% of pro-Bhutan Government point of view and 80% of anti-Bhutan Government point of view.
    But why should someone expect BNS to give 80% coverage to pro-Bhutanese Government opinion and only 20% coverage to anti-Bhutanese Government views? We need to remember the fact that this web site is being operated by most of those individuals who have been victimized and have been personally suffered as a result of Bhutan Government’s actions in the past.
    My suggestion to Bhutan News Service editors is that they need to keep their personal sufferings to themselves (I know it is not easy to do so), and should try to keep a balance of 50-50. In simple words, BNS should try to give both sides equal chance, because that is how a free and balanced media should run.

    Mr. Shahid M. Pasha, Massachusetts, USA.

  5. Dear Moderator/s of BNS
    We understand that this BNS site operates as a charity institution with the sole motto of conveying the information to the larger folks beyond the boundary. And people visit the site to see the new things and new happening within and outside the community.
    It is ok if there is no new news to update but we could see some of the opinions or articles are there for months, not only weeks. As mentioned above, people visit to see the new things but people need to wait for months to see the changes.
    Is it not possible to update the opinion and related articles weekly? There are many good writers like RP Subba, Dhurva and Govinda Rizal, IP Adhikari and others. Will not they timely contribute? Again your team produced many budding journalist through extensive outreach, will not they add the flavor so that the site tastes better?
    As a well wisher, I wanted to see this site grow and blossom.

  6. Mr D.K Karki, I am really sad that he passed away. When I heard about this I was worried and I really miss him because he was very nice for the community and also yuoth organizations of Bhutan(YOB)


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