We noted, before any kidney operation can be carried out in India, the hospital requires a No Objection Certificate, a letter drafted by the Nepali embassy in New Delhi confirming the donor as the kidney recipient's relative.

Photographs of the recipient and the relative, who would be the legitimate donor, were not included in the letter until recently.

Since Indian hospitals accept official Nepali documents, anyone could show up at the hospital, provide papers saying they were that person and have their kidney removed.

Activists say this is the loophole traffickers used for many years.

With the easy availability of forged documents, traffickers can beat the system.

While the Nepali government tries to tighten policies, Nepal's police officers are trying to crack down on the criminal rings.

Last year authorities arrested 10 people accused of organ trafficking in Kavre. Their case is still in court.

Sub-inspector Dipendra Chand, who led the police investigation, says stopping the underground trade is difficult.

"If we crackdown in one village, the traffickers simply move to another," Chand said.

Rajendra Ghimire says that the trafficking rings are now moving beyond Kavre.

"We have reports that this problem is expanding into other surrounding districts as well," Ghimire said.

The attention to this problem is growing in Kavre. Kidney trafficking stories are making headlines on the local and national newspapers.

But for victims like Pariyar and others, the media attention is too late.