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JULY 19, 2011 VOLUME 5, NUMBER 14 PAGES 341-366 WWW.GLOBALRESEARCHER.

COM

Organ Trafficking
CAN THE SMUGGLING OF HUMAN ORGANS BE STOPPED?

H
eadline-grabbing arrests of kidney brokers and renegade doctors provide glimpses into a global

black market in human organs that is thriving from South America to Asia. The World Health Or-

ganization estimates that 5-10 percent of the 100,000 organs transplanted each year have been pur-

chased illegally, typically from poor people desperate for cash. In China, thousands of organs re-

portedly have been forcibly removed from prisoners to feed a lucrative “transplant tourism” business. The full scope

of the global organ black market remains unknown because transplant doctors and hospitals either don’t know the

organs were trafficked or are complicit in the deals. Critics say hospitals should disclose the source of all transplant

organs so illegal sales can be tracked. Some doctors say legalizing government payments to organ donors — as Iran

has done — is the only way to eliminate

trafficking, but the mainstream medical

community says such payments would only

exploit the poor. Artificial organs eventually

could help satisfy the growing demand for

organs, eliminating the black market.

Since 2000, four members of a Pakistani family have sold


a kidney for about $1,200 apiece to pay off debts to their
employer, who gives them each $12 a week to work in his
Rawalpindi brick factory. Recent reports indicate a
resurgent organ black market in Pakistan, despite a ban
that became law in 2007. Shown displaying their surgery
scars in 2009, are (from right) brothers Mohamed Riiz, 22,
and Mohamed Ijaz, 25, and father, Karm Ali, 65. Ijaz’s wife
Farzana, 20, (seated) also sold a kidney.

PUBLISHED BY CQ PRESS, A DIVISION OF SAGE WWW.CQPRESS.COM


ORGAN TRAFFICKING

THE ISSUES 346 China Harvests Prisoners’


Organs
• Is the global black mar- Activists say China executes
343 ket for organs growing? “on demand” to provide or-
July 19, 2011
Volume 5, Number 14
• Would legally paying gans to foreigners.
donors discourage trafficking? MANAGING EDITOR: Kathy Koch
U.S. Kidney Sellers
• Should governments and 348 Receive the Most
kkoch@cqpress.com
hospitals do more to crack Payments can run from $750 CONTRIBUTING EDITORS: Thomas J. Billitteri
down on organ profiteers? to $30,000. tjb@cqpress.com; Thomas J. Colin
tcolin@cqpress.com
BACKGROUND Transplant Gaps Spur CONTRIBUTING WRITERS: Roland Flamini,
350 Organ Trafficking Sarah Glazer, Reed Karaim, Robert Kiener,
The First Transplants Jina Moore, Jennifer Weeks
352 A kidney was successfully
Disparity between organ sup-
ply and demand fuels sales. DESIGN/PRODUCTION EDITOR: Olu B. Davis
transplanted in 1954.
Chronology ASSISTANT EDITOR: Darrell Dela Rosa
Foreign Variations
353 Key events since 1901. FACT CHECKER: Michelle Harris
356 Some countries make every-
Singapore Allows Reim-
one an organ donor at 354 bursements to Organ
death unless they “opt out.” Donors
But is additional cash paid
Coercion and Bans
357 Workers often sell a kidney
under the table?
to pay off debts. Austria Leads in Per
358 Capita Transplants
A Division of SAGE
PRESIDENT AND PUBLISHER:
Norway has second-highest John A. Jenkins
CURRENT SITUATION rate.
DIRECTOR, REFERENCE SOLUTIONS:
At Issue Todd Baldwin
358 Major Criminal Cases
Several trafficking cases
359 Would regulated reimburse-
are pending. ments discourage organ traf- Copyright © 2011 CQ Press, A Division of
ficking? SAGE. SAGE reserves all copyright and other
Legalizing Payments rights herein, unless previously specified in
360 The transplant community 366 Voices from Abroad
Headlines and editorials from
writing. No part of this publication may be
reproduced electronically or otherwise, with-
is debating whether to around the world. out prior written permission. Unauthorized
sanction reimbursements. reproduction or transmission of SAGE copy-
righted material is a violation of federal law
FOR FURTHER RESEARCH carrying civil fines of up to $100,000.
OUTLOOK
For More Information CQ Press is a registered trademark of Con-
Making Trafficking
363 Organizations to contact. gressional Quarterly Inc.
361 Obsolete CQ Global Researcher is published twice
Bibliography
Eventually, artificial organs
could eliminate illicit sales.
364 Selected sources used.
monthly online in PDF and HTML format by
CQ Press, a division of SAGE Publications.
Annual full-service electronic subscriptions
The Next Step
365 Additional articles. start at $500. For pricing, call 1-800-834-9020,
SIDEBARS AND GRAPHICS ext. 1906. To purchase CQ Global Researcher
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344 Rich and Poor Collaborate 365 Sample bibliography formats. call 866-427-7737.
in Global Kidney Trade
Kidneys usually travel from
poor to rich countries.

Cover : AFP/Getty Images/Nicolas Asfouri

342 CQ Global Researcher


Organ Trafficking
BY SARAH GLAZER

THE ISSUES
or 23-year-old con-
plant tourism,” in which pa-
tients from, say, the United
States or Saudi Arabia trav-
el abroad for a kidney or

F struction worker Luis


Picado, it seemed like
a way to realize the Ameri-
part of a liver. As far as the
patients are concerned, op-
erations in a reputable hos-
can dream. Returning to his pital in India or Turkey may
home in a slum in Managua, appear perfectly legal, and
Nicaragua, one day in 2009, the hospital may assure the
he told his mother he had patient that the procedure is
met an American man who above-board. But the organ
promised him a job and apart- may have come from an im-
ment in New York if he’d poverished laborer who, un-

AFP/Getty Images/Prakash Mathema


donate one of his kidneys. beknownst to the patient, has
Three weeks later, Picado been promised from several
came out of surgery at a Man- hundred to several thousand
agua hospital bleeding inter- dollars by a broker or un-
nally from an artery doctors scrupulous doctor.
had severed in removing his It’s difficult for interna-
kidney, according to medical tional health organizations
records. Picado bled to death. and law enforcement agen-
Matthew Ryan, the Amer- cies to know which trans-
ican man who received the plants originated from an il-
In a high-profile case of coercive organ donation, transplant doctor
kidney, did not fare much legal sale because medical
Amit Kumar has been charged with illegally removing the kidneys
better. Two months after of some 500 impoverished laborers and farmers in Gurgaon, India. confidentiality rules typical-
receiving Picado’s kidney Some of them allegedly were lured there by false promises of jobs ly hide a donor’s identity
at the same hospital, the and then forced at gunpoint onto the operating table. Several and bar access to medical
68-year-old retired bus su- police officers also were charged with extortion and accepting records. And transplant
bribes in connection with the case, which is still pending.
pervisor from New York died. tourism can be perfectly legal
Prosecutors in Managua are if, for example, a Pakistani-
investigating whether Nicaragua’s law ker for arranging such a sale. In Iran, American goes to Pakistan to receive
prohibiting paying for an organ was such transactions are legal and fund- a kidney as a gift from a cousin there.
broken. 1 ed by the government. 2 The Geneva, Switzerland-based
Nicaragua is just one of the im- The illicit organ trade continues be- World Health Organization (WHO), which
poverished countries — along with cause knowing which transplants vi- oversees global organ transplant activi-
Pakistan, India, Egypt and China — olate the law can be tricky. If a pa- ty, estimated in 2007 that 5 to 10 per-
where people from the United States, tient shows up at hospital with a cousin cent of the 100,000 organ transplants
Japan, South Korea, Persian Gulf na- who says he’s willing to donate a kid- performed worldwide each year — 5,000-
tions and other wealthy countries go ney, for example, the transplant is pre- 10,000 such operations — are illegal. 3
to buy organ transplants. In many cases sumed to be legal in most countries. Most patients seeking transplants in
the patients, most of whom suffer from But the hospital has no way of know- recent years have traveled from Saudi
kidney disease, face the prospect of ing if the patient has written a big Arabia, other wealthy Arabian Gulf
dying while waiting the typical five to check to his cousin to express his countries, Taiwan, Malaysia and South
10 years for a donated organ in their “thanks.” Or, the donor could be a Korea, often because their home coun-
home country. stranger, solicited by a broker and try lacks modern transplant facilities. 4
The global black market in human masquerading as a devoted relative (See map, p. 344.)
organs continues to thrive in many for an agreed-upon sum. No one knows how many Ameri-
countries, even though virtually every The possibility of illegal payments cans travel abroad for transplants (or
nation except Iran has banned buy- becomes more likely, but just as hard how many of the operations are ille-
ing or selling organs or paying a bro- to trace, in cases of so-called “trans- gal). That’s because no one, including

www.globalresearcher.com July 19, 2011 343


ORGAN TRAFFICKING

Rich and Poor Collaborate in Global Kidney Trade


The illegal trade in kidneys from live donors generally flows from donors in poor, developing countries — such as Bolivia, India,
Romania and China — to patients in rich, developed nations, such as Canada, the United States, Japan and Saudi Arabia.
Affluent patients often travel to poorer countries overseas to buy kidneys because they can face up to 10 years waiting for a
donated kidney in their home countries — if they live that long. On the Internet, medical tourism sites and hospitals offer
cut-rate kidney transplants in India,Turkey and Latin America. In 2010, medical tourism was estimated to be a $100 billion
industry, but no one knows how much of that business is based on illegal transplants.

Countries of Origin for Kidney Buyers and Sellers

CANADA MOLDOVA
ROMANIA

UNITED STATES ITALY TURKEY


OF AMERICA CHINA JAPAN
ISRAEL IRAN
EGYPT SAUDI PAKISTAN
ARABIA
OMAN INDIA
PHILIPPINES

BRAZIL
PERU
BOLIVIA
AUSTRALIA

Countries of origin for those:


Selling kidneys
Buying kidneys

Source: Organs Watch; news reports. Map by Lewis Agrell

U.S. hospitals that treat such patients poor. In Egypt, South Africa, Brazil Meanwhile, some governments in
on their return, is required to report these and the Philippines, “international ca- developing countries have a strong in-
cases, according to Francis Delmonico, bals of doctors and corruptible ethics centive to look the other way: Medical
a Harvard Medical School surgeon and boards have slowly transformed slums tourism for all procedures, ranging from
president-elect of the Montreal-based . . . into veritable organ farms,” in- face lifts to transplants, brought in about
Transplantation Society, an organization vestigative journalist Scott Carney $100 billion in 2010. 6
of transplant specialists. writes in The Red Market: On the Popular images of the illegal organ
Yet news reports and occasional Trail of the World’s Organ Brokers, market abound, but they’re often un-
arrests of large-scale traffickers reveal Bone Thieves, Blood Farmers and realistic. An example is the scenario
that ostensibly legal transplants in Child Traffickers, a new book about portrayed in the 2002 movie “Dirty
hospitals abroad depend on a thriv- the worldwide illegal trade in organs Pretty Things,” in which a criminal
ing organ trade that preys on the and other body parts. 5 broker persuades desperate immi-

344 CQ Global Researcher


grants to have one of their kidneys
removed in a hotel room and then Poor Sellers vs. Rich Buyers
passes the organs in a Styrofoam The typical kidney seller in a developing country such as the Philippines is a
cooler to another kidney broker.
male under age 30 with a family income of less than $500 a year. By contrast,
“People don’t take out kidneys on
kitchen tables,” says Gabriel Danovitch, buyers in developed countries such as Israel are much older and typically have
medical director of the kidney trans- family incomes above $50,000.
plant program at the David Geffen
School of Medicine at the University Typical Kidney Buyers and Sellers in the Philippines and Israel
of California Los Angeles. “For trans-
plants to happen you need a decent
Typical seller Typical buyer
hospital and well-trained surgeons.”
(Philippines) (Israel)
Because organs last outside the body
for only a few hours, recipients typ- Age: 29 Age: 48
ically need to be in the same hos- Sex: Male Sex: Male
pital with the donor. Annual family Annual family
While rumors abound in develop- income: $480 income: $53,000
ing countries of people being kidnapped Education: 7 years Education: University degree
for their organs, such cases are rare.
However, there have been plenty of Source: Nancy Scheper-Hughes, “Organs Without Borders,” Foreign Policy, January-February 2005
instances of bonded workers, particu-
larly in Pakistan, being coerced into kidney missing have never been co warns that people who get trans-
selling a kidney to pay off a debt. In proven,” he says. plants overseas can contract an eso-
Gurgaon, India, an alleged outlaw doc- Often, studies find, a kidney broker teric, new antibiotic-resistant bacteria —
tor charged with removing the kidneys pays much less than he promised, and the superbug NDM-1 — or other in-
of 500 impoverished laborers and farm- the donor, typically poor and desper- fection, such as HIV. 9
ers in 2008, some of whom had been ate, suffers both physically and psy- Recently, some transplant surgeons
lured there by false promises of jobs chologically from lack of follow-up care. have been urging Western govern-
and then forced at gunpoint onto the “The seller is always a victim,” says Noël. ments to consider paying donors in
operating table. Others were persuad- In India’s Tamil Nadu province, Rani, order to eliminate the black market,
ed to sell. 7 the wife of an unemployed fisherman, reduce long waiting lists for donated
In China, human rights activists say agreed to sell her kidney to a broker organs and ratchet down health risks.
tens of thousands of imprisoned prac- to pay hospital costs for her daughter, Organ trafficking could be drastically
titioners of the Buddhist spiritual dis- who had tried to commit suicide by reduced, says Benjamin Hippen, a trans-
cipline Falun Gong have been killed drinking pesticide. Rani was paid $900 plant nephrologist in Charlotte, N.C., if
for their organs — largely at military up front to cover her daughter’s ex- “the incentives that allow it to be prof-
hospitals, which offer foreigners a trans- penses and promised $2,600 more when itable” were eliminated. If American and
plant in as little as a week. “It means the operation was over. But when she Western governments paid domestic
next Tuesday somebody has to be ex- awoke, the broker had vanished. Months donors, he maintains, it would satisfy
ecuted so that an American can get later, she said the pain in her side pre- demand in the countries sending trans-
an organ transplant,” says Delmonico. vented her from getting the only work plant tourists to poor countries for or-
(See sidebar, p. 346.) available to an unskilled woman: day gans. The United States has more than
But in most of the world, experts labor on construction sites. “The bro- 100,000 patients waiting for organs,
say, force is unnecessary. “It’s so easy kers should be stopped,” she said. “My and Europe has more than 56,000. 10
to put an amount of money on the real problem is poverty — I shouldn’t But proponents of payments remain
table that will bring in people that have to sell my kidney to save my a minority within the transplant com-
you don’t need to kidnap,” says Luc daughter’s life.” 8 munity. Almost every international body
Noël, coordinator in essential health “Transplant tourists” also face risks. opposes paying for organs, arguing that
technologies at WHO. Being poor and malnourished makes it would violate the existing altruistic sys-
“The rumors and the urban myth organ sellers more likely to be un- tem and turn human body parts into
of a person who wakes up in the healthy, with no incentive to disclose commodities. Poor donors would prob-
hotel bathtub with a big scar and a their true health conditions. Delmoni- ably lie about serious medical condi-

www.globalresearcher.com July 19, 2011 345


ORGAN TRAFFICKING
tions, putting recipients at risk, oppo- “If you used every market incentive the practice has only sent it into the
nents add. And paying donors likely out there, we’d still have a shortage,” shadows. In India, Pakistan, Iraq and
would reduce the overall organ supply, says Arthur Caplan, a professor of Indonesia, transplants have “been dri-
they say, because family members would bioethics at the University of Pennsyl- ven underground, like abortion, to an
feel less obligated to donate an organ vania and co-director of a United Na- underground basement,” says John
for a loved one. Nor would it increase tions study on organ trafficking. 11 Fung, director of the Cleveland Clin-
the supply of organs other than kidneys, Yet proponents of a regulated organ ic’s Transplantation Center and a sup-
most of which come from cadavers. market point out that simply banning porter of a legalized incentive payment

China Harvests Prisoners’ Organs


Activists say China executes “on demand” to provide foreigners with organs.
hinese government officials have acknowledged since those of executed Chinese prisoners. After Andrew M. Cuomo,

C July 2005 that up to 95 percent of the organs trans-


planted in China were harvested from convicted, exe-
cuted prisoners — allegedly with their consent. 1
then-attorney general of New York, investigated the allegations,
the exhibitor admitted that it had received the bodies from the
Chinese Bureau of Police and that, despite its prior denials, it
Yet in 2006, Canadian human rights activists reported that there could not verify that the human remains used in its exhibits
weren’t enough executed prisoners or other donors to account had not come from executed Chinese prisoners. On May 29,
for 41,500 transplants performed in China between 2000 and 2005. 2008, Cuomo announced a settlement with Premier Exhibitions.
The report’s authors, human rights lawyer David Matas and for- The company agreed henceforth to obtain documentation demon-
mer Canadian Parliament member David Kilgour, concluded that, strating the cause of death of its bodies and disclose on its web-
rather than coming from executed criminals, most of the organs site that it could not confirm whether currently displayed bodies
came from imprisoned practitioners of the Buddhist spiritual dis- had come from executed prisoners. It also said it would refund
cipline known as Falun Gong, who were either shot first or died ticket prices to prior visitors who requested it. 5
during the organ harvesting operation. 2 Perhaps in response to allegations of “execution on demand”
Since the government banned the practice of Falun Gong policies and to allay negative publicity during the 2008 Olympic
and declared it subversive in 1999, hundreds of thousands of Games, the Chinese government in 2007 banned the harvest-
practitioners have been arrested, and those who refused to re- ing of organs from living donors without their consent and
cant disappeared into slave labor camps, according to Matas and outlawed the sale of organs. 6 Many websites advertising cheap
Kilgour. The Laogai Research Foundation, a Washington-based transplants at Chinese hospitals suddenly disappeared. The gov-
advocacy group that exposes human rights violations in China, ernment also ordered that Chinese patients waiting for organs
estimated that in 2008 between 500,000 and 2 million Falun be given priority over transplant tourists, and it limited donors
Gong were being detained. 3 At least 62,000 were victims of to close relatives.
organ harvesting operations from 2000-2008, according to Matas John Fung, a Chinese-American transplant surgeon at the
and Kilgour and Ethan Gutmann, an investigative journalist. 4 Cleveland Clinic who frequently visits Chinese hospitals as a
Matas and Kilgour, who were nominated for a Nobel Prize visiting professor, says since China’s 2007 clampdown he no
for their investigation, say the organs were then “sold” to for- longer sees Saudi and Israeli patients in transplant wards. “I
eign transplant tourists. Conducted mainly at military hospitals haven’t seen a Caucasian in five years,” he says.
with access to prisoners, the transplants funneled $1 billion a The number of organ transplants did dip in 2007, and some
year to the hospitals, which had lost most of their subsidies observers wondered if harvesting of prisoners’ organs was be-
from the Communist government, according to Matas. coming a thing of the past. But since 2008, Matas maintains, over-
The activists’ undercover reports include taped conversations all transplants have returned to historic highs. Amnesty Interna-
with transplant doctors at Chinese hospitals promising foreign tional estimates that changes in Chinese law have cut in half the
callers that they could receive a transplant in as little as a week number of criminal prisoners executed. But that just means even
— a process that usually takes months to years in most coun- more of the approximately 10,000 annual transplants in China
tries. “They’re clearly blood-typing and tissue-typing prisoners” are coming from Falun Gong who have refused to recant their
— to match them to prospective recipients — “and then shoot- beliefs, Matas says. He estimates that the number of transplants
ing them,” says Arthur Caplan, a professor of bioethics at the harvested from Falun Gong members has risen from about 7,500
University of Pennsylvania. a year before 2007 to about 8,500 today.
In 2008, advocacy groups and media reports charged that Matas acknowledges that “there’s a real downturn in trans-
some of bodies and organs on display in the popular “Bod- plant tourism in China. There used to be charters going from
ies” exhibit that traveled to several major American cities were Taiwan to China organized by brokers, but the Chinese [gov-

346 CQ Global Researcher


AFP/Getty Images/Greg Wood
ernment] stopped them. There were whole wings of hospitals
in northern China that had nothing but Koreans in them.”
But the government crackdown and the scarcity of organs
also have spawned an undercover black market, according to
recent news reports. Each year, China has more than a million
people waiting for replacement organs, but only 1 percent re-
ceive a transplant. 7 A voluntary donation program started by
the government in 2009 has led to only 67 transplants in a
country with cultural traditions that oppose organ donation. 8
Some Chinese-language websites still advertise illegal pack- Activists in Australia protest the reported practice in China of
killing members of the banned Falun Gong spiritual movement,
ages aimed at Chinese patients, including accommodations,
detained in labor camps, and harvesting their organs to sell to
meals and a kidney transplant. 9 In a highly publicized case foreign transplant tourists. Websites advertising “transplant
reported this year, a 26-year-old welder, who changed his mind packages”disappeared after a government crackdown, but
after agreeing to sell his kidney for $6,000, had his kidney advocacy groups say prisoners still are being killed for their organs.
forcibly removed at a grungy local hospital in Shanxi province.
The brokers’ henchmen forced Hu Jie into the hospital where Caplan concurs that transplant tourism is a big money-maker
the recipient was waiting, and Hu Jie later woke up to find for China and other countries. “You’ve spent a lot of money to be
his kidney gone and $2,000 less in his bank account than the prestigious by doing transplants, and you need kidneys and livers
broker had promised, he said. 10 to transplant, but the only way you’re going to get them is through
Despite recent public declarations from the health minister living donor purchase,” he says, or from prisoners in China’s case.
that the government intends to stop harvesting organs from “So the government condemns it but looks the other way.”
prisoners over the next five years, it’s not clear that anything
— Sarah Glazer
has changed yet, experts say. “It’s an attempt to answer criti-
cism through a charm offensive, removing websites [advertis-
1 David Matas, “Anti-rejection Drug Trials and Sales in China,” speech given at
ing kidney transplants] as evidence for what they’re doing [with- Doctors Against Forced Organ Harvesting Forum, May 1, 2011, Philadelphia,
out] actually improving the situation,” says Matas. Penn., www.dafoh.org/Matas_speech.php.
Gutmann, an American investigative journalist whose esti- 2 David Matas and David Kilgour, Bloody Harvest (2009).
3 Matas, op. cit.
mates of the number of Falun Gong harvesting victims echoes
4 Scott Carney, The Red Market (2011), p. 82. Also see Matas and Kilgour,
those of Matas, says it’s hard to say what is happening now.
op. cit., and Ethan Gutmann, “ ‘How Many Harvested?’ Revisited,” East of
He doesn’t trust Chinese government statistics. “Frankly, I don’t Ethan blog, http://eastofethan.com/2011/03/10/how-many-harvested-revisited/.
know if harvesting of Falun Gong stopped, stopped and then 5 “Cuomo Settlement with ‘Bodies: the Exhibition’ Ends the Practice of Using
started again, or never stopped at all,” says Gutmann, an ad- Human Remains of Suspect Origins,” press release, Office of the New York
junct fellow at the Foundation for Defense of Democracies, a Attorney General, May 29, 2008, www.ag.ny.gov/media_center/2008/may29a_
08.html.
think tank in Washington. “My interviews with recent refugees 6 “Ending Abuse of Organ Transplantation in China,” China Uncensored,
yield only fragmented clues, and the Chinese health authori- Aug. 20, 2010, www.chinauncensored.com/index.php?option=com_content&
ties are certainly acting as if they want to put the issue to bed.” view=article&id=249:ending-abuse-of-organ-transplantation-in-china&catid=36:
organ-harvesting-in-china&Itemid=79.
It’s also unclear whether transplant tourism is still thriving 7 Bo Gu, “Chinese man wakes up — minus his kidney,” NBC News, March 31,
in China. “For the past six months to a year it looks like it’s 2011, http://behindthewall.msnbc.msn.com/_news/2011/03/31/6382271-chinese-
picking up again,” says Damon Noto, spokesman for Doctors man-wakes-up-minus-his-kidney.
8 Ted Alcorn, “China’s Organ Transplant System in Transition,” The Lancet,
Against Forced Organ Harvesting, an international group cam-
June 4, 2011, pp. 1905-1906.
paigning against forced organ harvesting in China. For military 9 “New Law Targets Organ Traders,” China Daily, Feb. 28, 2011, http://usa.china
hospitals, where the bulk of transplants are done, Noto says, daily.com.cn/epaper/2011-02/28/content_12087280_2.htm.
“their biggest source of income is organ transplant.” 10 Gu, op. cit.

to organ donors. “Once you ban some- balistic. “It’s not unlike slavery when Is the global black market for
thing and the demand is there, you you think you can own a part of an- organs growing?
no longer have accountability.” other person,” says journalist Carney. Because organ trafficking — the buy-
Yet others find the idea of selling As the debate over organ trans- ing and selling of organs — is illegal,
a body part — whether legally or ille- plants continues, here are some of the there are no reliable statistics on the ex-
gally — morally repellant, even canni- key questions being discussed: tent of the practice. From the buyers to

www.globalresearcher.com July 19, 2011 347


ORGAN TRAFFICKING
India appeared to bounce back, with
U.S. Kidney Sellers Receive the Most about 2,000 Indians selling a kidney
every year, according to the Voluntary
People who illegally sell one of their kidneys can receive from as little as $750 Health Association of India. 12
to $30,000, depending on where they live, according to the most recent Recent reports in the press and
available survey of organ trafficking in selected countries. The asking price for from medical experts indicate a resur-
an American kidney, for instance, is $30,000 — more than in any other gent organ black market in Pakistan,
country — because the buyers are wealthier. Kidneys sold in a developing despite a government ban that took
country — such as India, the Philippines and Iraq — garner less than $2,000. effect there in 2007. Pakistan once
vied with India as the world’s illegal
Compensation for a Trafficked Kidney organ bazaar, performing kidney trans-
(in selected countries) plants for more than 1,500 foreigners
a year. The new law appeared to halt
United States $30,000* the illegal donor trade, but only tem-
Israel $10,000-$20,000 porarily, according to the Sindh Insti-
Peru $10,000 tute of Urology and Transplantation
Turkey $7,500 in Karachi, which provides medical
Brazil $6,000 care to low-income patients. The ban
Moldova and Romania $2,700 is weakly enforced because authori-
India $1,500 ties look the other way, according to
Philippines $1,500
the institute.
At least 450 people in several vil-
Iraq (pre-war) $750-$1,000
lages have sold their kidneys since
0$ 5,000 10,000 15,000 20,000 25,000 30,000
the ban took effect, according to an
(in current $US)
eyewitness account presented at an
* Asking price April press conference by Kishwer
Source: Nancy Scheper-Hughes, “Organs Without Borders,” Foreign Policy, January-February 2005
Zehra, a member of Pakistan’s par-
liament. Typically, these kidney sell-
the surgeons, participants have every in- perts think the trade is decreasing, he ers are bonded agricultural laborers
centive to hide the transaction under says, “My colleagues from the Middle whose indebtedness to their land-
the cloak of a legal operation in a main- East tell me, ‘It’s business as usual.’ ” lords makes them near-slaves. They
stream hospital. Thus, what starts as an Transplant tourism has become sell their organs in a vain attempt to
illegal sale of a kidney in one country “much less visible” since the World escape from lifelong debts but often
often ends up in a transplant operation Health Organization’s 2007 report, and end up worse off, a 2011 report on
that is ostensibly legal in another. “because it’s gone underground” it’s Pakistan’s organ black market said,
WHO — which does not regularly more difficult to estimate the scope of because there is no postoperative care,
collect statistics on this activity — the problem, says WHO’s Noël. “We medicines or follow-up. 13
has not revised its 2007 estimate that speculate it has decreased to some ex- “Entire villages in southern Punjab
5-10 percent of transplants involve il- tent,” despite some high-profile cases, are selling their kidneys out of des-
legally removed organs. “We don’t know such as the alleged 2008 coercion in- peration of debt, poverty and landlord
how many illegal transplants there cident in Gurgaon, India. coercion,” with doctors “at the center
are,” says the Transplantation Society’s Recent bans on organ-selling in such of this trade,” said Adibul Hasan Rizvi,
Delmonico. countries as Pakistan, China and Egypt a physician and president of the Trans-
“I receive anecdotal information,” he may account for more activity occur- plantation Society of Pakistan at an
says, such as when “a colleague tells ring under the radar. For example, April press conference at the Sindh In-
us an American has been here [at a India’s 1994 ban on the organ trade stitute of Urology and Transplantation
foreign hospital] or someone from the caused a drop in the number of for- in Karachi. “Pakistan is being dragged
Mideast comes to a U.S. center for an eign recipients but apparently spurred back to the era of illegal organ traf-
organ transplant” — which would be more foreigners seeking transplants to ficking, spurred on by the unrelent-
illegal if, say, the patient brought along head to Pakistan or the Philippines. ing greed of the medical profession
a “friend” who had actually been paid And after the ban was in effect for a in collusion with the law-enforcing
or promised money. Although some ex- few years, the underground market in authorities.” 14

348 CQ Global Researcher


Earlier this month, three doctors were ment? Answer: Enough to eliminate “To me it’s horrifying that the area
apprehended as they were about to per- the U.S. waiting lists for organs, Nobel of medicine I’ve devoted my life to
form an illegal kidney transplant for a Prize-winning economist Gary S. Beck- may be responsible for atrocities around
Somali man in a private house in the er estimated in 2002. Becker proposed the world,” says transplant nephrolo-
Pakistani provincial capital of Lahore. paying both living and deceased donors gist Hippen, who has been a promi-
According to law enforcement authori- (or their heirs) for any organ. nent advocate of government payments
ties, 40 kidney operations had been car-
ried out mostly on Arab and Middle East
clients, while most of the kidney sellers
were from poor Pakistani families. 15
Demand for kidneys is growing in
both wealthy and developing countries
for several reasons. Developing coun-
tries are building transplant facilities and
offering transplants for less than they
cost in wealthy countries. New im-

AFP/Getty Images/Adek Berry


munosuppressive drugs have improved
transplant survival rates, and doctors are
adding older, sicker patients, who now
have a better chance of survival, to
transplant lists. 16 In countries such as
Japan, South Korea and Taiwan, de-
mand for transplants has increased as
the population has grown wealthier. If
China follows the same pattern, its wait- Cash-strapped Indonesians reportedly are selling their organs online, exploiting a loophole in
ing lists for kidney transplants could local laws and fueling a dangerous and illegal trade in human body parts. “I want to sell my
double in 15 years. 17 kidney to buy a house for my mother, thanks call me,” reads the online ad. Such ads on
That global growth — in both de- Indonesian personal websites offer kidneys for as little as 50 million rupiah ($5,860).
mand and transplants — is likely push-
ing up demand for trafficked organs, If governments or health insurance for organs. “I don’t see another way
some observers say. “Why wouldn’t companies could legally make such to fix that.”
the criminal market be growing?” asks payments, it “would essentially knock Arthur J. Matas, a professor of surgery
journalist Carney. Declining costs for out the black market,” he argued. With at the University of Minnesota, calcu-
transplants have been driving up glob- an increased supply of organs stimu- lated in 2004 that U.S. society could
al demand for them, he writes in The lated by financial incentives, patients break even by paying $90,000 to a live
Red Market. would no longer have to travel over- kidney donor, because it would save
“We’re seeing people more com- seas for a transplant, Becker conclud- the cost of months or years on dialy-
fortable with medical tourism. And med- ed. Legalization also would reduce the sis (funded by Medicare, Medicaid or
ical tourism is definitely growing,” he advantage wealthy patients enjoy over health insurance) while the recipient
points out, adding that countries such poorer patients, who can’t afford to waited for a donated kidney. 21 Today,
as India are aiming to reap billions jump the queue by paying cash for a he estimates that break-even point could
from the industry. India’s Council on quick, illegal transplant. 20 be as high as $500,000, if one includes
Medical Research predicts that medical In recent years, some kidney trans- the benefits from the patient’s improved
tourism could generate $2.3 billion in plant physicians have embraced the quality of life. He adds, “If everyone
annual revenue by 2012. 18 India’s med- idea of a government-regulated organ could have a transplant in an above-
ical tourism industry predicts growth market. Financial incentives to live board market, who would go abroad
of around 17 percent annually. 19 donors would bring in enough kid- to get an illegal transplant?”
neys to satisfy demand, they say, and Matas does not think donors should
Would legalizing payments to save the lives of those who otherwise necessarily be paid in cash, however.
donors discourage trafficking? might die while on a waiting list. It “It could be a tax deduction, a small
Offer: $175,000 for your kidney. How also would put unscrupulous brokers amount that the donor gets each year
many people would jump at that pay- who exploit the poor out of business. to come back for a check-up, college

www.globalresearcher.com July 19, 2011 349


ORGAN TRAFFICKING
plant patients demand healthier, stronger,
Transplant Gaps Spur Organ Trafficking better-off kidney donors, and are will-
ing to pay for a ‘higher quality’ and ‘more
More than 105,000 people were on organ transplant waiting lists in the educated’ organ. Rather than replace the
United States in 2009, but there were fewer than 15,000 donors. Such gaps black market, the government of Iran
between supply and demand in wealthier countries such as the United States has legalized it,” she has argued. 24
help to explain why affluent patients often travel to poorer countries for “A government-regulated program
transplants, fueling the black market in organs. will not end the black market,” argues
Debra Budiani-Saberi, executive director
(No. of people)
No. of Organ Donors and People on of the Cairo, Egypt- and Washington-
120,000
U.S.Transplant Waiting Lists, based Coalition for Organ-Failure So-
100,000 lutions, which works with organ sell-
1989-2009
80,000 ers victimized by the black market
60,000 Donors
trade. “People will go where the price
Waiting list
is cheaper, and it will always be cheap-
40,000 er somewhere.”
20,000 “Under the circumstances, where
0 developing countries have almost no
1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 mechanism of regulation, to think
that the government could run a reg-
Source: “The Gap Continues to Widen,” U.S. Department of Health and Human Services, ulated [market] program is idiotic,”
www.organdonor.gov/DLINK-gapgraph.asp says Farhat Moazam, chairperson of
the Sindh Institute’s Centre of Bio-
tuition or assistance with getting a job,” Besides a fixed government fee of medical Ethics and Culture. She
he says. $1,200, each Iranian kidney donor points out that even in the United
Proponents often cite Iran’s experi- also may receive a “rewarding gift,” States a Brooklyn kidney broker was
ence in paying donors for organs. After negotiated between donor and recip- arrested in a 2009 FBI sting in New
legalizing government payments to ient under the auspices of a patient- Jersey after allegedly arranging for
donors in 1988, Iran claims to have elim- run kidney foundation, which match- purchased kidneys to be transplant-
inated its organ waiting lists and avoid- es donors with compatible recipients. ed at reputable U.S. hospitals for
ed transplant tourism by prohibiting trans- The gifts can run as high as $5,000, years without being discovered.
plantation to foreigners. It also boasts according to Nasrollah Ghahramani, Market supporters Matas and Hip-
good postoperative health for organ re- a transplant nephrologist at Penn pen, however, say they are proposing
cipients, although some studies show State College of Medicine in Hershey, a regulated market only for the Unit-
sellers often experience deteriorating Pa., who practiced medicine in Iran ed States — and perhaps Western Eu-
health. 22 (See Background, p. 357.) for a decade. rope — where law enforcement is
But critics say middlemen continue However, Ghahramani, who visited more trustworthy. And by satisfying
to exploit the poor in Iran, and UCLA’s Iran recently, says Scheper-Hughes’ pic- demand in wealthy countries, the traf-
Danovitch doubts that Iran’s waiting ture of brokers trolling the streets is ficking in poorer countries almost could
list counts every kidney patient who not accurate. “Most people in larger be eliminated, they argue.
needs a transplant. Nancy Scheper- metropolitan areas with access to the However, Danovitch doubts such a
Hughes, an anthropologist at the Uni- media are aware that . . . they can go market could be contained within U.S.
versity of California, Berkeley, who directly to the patient advocacy group” borders. In the age of Twitter, he pre-
studies the organ trade, has reported, to find a match, he says. But he wor- dicts, “Within three seconds flat there
“When the government took over re- ries that under the so-called gift ex- will be twice the U.S. price offered in
sponsibility for managing the black change, the donor and recipient can Singapore or somewhere else.”
market kidney trade, the so-called bro- contact each other. “Nothing says they International bodies such as the WHO
kers and kidney hunters were re- can’t meet and potentially coerce one and U.N. and pillars of the medical
branded as ‘transplant coordinators.’ another into higher or lower bargain- world, such as the U.S.-based Institute
But they’re still just thugs who troll ing” under the table, he says. of Medicine, all oppose the payment
the streets and homeless shelters for That’s exactly what’s happening, says idea, largely on moral grounds. 25 “Most
people to donate on the cheap.” 23 Scheper-Hughes. “More affluent trans- people wouldn’t want to live in a

350 CQ Global Researcher


society where the government paid the
poor to be organ supplies,” Budiani-
Saberi says.
International groups contend that
paying donors would reduce the over-
all organ supply because fewer rela-
tives would donate an organ. But pro-
ponents point out that while donations
dropped sharply after payment was le-
galized in Iran, paid organs more than
made up for the difference. 26
Many opponents of outright payment
say they would support reimbursements
for things such as transportation to the
hospital, accommodations and medical
expenses, which are not always cov-
ered by health insurance in the United
States. In Britain and Europe donor ex-
penses for surgery and follow-up care
are generally covered.

Should governments and hospitals


do more to crack down on organ
profiteers?
Who profits most when organs are

AP Photo/Mel Evans
trafficked? “They’re called ‘doctors’ —
and that’s why they’re untouchable,” says
journalist Carney. “You don’t go to a
Mafia don in Bangalore to get a kid-
ney,” he says, “You go to a hospital.”
“It’s mainstream elite hospitals and
Levy Izhak Rosenbaum, of Brooklyn, N.Y, was arrested in 2009 as part of an FBI sting and
doctors,” adds bioethicist Caplan, who charged with conspiring to broker the sale of an Israeli citizen’s kidney — for $160,000 —
co-chaired a U.N. investigation of traf- for an American transplant patient. Rosenbaum allegedly had been
ficking in 2009. “It’s not gangs of brokering kidney sales for 10 years. Critics of the organ transplant process
thugs; they’re around, but they’re not say look-the-other-way hospital policies foster the illegal trade.
the driver.” 27
Indeed, white-coated doctors are the tect doctors behind India’s largest re- cedure. Although brokers took a cut
real brokers at the end of an illegal cent organ-selling scandal. In Tamil Nadu of what recipients paid for a kidney
chain, says Carney, either by directly province, a refugee camp for survivors transplant — typically $14,000 — doc-
purchasing organs or just turning “a of the 2004 tsunami had so many peo- tors and hospitals profited the most,
blind eye to something they know about.” ple selling their kidneys that it became according to Carney. Even though
When the FBI sting operation in known as Kidneyvakkam or “Kid- paper trails linked dozens of surgeons
2009 uncovered a criminal ring that neyville.” After local newspapers began to more than 2,000 illegal transplants,
paid Israelis to donate organs to covering the scandal in 2007, the De- authorities let the doctors off with a
American patients, the surgeries were partment of Medical Services discov- lecture, forcing only two small nurs-
being performed at reputable New ered that 52 Indian hospitals were in- ing homes to close. 28
York City hospitals, according to volved in transplanting sold organs from In Pakistan, rural villagers and bond-
Scheper-Hughes, who had investigat- thousands of impoverished refugees. ed laborers view doctors as the like-
ed the kidney broker who was ar- Those who sold a kidney were typ- ly purveyors of their kidneys, Farhat
rested. (See Current Situation, p. 360.) ically offered the equivalent of about Moazam, chairperson of the Sindh In-
A combination of medical prestige, $3,000 by brokers, but most received stitute’s Centre of Biomedical Ethics
corruption and cronyism helped pro- only a fraction of that after their pro- and Culture, discovered in 2007 while

www.globalresearcher.com July 19, 2011 351


ORGAN TRAFFICKING
conducting interviews in the country- Delmonico notes that in Israel, in the behavior, you could get be-
side. She was shocked when poor vil- where religious objections traditionally havior to change,” Caplan says.
lagers approached her colleagues wear- keep donation rates low, insurance But Carney sees these as only half-
ing physicians’ garb and asked if they companies used to pay for overseas measures. “It seems like doctors don’t
could help with selling a kidney. 29 transplants. But Israel recently banned want to reevaluate their own role,” he
To the extent there are criminal rings insurance payments if the overseas op- says. That will only happen, he says,
in Pakistan, Moazam says, “You can erations were illegal. “I would hope the if the profession agrees to make the
call it a kind of Mafia . . . connected U.S. government would take the same supply chain transparent.
to certain doctors and certain hospi- approach,” says Delmonico.
tals.” Although the middlemen take a Carney, in his book, cites health in-
cut, black market brokers can be quite
poor themselves, while “the surgeons
and hospitals make a whole lot of
surance companies that have touted
transplant operations abroad as cheap-
er than at home. “Their websites say
BACKGROUND
bucks out of it,” she contends. they will only cover things that are legal
Several Pakistani transplant surgeons in the [United] States,” he says. But would
involved in this illegal activity are well- they actually cover an illegal transplant? The First Transplants
known, according to Moazam, but no That’s an open question, he says: “It’s
physicians have been jailed even not difficult in India to make an illegal
though the law calls for up to 10 years transplant look legal.” n unfettered market in human
in prison for selling or buying organs.
“There’s quite a strong lobby among
In Chennai, India, the committee
responsible for authorizing transplants
A tissue and blood was both com-
mon and legal in the United States
transplant surgeons in Punjab,” she says. admitted to Carney on tape that it was and other countries for nearly three-
In Pakistan, police arrested doctors taking bribes. Even reputable hospi- quarters of the 20th century.
earlier this month, charging them with tals “won’t look harder than they’re The discovery in 1901 of four sep-
running an illegal kidney transplant legally forced to,” he says, partly be- arate blood types ushered in an era
ring in Lahore using kidneys bought cause they benefit financially from per- of blood transfusion, permitting more
from poor Pakistanis and sold to for- forming operations with “donated” or- extensive surgeries. Selling blood was
eign patients, yielding an estimated gans, which may actually have been legal and increasingly in demand in
$1 million. 30 purchased under the table. the United States. After World War II,
Carney says hospitals should be re- In the United States, doctors say blood collection clinics sprang up in
quired to provide the identity of every that when a patient shows up at the skid row neighborhoods of every major
organ recipient and donor. “It isn’t hospital with a purported friend or rel- city, endangering the blood supply with
legal to sell stolen cars, nor is it legal ative wanting to donate a kidney, it is blood sold by alcoholics, drug users
to sell ones that are sure to break difficult to determine whether an ille- and others suffering from hepatitis and
down,” he writes. The same standards gal organ sale has occurred. The hos- other blood-borne diseases. 33
should apply to body parts, he says. pital’s social workers and psychiatrists This market approach changed rad-
Some countries, such as Switzerland, probe the donors about their real mo- ically with the publication in 1970 of
allow authorities — including foreign tives, but a question often remains: “Is a highly influential book by Robert
authorities and international organiza- the motivation really ‘I want to help Titmuss, a British social researcher
tions — to examine medical records in someone’ . . . or get $1,000?” asks New and professor of social administration
order to expose illegal organ traffick- York University transplant surgeon at the London School of Economics.
ing. “Every country’s transplantation laws Thomas Diflo. 32 In The Gift Relationship: From Human
should allow this form of disclosure “The transplant community can do Blood to Social Policy, he argued that
and traceability,” Canadian human rights a lot to control black markets and ex- selling blood and human tissue is ex-
lawyer David Matas has urged. 31 ploitation, but they just haven’t cho- ploitative and that an “altruistic” ap-
Yet many members of the medical sen to do it,” says Caplan. He urges proach, in which people donate their
community resist revealing donors’ doctors to boycott conferences if they blood, would yield a safer and more
names. Caplan would like to “hold the involve transplant research in China ample supply.
transplant centers accountable for based on organs from executed pris- When people can sell their blood,
where they get organs” but says this oners. And Danovitch urges journals he argued, the desperately poor lie
can be done without violating patient not to publish similar articles. “If you about drug use or prostitution and the
confidentiality. make pariahs of people who engage Continued on p. 354

352 CQ Global Researcher


Chronology
transplants safer, sparks rise in in India, New Jersey and Istan-
1900s-1950s
Sale of blood and organs is
demand, raising concern about bul, but trafficking continues
distribution and safety of organs. in Pakistan, Egypt, China.
legal in many countries. United States, other countries
ban organ sales. 2006
1901 Two Canadian human rights lawyers
Discovery of four blood groups al- 1983 report China is harvesting organs
lows transfusion-aided surgery. Anti-rejection drug cyclosporine from Falun Gong prisoners and sell-
approved in the United States. . . . ing them to “transplant tourists.”
Dec. 23, 1954 Reston, Va., doctor announces kid-
Doctors in Boston perform first ney exchange to buy/sell kidneys, 2007
successful kidney transplant. arousing concern in Congress. WHO estimates 5-10 percent of
organ transplants are illegal. . . .
• 1984 Pakistan bans organ sales. . . .
Congress passes National Organ China bans organ sales, gives Chi-
Transplant Act banning organ sales. nese citizens priority for transplants
1960s-1970s
First lung, heart transplanted;
over foreigners.

states adopt organ donation laws, 2008
which make it easier for individu- Declaration of Istanbul condemns
als to donate their organs after
death, specifying it is a “gift.”
1990s India, the
world’s organ bazaar, bans
organ selling. . . . EU formulates
Organs Directive for members,
organ sales; Iran legalizes pay- emphasizing organ donations must
1963 ments. European Union (EU) is be unpaid, requiring traceability of
First lung transplant performed in empowered to harmonize mem- organs.
Jackson, Miss. ber states’ laws governing
blood, organ distribution. 2008
1967 Amit Kumar, a doctor in Gurgaon,
First heart transplanted, in South 1994 India, arrested for 500 illegal trans-
Africa. India bans organ sales; illegal sales plants.
continue.
1970 2009
British social researcher Robert Titmuss 1998 Brooklyn man charged with bro-
publishes The Gift Relationship, urg- Iranian government begins paying kering organ from Israel for U.S.
ing altruism as the basis of organ living donors for their organs. patient.
donation in U.S. and U.K.
1999 2010
1971 Iran claims to have eliminated its Pakistan’s ban becomes law. . . .
All 50 states have adopted the kidney waiting list. . . . EU gets Egypt bans trafficking. . . . EU
Uniform Anatomical Gift Act, giv- new powers to harmonize members’ finds Kosovar politicians ran organ
ing individuals the right to donate laws governing organs. smuggling ring.
their organs after death with a
simple document or donor card; • 2011
some interpret law as barring in- Turkish doctor arrested for alleged
centives for living donors. involvement in Kosovo organ


2000s Medical groups
condemn organ trafficking, Chi-
smuggling ring. . . . Pakistan’s ille-
gal trade returns.
nese organ harvesting from
Aug. 27, 2012
1980s New immuno-
suppressive drug makes organ
prisoners; debate over legalizing
payment for organs heats up.
Organ traffickers are arrested
Deadline for EU states to adopt the
Organs Directive.

www.globalresearcher.com July 19, 2011 353


ORGAN TRAFFICKING
Continued from p. 352 lines about the first successful heart transplants. It also spurred concerns
supply is at risk for blood-borne dis- transplant, in Cape Town, South Africa, about how to distribute available or-
eases. Based on a comparative study by surgeon Christiaan Barnard. 35 gans, which fell short of demand.
of blood supplies in England and the A few months later the National In 1984 lawmakers passed the land-
United States, he concluded that Eng- Conference of Commissioners on Uni- mark National Organ Transplant Act
land, where most blood donations came form State Laws produced a frame- (NOTA), which makes it “unlawful for
from unpaid volunteers, had a safer work for standardizing organ and tis- any person to knowingly acquire, re-
supply than did the United States. 34 sue donation laws in the United ceive, or otherwise transfer any human
Titmuss’ altruism concept eventual- States, and by 1971 the model Uni- organ for valuable consideration” — a
ly became the dominant ethical prin- form Anatomical Gift Act of 1968 was vaguely-defined term that has been the
ciple, not just for blood but also for adopted in nearly identical form by subject of legal debate. A violation of
organ distribution in the United States all 50 states. 36 It made it easier for the ban is punishable by a $50,000
and most other Western countries. The people to donate their organs for fine, five years in prison or both. 37
first successful kidney transplant was medical purposes after death. But it exempts “reasonable payments”
conducted on Dec. 23, 1954, in Boston, In 1983, the Food and Drug Ad- to donors to cover travel, housing and
and the first lung transplant in 1963 at ministration’s approval of cyclosporine, lost wages incurred by the donation. 38
the University of Mississippi in Jack- a revolutionary anti-rejection drug, Similar bans were adopted in other
son. On Dec. 3, 1967, newspapers across promised improved transplant survival countries. The sale of blood and tis-
the world splashed front-page head- rates and sparked a huge increase in sue is now illegal in most countries.

Singapore Allows Reimbursements to Organ Donors


But is additional cash paid under the table?
ingapore retail tycoon Tang Wee Sung had a net worth Lawmaker Halimah Yacob expressed fears that foreign la-

S estimated at more than $170 million. He also had end-


stage kidney disease. 1
But even Tang couldn’t count on getting a legal kidney in
borers might “become a ready, vulnerable pool of organ donors
to be exploited and abused.” 5
Unlike transplant procedures elsewhere, in Singapore the
Singapore, where the wait for a donated kidney is up to nine prospective donor and recipient apply as a pair for the trans-
years. In 2008 he was convicted of offering to pay an organ plant and usually know one another. The law also permits the
broker the equivalent of $244,558 for a kidney from an In- recipient to pay whatever reimbursement costs he chooses,
donesian man. 2 Tang served a day in prison and was fined which must be approved by a three-person ethics committee,
about $14,000. 3 composed of two doctors and a layperson.
The highly publicized case spurred a debate in Singapore Jacqueline Chin, who teaches medical ethics at the National
over how best to control the illegal organ trade. During a par- University of Singapore’s Centre for Biomedical Ethics and has
liamentary hearing on proposed legislation, health minister reviewed eight such cases as a member of a transplant com-
Khaw Boon Wan said the Southeast Asian city-state should con- mittee, says the system has flaws. Under the law, the commit-
sider legalizing payments to kidney donors. “We may be able tee must reject the transplant if it suspects money has changed
to find an acceptable way to allow a meaningful compensa- hands. If an employee is donating his kidney to his employer,
tion for some living, unrelated kidney donors without breach- she says, “Those things get our antennae up.”
ing ethical principles or hurting the sensitivities of others.” But, she observes, “We have no expertise or powers to inves-
However, Singapore didn’t go quite that far. It did allow tigate” whether there’s been a cash exchange under the table. By
donors to be reimbursed for donation-related costs, such as the time a foreign donor-recipient pair shows up on Singapore’s
medical care, loss of income, travel and lodging. It also ex- shores, the recipient has presumably already paid for the donor’s
tended the prison sentences of anyone convicted of buying or airfare and possibly promised other compensation.
selling organs, to up to 10 years. 4 Ideally, to prevent an under-the-table sale of an organ, there
The law, which took effect in 2009, came in for harsh should be a third party who collects the money from the recip-
criticism from some legislators, who charged it would lead ient and passes it on to the donor, Chin says. Currently, Singa-
to an organ trading market. The law not only permits for- pore’s National Kidney Foundation offers up to 5,000 Singapore
eigners who donate an organ in Singapore to be reimbursed dollars ($4,100) in lost income to organ donors.
but also allows foreigners to receive a transplant there after The ethics committee also has no way to enforce the re-
agreeing to pay a donor’s costs. cipient’s promise to pay for the donor’s operation or follow-up

354 CQ Global Researcher


medical care. “If we have any doubts that the recipient is not “I think Singapore wants to establish a reputation for trans-
sincere about reimbursing, we’ll not authorize the transplant,” plantation expertise,” Chin says. “To do that, you have to do a
she says. But what if the recipient just walks away without lot of operations.”
paying? “Lately, I’m concerned about this. I ask the hospital As for the tycoon Tang, he finally got a kidney. In January
and physicians if they are intending to pursue the donor for 2009 he received one from organized-crime boss Tan Chor Jin,
payment.” known as the “One-Eyed Dragon” because he had lost an eye.
Singapore’s system, for all its flaws, is intended to follow Tan, who was hanged for murdering a nightclub owner, re-
international guidelines specifying that donations should be an portedly donated his kidney voluntarily. 7
“altruistic” gift, not an exchange for money or valuables. But
sometimes those lines become blurred, especially if the donor — Sarah Glazer
is a poor relation or an employee in a wealthier cousin’s family-
owned business. If the family patriarch dies, the poor employee 1 “Tang Wee Kit,” Forbes, Aug. 24, 2006, www.forbes.com/lists/2006/79/06singa

might be out of a job, Chin points out. Might not a poor per- pore_Tang-Wee-Kit_JU3W.html.
2 Peter Ritter, “Legalizing the Organ Trade?” Time, Aug. 19, 2008, www.time.com/
son want to donate an organ to a rich employer “to put some time/world/article/0,8599,1833858,00.html#ixzz1QyTcaZIK.
food on the table, give my children a better education, get 3 “Tang Wee Sung Gets 1-day Jail,” Channelnewsasia.com, Sept. 3, 2008,
some health insurance?” she asks. www.channelnewsasia.com/stories/singaporelocalnews/view/373494/1/.html.
4 See “Human Organ Transplant Act (HOTA), FAQs,” Singapore Ministry of Health,
Critics of the new law question why the government didn’t
www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx?qst=2fN7e274RAp%2bbUzLd
prohibit foreigners from receiving transplants and reimbursements EL%2fmJu3ZDKARR3p5Nl92FNtJie8pByIMium%2b96IFsmAcEka%2bpIKxFLl%2bbs
in order to crack down on the international organ trade. TxHVE3%2fpFsXIkii%2bakrP9JvTq0g9m%2fgz6kkbcvQptk23HEACXM9FNn0UQ
Singapore, like Thailand and Malaysia, is heavily com- qJ%2fPlcO17qN9e7L%2b43g4GT9QiZGWWvdvoB4Vi%2bNy6oZpxAfJtcAR%
2fEIKqmp2YAozrd9VgIg%3d..
mitted to medical tourism — which attracts all types of pa- 5 David Gutierrez, “Singapore to Legalize Financial Compensation for Organ
tients, not just those seeking transplants. In 2003, Singapore’s Donors,” Natural News, July 14, 2009, www.naturalnews.com/026619_Singa
government set up an agency just to attract foreigners to its pore_organ_donor_WHO.html.
6 Ritter, op. cit.
up-to-date hospitals, which are some of the finest in Asia.
7 Gutierrez, op. cit. Also see Jessica Jaganathan and Teh Joo Lin, “Tang gets
At some of Singapore’s best private hospitals, foreigners ac-
kidney, believed to be from ‘One-Eyed Dragon,’ ” The Straits Times (Singapore),
count for a third of the patients — and up to 40 percent of Jan. 10, 2009.
revenue. 6

(It remains legal in the United States a state-administered fund for those who organ. At least 30 have provided paid
for donors to sell blood plasma, a prod- agreed to donate organs after death. or unpaid leave for bone marrow or
uct extracted from blood, and women’s Questions about whether the law vio- organ donors who are state employ-
eggs as well as sperm.) lated NOTA led the state to specify that ees. At least eight states have required
But the law did not eliminate prof- the funds should be used to pay only companies to provide a leave of ab-
its from the organ business, Red Mar- for food, travel, lodging and lost wages sence for employees who donate. 43
ket author Carney points out. In fact, — already authorized by NOTA. In In 2007, questions arose about
the donation requirement allowed U.S. European countries, deceased donors’ whether NOTA’s ban on “valuable con-
hospitals to acquire organs virtually for families commonly are reimbursed for sideration” was being violated by so-
free while charging up to $500,000 for funeral expenses. 40 called paired donations, in which
their transplantation. That system, plus In 2003 the first tax incentive to en- donor-recipient pairs who were not a
medical privacy rules that forbid pub- courage organ donation was adopted good transplant match swapped kid-
lic scrutiny of donors, masks the true in Wisconsin, allowing donors to claim neys with another incompatible pair
nature of the supply — including il- a $10,000 state deduction to cover lost so that each patient received a suit-
legal transactions — “behind a curtain wages and expenses for travel, lodg- able organ. In 2007 the U.S. Attorney
of ethics,” he writes. 39 ing and medical care. 41 Since then, 15 General’s office said the approach did
NOTA has been challenged only states have adopted similar laws. 42 By not violate NOTA. On Dec. 21, 2007,
once in the United States, when Penn- 2008, many states had passed other the Living Organ Donation Act was
sylvania in 1994 enacted its Burial Ben- laws aimed at offering inducements or signed, clarifying that NOTA did not
efit Act, providing funeral expenses from removing disincentives for donating an outlaw paired donations. 44

www.globalresearcher.com July 19, 2011 355


ORGAN TRAFFICKING
consent law, organ donation rates start- gans Directive, formulated in 2008, the
Foreign Variations ed to rise only after Spain created a co- first legally binding international regime
ordinated hospital-based policy of en- imposing legislative requirements on
rgan shortages vary dramatically
O across the European Union, a dif-
ference that many experts attribute to
couraging consensual donation, known
as the “Spanish model.” 46
Under the policy, every hospital ap-
organ donation. Among other mea-
sures, it draws on the Spanish ap-
proach of appointing specially trained
differences in national laws and poli- points as donation coordinator a senior coordinators at hospitals to speak with
cies governing how organs are donat- physician with special training in talk- families about donating. 47
ed. For example, deceased-donation rates ing with families of dying patients. By However, the directive says little
range from a low of 14.7 per million contrast, in Britain, a very junior staff about organ trafficking except that the
people in Britain to a high of 34.4 mil- member, typically untrained in how to EU will monitor the situation — a
lion in Spain. 45 sensitively approach this difficult sub- vagueness due in part to the lack of
data on how extensive trafficking is
in Europe. 48 That information may be
uncovered by the directive’s require-
ment that members begin verifying
donor identities and the origins of or-
gans — not just within donors’ own
countries but also in organ exchanges
with other countries. 49
Under the directive, EU nations must
ensure that donations are voluntary and
unpaid, although this does not prevent
AFP/Getty Images/Raveendran living donors from being reimbursed for
expenses or loss of income. However,
in an analysis published this year,
Anne-Maree Farrell, a senior lecturer in
law at the University of Manchester’s
Centre for Social Ethics and Policy,
criticized the directive for failing to ac-
knowledge the “longstanding academ-
ic and policy debate” over legalized
Activists from India’s main opposition Bharathiya Janata Party demand an investigation of a payments and other alternative incen-
kidney black market uncovered in New Delhi in February 2008. Although India banned organ tives for donations. She blames the EU’s
sales in 1994, police have seen a resurgence in the underground organ market, with about avoidance of this crucial issue on “a
2,000 Indians selling a kidney every year, according to the Voluntary Health Association of India. largely technocratic mindset.” 50
Live donor rates in the EU also vary
Spain is one of several EU coun- ject, raises the issue with the family, widely — low in Spain but much high-
tries with a policy of “presumed con- says Margaret Brazier, a law professor er in Scandinavia. Only 17 percent of
sent,” in which organs are taken after at the University of Manchester. organ donations across Europe come
death unless a person “opts out” be- “Perhaps we could avoid radical from living donors. 51 In Britain, live
fore death or the family objects. By changes” such as legalizing payments donations have been controversial, part-
contrast, Britain — like the United to donors, “by just having a thoroughly ly because of concerns about possi-
States — has an “opt in” system, in good system for encouraging consen- ble abuses, according to David Price,
which a donor must specify on a dri- sual donation,” she says, citing Spain professor of medical law at Britain’s
ver’s license or other directive a de- as “the shining example.” De Montfort University in Leicester.
sire to donate an organ after death. In 1999, the EU gained new pow- But legislation in Britain in 2004 and
Many experts suggest countries with- ers to adopt measures aimed at “har- 2006 explicitly endorsed such dona-
out presumed consent could eliminate monizing” member states’ measures tions and regulated them. 52
their organ shortfalls by following Spain’s governing blood, human tissue and Britain and many other European
example. While Spain’s high donation organ donations. Members have until nations are “actively promoting living
rate might be attributed to its presumed Aug. 27, 2012, to adopt the EU’s Or- organ donation to help boost trans-

356 CQ Global Researcher


plant rates,” according to Price. In By 1999, Iran said its kidney wait- ied by a research team at The Johns Hop-
Britain, the National Health Service ing list had been eliminated. More than kins School of Public Health had sold a
now funds transplants of liver sections 78 percent of kidneys transplanted in kidney in hopes of paying off debts,
from living donors, in addition to kid- Iran come from living donors unre- three-quarters were still in debt six years
neys. The legal framework also allows lated to recipients. 56 after the organ was removed. 57
swaps of kidneys between pairs or In Egypt, poor kidney sellers who
within groups of pairs. 53 Under the have been cheated on the price quot-
Human Tissue Act of 2004, which took Coercion and Bans ed by a broker or who suffer phys-
effect in England in 2006, an inde- ical ailments after the surgery are
pendent agency must approve proce- ven though it banned organ sales frequently afraid to report their ex-
dures where there could be abuses,
such as paired swaps or donations by
E in 1994, India became a major des-
tination for Western organ tourism in
ploitation for fear of arrest, accord-
ing to the Coalition for Organ-Failure
children or vulnerable adults. 54
Consensus documents from med-
ical professional groups around the

Chicago Tribune/McClatchy Tribune via Getty Images/Laurie Goering


world increasingly establish guide-
lines to ensure voluntary and in-
formed consent of donors. They fre-
quently recommend psychological and
psychosocial evaluation of donors to
ensure there has been no pressure to
donate. However, Price points out, there
is no legal requirement in Britain to
follow this guideline. 55
Since the 1980s, many countries
have banned compensation for organs.
Iran’s compensation system evolved in
a war-torn country without the facili-
ties to perform organ transplants for
its citizens with kidney disease. Be-
tween 1967 and 1988, the number of
Iranians on dialysis steadily increased,
but only 100 transplants occurred.
In 1980, the health minister allowed Marsha Payne and her husband James — “transplant tourists” from South Florida —
Iranians to get transplants abroad, paid traveled to New Delhi’s premiere Apollo hospital, where she donated half her liver for James’
liver transplant in 2008. The operation, plus the couple’s 10-week hospital stay, cost the
for by the government. The lack of a uninsured former investment banker $58,000 — a fraction of the $450,000 he was quoted
deceased-donor program meant the in Florida for the same procedure. The $100 billion global medical tourism industry is helping
country had no other source of organ to reduce the cost of transplants and increasing the demand for organs, but it is often
donations. Between 1980 and 1985, more difficult for hospitals to determine whether “donated” organs have been purchased.
than 400 traveled abroad for transplants,
and by 1988 there were long waiting the 1990s, and by 2002 sales through Solutions. The group says men from
lists for overseas transplants. corrupt brokers were commonplace, ac- western Sudan’s troubled Darfur re-
Faced with the rising cost of oper- cording to a widely cited study. The law gion have been recruited for jobs in
ations abroad, the government in 1988 permitted nonfamily members to donate Cairo, where they were forced to work
introduced a plan to subsidize organ an organ if they signed a form saying without pay, accumulated rent debts
transplants at home. Currently the gov- they had not been paid, so brokers per- and then were lured into selling a
ernment pays donors $1,200, which suaded impoverished people to lie. kidney to pay the debts. 58
can be supplemented by payments Frequently, local moneylenders de- Black market sellers are frequently
from recipients for associated expens- manded that debtors sell a kidney to pay financially and physically worse off.
es. After the program began, the num- off debts and refused additional credit to Of 32 Pakistani laborers who sold a
ber of transplant teams in Iran jumped those who still had both kidneys. Al- kidney to pay off debts to their land-
from two to 25. though 91 percent of organ sellers stud- lords, none received the amount they

www.globalresearcher.com July 19, 2011 357


ORGAN TRAFFICKING
were promised, and most remained In Pakistan, reports of organ sales
in debt after the sale, according to a Austria Leads in Per by impoverished people surfaced in
study by Moazam, of the Sindh In- Capita Transplants April, and again just this month in the
stitute’s Centre of Biomedical Ethics arrest of several Lahore doctors charged
and Culture. Three years later, all Austria has the world’s highest per with transplanting purchased kidneys,
complained of symptoms related to capita organ transplant rate, with despite the ordinance criminalizing
their operations, and all said they could 95 transplants each year for every organ-selling. 64
not work as hard as before. 59 Simi- million residents. Kidney transplants The Chinese government’s 2007 reg-
lar after-effects, including high rates of are the most common. Most trans- ulations prohibiting organ trafficking and
depression and worsened financial sit- removal of organs from the living with-
plants are performed in the United
uations, have been found among organ out their consent were aimed at dis-
sellers in India and the Philippines.
States, followed by China, say couraging transplant tourism. The gov-
Strikingly, most sellers in Iran have experts who caution that Chinese ernment also began giving Chinese citizens
experienced deteriorating health, and statistics are unreliable. priority for organs and in 2009 limited
many have expressed regrets similar donors to close relatives. 65
to those of illegal sellers in other coun- Top 20 Organ Transplanting
tries, according to several recent stud- Countries, 2011
ies. Many said they’d been stigmatized
by their families and communities for
selling a kidney. 60
(based on number of transplants
per million population) CURRENT
In 2008, the international Transplan-
tation Society and the International So-
ciety of Nephrology, meeting in Istan-
Austria
Norway
United States
95.24
91.88
90.38
SITUATION
bul, adopted the Declaration of Istanbul
Portugal 87.55
on Organ Trafficking and Transplant
Tourism, a document condemning poli- Spain 86.16 Major Criminal Cases
cies “in which an organ is treated as Belgium 83.80
France 71.94 everal high-profile cases against
a commodity, including by being bought
or sold or used for material gain.” 61
Since then, Pakistan and Egypt have
Sweden 71.61 S organ-traffickers are pending around
the world, including those against:
Netherlands 64.85
banned organ-selling, but the bans have • Alleged renegade doctor Amit
only “curbed” the organ trade, accord-
Canada 64.45 Kumar, in Gurgaon, India, who is
ing to the Coalition for Organ-Failure Switzerland 62.11 in jail awaiting the resolution of his
Solutions’ Budiani-Saberi. They have “by United Kingdom 61.47 trial. 66 He is charged with illegal-
no means ended it.” Croatia 60.23 ly removing the kidneys of some
In Egypt, organs traditionally were Denmark 59.45 500 day-laborers, farmers and rick-
distributed through sales, although shaw drivers. 67 Several police of-
Ireland 58.00 ficers also have been charged with
most recipients were not foreigners.
As recently as 2009, some 80-90 per- Czech Republic 57.62 extortion and accepting bribes. 68
cent of living kidney donors in Egypt Germany 57.45 • Brooklyn, N.Y., resident Levy Izhak
had no family link to the recipients. Italy 56.81 Rosenbaum, arrested in 2009 on
In February 2010, Egypt banned organ Malta 55.00 charges of conspiring to broker
trafficking, and, for the first time, per- the sale of a human kidney for
Australia 53.62
mitted transplants from deceased transplant at a cost of $160,000 to
donors. 62 Source: Global Observatory on Donation an American buyer. According to
But the law has not been aggres- and Transplantation, World Health Organiza- the complaint, filed in the U.S.
sively enforced, according to Budiani- tion, www.transplant-observatory.org District Court of New Jersey, Rosen-
Saberi, whose organization works with baum had been brokering kidney
Egyptian victims of organ trafficking. enforcing the transplant law is not a sales for 10 years. He allegedly
And with the current vacuum in the high priority, she observes. “Traffick- instructed an undercover buyer to
government following this spring’s ing could flourish again, because it’s pretend to be a relative or friend
ouster of President Hosni Mubarak, a vulnerable moment,” she warns. 63 Continued on p. 360

358 CQ Global Researcher


At Issue:
Would regulated reimbursements discourage organ trafficking?
yes

BENJAMIN HIPPEN, MD GABRIEL DANOVITCH, MD


TRANSPLANT NEPHROLOGIST MEDICAL DIRECTOR, KIDNEY TRANSPLANT
CHARLOTTE, N.C. PROGRAM, DAVID GEFFEN SCHOOL OF
MEDICINE, UNIVERSITY OF CALIFORNIA
WRITTEN FOR CQ GLOBAL RESEARCHER, JULY 2011 LOS ANGELES

WRITTEN FOR CQ GLOBAL RESEARCHER, JULY 2011

r egulation probably would discourage trafficking. But issu-

t
yes no
ing broad generalizations about illegal, underground he 2008 Declaration of Istanbul on Organ Trafficking and
organ trafficking in developing countries is a hazardous Transplant Tourism (www.declarationofistanbul.org) and the
proposition. Published information about the workings and out- Guiding Principles endorsed by the World Health Organi-
comes of organ trafficking around the world is piecemeal and zation (WHO) have helped to reduce the venal exploitation of
often second- or third-hand. The information we do have indi- vulnerable organ donors intrinsic to organ trafficking. The wide-
cates that it typically involves the transfer of organs from the spread endorsement of these pronouncements represents an un-
very poorest to the comparatively very rich, and that those pur- precedented consensus against all forms of organ commercialism.
chasing organs on the black market do so because the opportu- Though organ trafficking still occurs, distinct and measured
nities for transplantation in their native country are limited. progress has been made in countries previously designated as
For the last decade, the core strategy of most transplanta- “hotspots” by the WHO. Plus, several countries that traditionally
tion opinion leaders has been to aggressively condemn organ have “exported” transplant tourists have taken measures to re-
trafficking; identify and apply public pressure on high-level duce the trade. For example, Japan passed brain-death laws
government functionaries in the worst-offending countries and that enable it to start addressing its citizens’ transplant needs,
encourage the development of robust deceased-donor pro- and Israel prohibited insurance reimbursements for citizens
grams in the developing world. who travel abroad for transplants.
It’s impossible to know whether this strategy has had any Commercialization of organ (typically kidney) donation has
meaningful impact on the prevalence of organ trafficking, been shown to undermine the very fabric of the organ trans-
though there is ample room for doubt. Pakistan, for instance, plant endeavor, which is based on mutual benefit and trust —
passed the Human Organ Tissue Transplant Act (HOTTA) to both in the diagnosis of death and in the welfare of living
great acclaim and trumpeted its success in the media and in donors and their recipients. The outcome for kidney sellers is
at least one bioethics journal last year. Although the law worse than for altruistic donors — from both a medical view-
banned the sale of organs, reports now are surfacing of a point and a psychosocial one. Recipients are also put at greater
resurgence of illegal underground trafficking. risk as the mutual caring that underlies successful living donor
More specifically, this anti-trafficking strategy fails to address transplantation is displaced by financial considerations.
the fundamental social and economic allure of organ trafficking: Furthermore, a “regulated organ market” is an oxymoron. In
desperation. When a person’s very life depends on a new Iran, where such a system has been in place since 1970,
organ, he suddenly finds himself willing to pay exorbitant “under the table” payments to “supplement” the regulated gov-
sums to individuals he knows nearly nothing about; risk his ernment payment are near universal. The transplant communi-
life (and the lives of others); violate established laws in a ty has documented the inferior outcomes for vulnerable
country where he is a visitor, and undertake a major surgical donors and is struggling to unburden itself from a system that
procedure in sometimes substandard conditions. has hampered the development of related living donation and
The flourishing of organ trafficking in developing countries voluntary deceased donation.
is caused by the manifest failure of organ procurement poli- Moreover, it is facile to think that commercial organ dona-
cies in developed countries to meet the growing demand for tion would somehow “solve” the organ donor shortage. Expe-
organs. It is the current system that is, and has been, morally rience has shown that paid donation comes at the expense of
complicit in the existence of organ trafficking. It is time to ac- and not in addition to voluntary donation.
cept that this strategy has been insufficient to the challenge. Countries and regions must strive to become self-sufficient
A regulated market may or may not cure much of what in answering their citizens’ transplant needs. We must redouble
ails global organ transplantation. But, correctly structured, such our efforts to prevent end-stage organ failure and do our utmost
a market would assuredly remove the incentives for recipients to remove the economic, educational, legal and cultural disin-
of means to provide key economic support for organ traffick- centives to organ donation, so both the living and deceased
ing. And, it is a reasonable hypothesis that, absent this crucial can manifest the humanity that is the core of a safe, successful
economic support, organ trafficking will wither and die.
no
and effective organ transplant endeavor.

www.globalresearcher.com July 19, 2011 359


ORGAN TRAFFICKING
Continued from p. 358 It further claimed that Kosovo Nadey Hakim, surgical director of the
of an Israeli donor-seller he would Prime Minister Hashim Thaci, a for- transplant unit at London’s Hammersmith
bring to New York City for the mer Kosovo Liberation Army leader, Hospital, said he became interested in
transplant operation. Rosenbaum headed the faction that controlled il- a regulated market after presenting a
was arrested as part of an FBI licit criminal enterprises, including the news program on organ trafficking for
sting that charged 44 people — organ trafficking. Thaci has denied the a British television station. Since then,
including New Jersey politicians charges. The report suggested the organ he says, more colleagues have begun
and rabbis — with a variety of trafficking continued after the war, and to support the idea.
crimes including international that there was a link between the ring “Instead of abusing patients in
money laundering. 69 A trial date and the Kosovo clinic where Sonmez Third World countries and offering
has not yet been set. was working in 2008. 70 them peanuts for their kidneys, we
ought to legalize organ payments in
the United Kingdom so at least it’s
well-organized,” he says. But he would
pay only British donors.
Despite the renewed interest, the
debate so far has been more theoret-
ical than legislative. In the United States,
in 2008 former Sen. Arlen Specter, then
a Republican from Pennsylvania, draft-
ed a bill that would have allowed fed-
eral, state or local governments to pro-
vide donors with in-kind rewards. 72
AP Photo/Ibrahim Usta However, the bill — expected to face
fierce opposition from medical groups
— was never introduced.
Nevertheless, the once-taboo idea of
providing donors with financial incen-
tives, or at least reimbursement, appears
to now have the support of a sizable
Police escort Turkish doctor Yusuf Ercin Sonmez to a court in Istanbul, Turkey, on Jan. 12, 2011. proportion of American transplant doc-
He was arrested in January and charged with organ trafficking at a Kosovo clinic in 2008 tors, according to a 2009 survey by the
and has been implicated in an organ smuggling ring based in Kosovo in 1999. Society of Transplant Surgeons. It found
that most members support providing
• Yusuf Ercin Sonmez, a Turkish living donors with coverage for lost wages,
doctor arrested in January for al- Legalizing Payments guaranteed health insurance and an in-
leged involvement in an organ come tax credit. For deceased donors
smuggling ring based in Kosovo, roposals to allow payments for or- the poll showed support for paying
described in a recent Council of
Europe * investigation.
P gans are being vigorously debated
in Europe and the United States.
funeral expenses. But most oppose pro-
viding lump-sum cash payments. 73
According to the 2011 report, Koso- “There has been in general a willing- UCLA’s Danovitch notes that U.S.
var politicians stole organs when the ness to look at the issue again,” says organ donation rates have been de-
Kosovo Liberation Army was fighting Brazier, the British law professor. clining slightly in recent years, which
Serbian forces in the late 1990s. Their The Nuffield Council on Bioethics, he blames on the recession. People
criminal faction detained Serb pris- an influential British think tank, is worried about holding onto their jobs
oners in Albania and killed them in scheduled to release a report this fall are reluctant to take time off from
order to extract organs for shipment considering various incentives to en- work, another reason to consider re-
abroad, the report alleges. courage organ donations, including imbursing them for lost wages and
cash payments, priority on the trans- other expenses, he says.
* The council is an organization of 47 coun- plant waiting list for previous donors In China, with its low donation rate,
tries in Europe that seeks to ensure human and payment of funeral expenses of the health minister has said the gov-
rights and democratic principles. deceased donors. 71 ernment should consider providing

360 CQ Global Researcher


funeral costs, tax rebates, medical in- than politically charged market pro- Otherwise, he says, the poor half
surance, hospital costs or tuition waivers posals. “You’re not going to get a so- of the world will continue selling or-
for donors’ family members. 74 lution to the needs of people in organ gans to the wealthier half.
failure by arguing about markets,” he
says, noting that millions of patients

OUTLOOK aren’t even on a transplant list “because


there’s no transplant center where they
live in Bolivia or Mozambique.”
1
Notes
Other experts see an even simpler Michael Smith, “Kidneys at Hub of Deadly
way to reduce black market demand: ‘Transplant Tourism,’ ” Bloomberg News, in The
better disease prevention so patients News Tribune, May 15, 2011, www.thenews
Making Trafficking tribune.com/2011/05/15/1665819/kidneys-at-hub-
Obsolete don’t need a replacement organ. A
of-deadly-transplant.html.
growing epidemic of obesity and the 2 For background, see Barbara Mantel,
resultant growth in diabetes is a major “Organ Donations,” CQ Researcher, April 15,
ome experts think medical advances
S — such as the use of regenerative
medicine to produce artificial organs —
driver of the increasing demand for
kidney transplants.
2011, pp. 337-360.
3 Yosuke Shimazono, “The State of the Inter-
In addition, “there are about to be national Organ Trade: A Provisional Picture
could kill the black market in organs several dramatic improvements in treat- Based on Integration of Available Information,”
by reducing the need for transplants. ing hepatitis C — a major cause of Bulletin of the World Health Organization, De-
Although the use of artificial organs end-stage liver disease,” which could cember 2007, pp. 901-980, www.who.int/bulletin/
on a mass basis may not happen for “dramatically reduce the need for liver volumes/85/12/06-039370/en/#. Also see, Coun-
at least another decade, many experts transplants,” says UCLA’s Danovitch. cil of Europe/United Nations, “Trafficking in
say, surgeons in Sweden have just given
a cancer patient a new windpipe,
made with stem cells from the pa-
tient’s bone marrow, the BBC report-
ed on July 7. It was the first trans- “Entire villages in southern Punjab are selling their
plant of a synthetic organ that did not
require a donor. 75 kidneys out of desperation, . . . debt, poverty and
“Thanks to nanotechnology, this new
branch of regenerative medicine, we landlord coercion. Pakistan is being dragged back to
are now able to produce a custom-
made windpipe within two days or one
the era of illegal organ trafficking, spurred on by the
week,” said Paolo Macchiarini, chairman unrelenting greed of the medical profession in
of the Hospital Clínic at the University
of Barcelona in Spain, who led the collusion with the law-enforcing authorities.”
transplant team. “This is a synthetic wind-
pipe. The beauty of this is you can — Adibul Hasan Rizvi,
have it immediately. There is no delay.”
In addition, “This technique does not President, Transplantation Society of Pakistan
rely on a human donation.” 76
He said many other organs could
be repaired or replaced in the same
way. Other research aims to use stem Waiting times for heart transplants Organs, Tissues and Cells and Trafficking in
cells to repair defective organs or cre- have already declined, he points out, Human Beings for the Purpose of the Removal
ate hearts and livers from a patient’s of Organs,” 2009, www.un.org/apps/news/story.
because treatment of heart failure has
own cells by growing cells on plastic asp?NewsID=32521&Cr=&Cr1=.
improved over the past five to 10 4 D. A. Budiani-Saberi and F. L. Delmonico,
or natural scaffolds. 77 years. “Prevention,” Danovitch main- “Organ Trafficking and Transplant Tourism,”
“If we pushed, we could see cell re- tains, “is the best way and the only American Journal of Transplantation, 2008,
placement in 10 years,” says bioethicist solution” to stem the shortage-driven p. 927, www.cofs.org/COFS-Publications/Budi
Caplan, which he says will be far more black market and the inevitable flow ani_and_Delmonico-AJT_April_2008.pdf.
effective in ending organ trafficking of organs from poor to rich countries. 5 Scott Carney, The Red Market (2011), p. 65.

www.globalresearcher.com July 19, 2011 361


ORGAN TRAFFICKING
6 Smith, op. cit. Asian-Countries-amongst-Favorites-for-Medical- science/trafficking-the-traffickers-undercover-
7 Amelia Gentleman, “Poor Donors Duped by Tourism.htm. ethnography-in-the-organs-trafficking-under
20 Gary S. Becker and Julio Jorge Elías, “In- world/147/.
Organ-Transplant Racket in India,” The New York
troducing Incentives in the Market for Live and 33 Carney, op. cit., p. 9.
Times, Jan. 9, 2008, www.nytimes.com/2008/01/
Cadaveric Organ Donations,” presented at the 34 Critics have pointed out that a few years
29/world/asia/29iht-kidney.3.9573650.html.
8 Carney, op. cit., pp. 69-70. Note: Names conference, “Organ Transplantation: Economic, after Titmuss’ book came out, new tests were
have been changed in Carney’s book to pro- Ethical and Policy Issues,” University of Chica- introduced for hepatitis C, hepatitis B and
tect the privacy of interviewees. go, May 16, 2003. An earlier version was pre- later HIV, and transfusion-related diseases
9 See Robert C. Moellering Jr., “NDM-1: A sented in 2002, http://home.uchicago.edu/ plummeted. See Sally Satel, When Altruism
Cause for Worldwide Concern,” The New Eng- gbecker/MarketforLiveandCadavericOrganDo Isn’t Enough (2008), p. 103.
nations_Becker_Elias.pdf. 35 Ibid., p. 131.
land Journal of Medicine, Dec. 16, 2010, www.
21 Arthur J. Matas and Mark Schnitzler, “Pay- 36 Ibid.
nejm.org/doi/full/10.1056/NEJMp1011715.
10 Anne-Maree Farrell, et al., Organ Short- ment for Living Donor (Vendor) Kidneys,” Amer- 37 Ibid., p. 114.

ican Journal of Transplantation, Feb. 25, 2004, 38 Ibid., p. 135. Also see http://history.nih.gov/
age: Ethics, Law and Pragmatism (2011), pp.
195, 229. www.medscape.com/viewarticle/468104_1. research/downloads/PL98-507.pdf.
11 Council of Europe/United Nations, op. cit. 22 Council of Europe/United Nations, op. cit. 39 Carney, op. cit., pp. 13-14.
12 Shimazono, op. cit. Also see Ghods and Savaj, op. cit. 40 Farrell, op. cit., p. 29.
13 “Resurgence of Pakistan’s Organ Bazaar. 23 Carney, op. cit., pp. 81-82. 41 Ibid., p. 118.
24 Nancy Scheper-Hughes, “A World Cut in 42 For recent state laws see, www.kidney.
Can You Still Deny? Continued Violation of
Transplant Law in Pakistan,” Sindh Institute of Two,” British Medical Journal, June 21, 2008, org/transplantation/livingdonors/pdf/LDTax
Urology and Transplantation, April 29, 2011, www.bmj.com/content/336/7657/1342.full/reply Ded_Leave.pdf.
#bmj_el_197479. 43 Satel, op. cit., p. 140.
www.siut.org/news-events/news/resurgence-
25 Council of Europe/United Nations, op. cit. 44 Farrell, op. cit., p. 211.
of-pakistan.
14 Ibid. Also see Institute of Medicine, “Organ Do- 45 Ibid., p. 229.
15 Asif Chaudhry, “Probe into illegal kidney nation: Opportunities for Action,” May 2006, 46 See Monica Navarro-Michel, “Institutional

transplants Surgeons made $1m from 40 clients,” www.iom.edu/Reports/2006/Organ-Donation- Organisation and Transplanting the ‘Spanish
Dawn, July 7, 2011, www.dawn.com/2011/07/ Opportunities-for-Action.aspx. Model,’ ” in ibid., pp. 151-170. Presumed con-
26 Ghods and Savaj, op. cit. sent legislation can be found in countries
07/probe-into-illegal-kidney-transplants-surgeons-
27 Council of Europe/United Nations, op. cit. with some of the highest rates of deceased-organ
made-1m-from-40-clients.html.
16 Ahad J. Ghods and Shekoufeh Savaj, “Iran- 28 Carney, op. cit., p. 65. donation (Spain, Portugal, Belgium, France) and
29 Farhat Moazam, et al., “Conversations with some of the lowest (Bulgaria, Greece, Lithuania).
ian Model of Paid and Regulated Living-Un-
Kidney Vendors in Pakistan: An Ethnographic 47 Farrell, op cit., pp. 238-239. The Directive
related Kidney Donation,” Clinical Journal of
the American Society of Nephrology, Novem- Study,” Hastings Center Report, May-June 2009, establishes minimum guidelines but does not
ber 2006, pp. 1136-1145, http://cjasn.asn pp. 29-44, www.thehastingscenter.org/Publica affect EU countries’ existing national laws on
journals.org/content/1/6/1136.full. Also see tions/HCR/Detail.aspx?id=3472. the donation or medical use of organs.
30 Chaudhry, op. cit. 48 Ibid., p. 236.
Mantel, op. cit.
17 Ted Alcorn, “China’s Organ Transplant Sys- 31 David Matas, “Anti-rejection Drug Trials and 49 Ibid., p. 238.

Sales in China,” speech at the Doctors Against 50 Ibid., pp. 240-243.


tem in Transition,” Lancet, June 4, 2011, pp.
Forced Organ Harvesting Forum, May 1, 2011, 51 Ibid., p. 234.
1905-1906, www.thelancet.com/journals/lancet/
Philadelphia, Penn., www.dafoh.org/Matas_ 52 See David Price, “Promoting Organ Do-
article/PIIS0140-6736(11)60794-0/fulltext?ver
sion=printerFriendly. speech.php. nation: Challenges for the Future,” in ibid.,
18 Carney, op. cit., p. 142. 32 Diflo quotes from a discussion session at p. 256.
19 See “Asian Countries amongst Favorites for a New York Academy of Sciences Anthro- 53 Ibid., pp. 256-7.

pology Session, “Trafficking the Traffickers,” 54 Ibid., pp. 257-258.


Medical Tourism,” press release, RNCOS,
Oct. 6, 2008, www.thirteen.org/forum/topics/ 55 Ibid.
April 21, 2011, www.rncos.com/Press_Releases/
56 Ghods and Savaj, op. cit.
57 Ibid., p. 55. Also see Madhav Goyal, et al.,

About the Author “Economic and Health Consequences of Selling


a Kidney in India,” Journal of the American
Sarah Glazer, a London-based freelancer, is a regular con- Medical Association, 2002, pp. 1589-1592.
58 Debra Budiani-Saberi and Amr Mostafa,
tributor to CQ Global Researcher. Her articles on health,
education and social-policy issues also have appeared in “Care for Commercial Living Donors: the ex-
The New York Times and The Washington Post. Her recent perience of an NGO’s outreach in Egypt,”
CQ Global Researcher reports include “Radical Islam in Eu- Transplant International, 2010, pp. 1-7, http://on
linelibrary.wiley.com/doi/10.1111/j.1432-2277.
rope” and “Social Welfare in Europe.” She graduated from
2010.01189.x/pdf. For background, see Karen
the University of Chicago with a B.A. in American history.
Foerstal, “Crisis in Darfur,” CQ Global Researcher,

362 CQ Global Researcher


Sept. 1, 2008, pp. 243-270.
59 Moazam, et al., op. cit., pp. 33-34.
60 Budiani-Saberi and Mostafa, op. cit., pp. 3, 4. FOR MORE INFORMATION
61 Satel, op. cit., pp. 50-51. Also see www.de
Centre for Biomedical Ethics, National University of Singapore, Clinical Research
clarationofistanbul.com and Budiani-Saberi and
Centre, Block MD11, #02-0110 Medical Drive, Singapore 117597; (65) 6516 7201;
Mostafa, op. cit. http://cbme.nus.edu.sg. Academic center that tracks organ trafficking and legislation
62 Budiani-Saberi and Mostafa, op. cit.
to curb it.
63 For background, see Roland Flamini, “Tur-

moil in the Arab World,” CQ Global Researcher, Coalition for Organ-Failure Solutions, 5 Sakr Kouraish, Apt. 1, Zone 7, Nasr City,
May 3, 2011, pp. 209-236. Cairo, Egypt; U.S. phone: (330) 701-8399; www.cofs.org. Nonprofit international
64 “Resurgence of Pakistan’s Organ Bazaar. health and human rights organization dedicated to combating organ trafficking.
Can You Still Deny? Continued Violation of
Transplant Law in Pakistan,” op. cit. Also see Declaration of Istanbul on Organ Trafficking and Transplant Tourism;
Chaudhry, op. cit. www.declarationofistanbul.org. A website providing up-to-date news about organ
65 “Ending Abuse of Organ Transplantation in trafficking hosted by signers of the 2008 Declaration of Istanbul, a proclamation
issued by transplant specialists condemning organ selling.
China,” China Uncensored, Aug. 20, 2010, www.
chinauncensored.com/index.php?option=com_ Doctors Against Forced Organ Harvesting, P.O. Box 58123, Washington, DC,
content&view=article&id=249:ending-abuse-of- 20037; (202) 510-3894; www.dafoh.org. International group of doctors campaign-
organ-transplantation-in-china&catid=36:organ- ing to end China’s use of prisoners for organ harvesting.
harvesting-in-china&Itemid=79.
66 “Kidney Racket Case,” indianexpress.com,
Falun Dafa Information Center, P.O. Box 577, New York, NY 10956-9998;
June 8, 2011, www.indianexpress.com/news/ (845) 418-4870; www.faluninfo.net. Organization provides information about the
kidney-racket-case-cbi-wants-modification-in- persecution of Falun Gong practitioners in China, including deaths from organ
hc-order/800842. harvesting.
67 Gentleman, op. cit.
68 “Court Grants Bail to Accused Police In- Global Observatory on Donation and Harvesting, www.transplant-observatory.
org/pages/home.aspx. Hosted by the World Health Organization and the Spanish
spector,” Hindustan Times, Sept. 23, 2008, www.
National Transplant Organization (www.ont.es); tracks news and data on organ
hindustantimes.com/special-news-report/News- trafficking and transplantation activities worldwide.
Feed/Court-grants-bail-to-accused-police-inspec
tor/Article1-339821.aspx. The Hastings Center, 21 Malcolm Gordon Road, Garrison, NY 10524-4125; (845)
69 “Two-Track Investigation of Political Cor-
424-4040; www.thehastingscenter.org. Bioethics center that has published reports
ruption and International Money Laundering and articles about the ethics of organ donation.
Rings Nets 44 Individuals,” Press Release, U.S.
Attorney, District of New Jersey, July 23, 2009, Laogai Research Foundation, 1734 20th St., N.W., Washington, DC 20009; (202)
www.fbi.gov/newark/press-releases/2009/nk07 408-8300; Founded by Harry Wu, a survivor of the Chinese slave-labor camps
2309.htm. Also see USA v. Levy Izhak Rosen- known as laogai; provides information about the camps and other Chinese
human rights abuses including organ harvesting from executed prisoners.
baum, Criminal Complaint Mag No. 09-3620,
U.S. District Court, District of New Jersey.
70 “Turkish doctor suspected of human organ
Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi 74200,
Pakistan; (92-21) 9215752 & 9215718; www.siut.org. Provides transplants and med-
trafficking arrested,” CNN, Jan. 12, 2011, http:// ical care for low-income patients; monitors Pakistan’s resurgent organ trade.
premium.edition.cnn.com/2011/WORLD/europe/
01/12/kosovo.organs/index.html?iref=topnews. The Transplantation Society, International Headquarters, 1255 University St.,
Also see “Trafficking Investigations Put Surgeon Suite 605, Montreal, QC, Canada H3B 3V9; (515) 874-1717; www.tts.org. Interna-
in Spotlight,” The New York Times, Feb. 11, 2011, tional group of transplant physicians and specialists.
www.nytimes.com/2011/02/11/world/europe/
11organ.html?pagewanted=1&_r=2&emc=eta1. World Health Organization, Clinical Procedures, CPR/EHT/HSS, Essential Health
71 “Organ Donors Could Be Rewarded Under Technologies, Avenue Appia 20, 1211 Geneva 27, Switzerland; 41 22 791 21 11;
www.who.int/transplantation/en/. Web site of the WHO unit responsible for pro-
Plans to Boost Registration,” The Times, April 20,
moting ethical donation and transplantation.
2010, www.timesonline.co.uk/tol/life_and_style/
health/article7102299.ece. Also see www.nuffield
bioethics.org/human-bodies. http://deepblue.lib.umich.edu/bitstream/2027. 75 Michelle Roberts, “Surgeons Carry out First
72 Satel, op. cit., p. 153. 42/74730/1/j.1600-6143.2009.02741.x.pdf. Synthetic Windpipe Transplant,” BBC News,
73 J. R. Rodrigue, et al., “Stimulus for Organ 74 “China Considers Financial Incentives to
July 7, 2011, www.bbc.co.uk/news/health-140
Donation: A Survey of the American Society of Promote Organ Donation,” Reuters, April 25, 47670.
Transplant Surgeons Membership,” American 2011, www.reuters.com/article/2011/04/25/us- 76 Ibid.
Journal of Transplantation, 2009, pp. 2172-2176, china-organs-idUSTRE73O1HX20110425. 77 Farrell, op. cit., p. 22.

www.globalresearcher.com July 19, 2011 363


Bibliography
Selected Sources

Books Interlandi, Jeneen, “Not Just Urban Legend,” Newsweek,


Jan. 10, 2009, www.newsweek.com/2009/01/09/not-just-
Carney, Scott, The Red Market: On the Trail of the World’s urban-legend.html.
Organ Brokers, Bone Thieves, Blood Farmers and Child A reporter describes the organ trafficking investigations of
Traffickers, William Morrow, 2011. anthropologist Nancy Scheper-Hughes.
An investigative journalist spent five years tracing the routes
of illegal organs and other body parts from the original sellers Moazam, Farhat, et al., “Conversations with Kidney Vendors
through brokers to recipients. in Pakistan: An Ethnographic Study,” Hastings Center Report,
May-June 2009, www.thehastingscenter.org/Publications/
Farrell, Anne-Maree, David Price and Muireann Quigley, HCR/Detail.aspx?id=3472.
Organ Shortage: Ethics, Law and Pragmatism, Cambridge The chair of the Centre of Biomedical Ethics and Culture
University Press, 2011. in Karachi and her team interviewed 32 Pakistani laborers
Academics from Britain and elsewhere discuss financial in- who sold a kidney to pay off debts to their landlords.
centives for organ donation and the donation experience in
the United Kingdom, European Union and United States. Shimazono, Yosuke, “The State of the International Organ
Trade: A Provisional Picture Based on Integration of
Matas, David and David Kilgour, Bloody Harvest, Seraphim Available Information,” Bulletin of the World Health Or-
Editions, 2010. ganization, December 2007, pp. 901-980, www.who.int/
Two Canadian lawyer/human rights activists were nomi- bulletin/volumes/85/12/06-039370/en/#.
nated for a Nobel Prize for this investigation concluding that Based on an analysis of more than 300 articles and re-
thousands of Falun Gong practitioners in China have been ports, the article concludes that, conservatively, about 5 per-
killed for their organs. cent of all organ transplants worldwide in 2005 involved
black market transactions. The World Health Organization
Satel, Sally, When Altruism Isn’t Enough: The Case for used the article as the basis of its estimate that 5-10 percent
Compensating Kidney Donors, AEI Press, 2008. of transplants each year involve illegal sales.
Experts argue for legalizing payments to organ donors to
increase supply. The book is based on a conference spon- Smith, Michael, “Kidneys at Hub of Deadly ‘Transplant
sored by the conservative American Enterprise Institute. Tourism,’ ” The News Tribune, May 15, 2011, www.thenews
tribune.com/2011/05/15/1665819/kidneys-at-hub-of-deadly-
Articles transplant.html.
A Bloomberg News reporter describes the illicit market for
Alcorn, Ted, “China’s Organ Transplant System in Transition,” organ transplants in Nicaragua and around the world stimulated
Lancet, June 4, 2011, pp. 1905-1906. by the growing “transplant tourism” business.
Alcorn describes China’s still-paltry efforts to adopt a voluntary
organ-donation system and crack down on transplant tourism. Reports and Studies
Gu, Bo, “Chinese man wakes up — minus his kidney,” “Resurgence of Pakistan’s Organ Bazaar. Can You Still
March 31, 2011,MSNBC, http://behindthewall.msnbc.msn. Deny? Continued Violation of Transplant Law in Pakistan,”
com/_news/2011/03/31/6382271-chinese-man-wakes-up- Sindh Institute of Urology and Transplantation, April 29,
minus-his-kidney. 2011, www.siut.org/media-siut/data-files/resurgence-of-
Twenty-six-year-old Hu Jie, who changed his mind about pakistan-organ-trade.pdf.
selling a kidney, describes how his kidney was forcibly re- A Karachi medical center reports a resurgence of Pakistan’s
moved by a broker’s henchmen, a widely publicized story illegal organ trade since a law criminalizing organ selling took
signaling a renewed black market in China. effect in 2007.

Gutmann, Ethan, “China’s Gruesome Organ Harvest,” The “Trafficking in Organs, Tissues and Cells and Trafficking in
Weekly Standard, Nov. 24, 2008, www.weeklystandard. Human Beings for the Purpose of the Removal of Organs,”
com/Content/Public/Articles/000/000/015/824qbcjr.asp. Council of Europe/United Nations, 2009, www.coe.int/t/dghl/
An investigative journalist and fellow at the Foundation for monitoring/trafficking/docs/news/OrganTrafficking_study.
Defense of Democracies, an advocacy group in Washington, pdf.
describes large-scale organ harvesting from Falun Gong pris- A WHO estimate that 5-10 percent of annual worldwide
oners while still alive, confirmed by his interviews with es- kidney transplants involve trafficking is conservative, according
capees from Chinese labor camps. to this comprehensive report.

364 CQ Global Researcher


The Next Step:
Additional Articles from Current Periodicals
Black Market Smith, Lewis, “Sale of Human Organs Should Be Legalised,
Say Surgeons,” The Independent (England), Jan. 5, 2011,
Bryant, Lisa, “EU May Investigate Kosovo PM for Organ www.independent.co.uk/life-style/health-and-families/health-
Trafficking,” Voice of America, Dec. 15, 2010, www.voa news/sale-of-human-organs-should-be-legalised-say-surgeons-
news.com/english/news/europe/EU-May-Investigate-Kosovo- 2176110.html.
PM-for-Organ-Trafficking-111952224.html. Many leading British surgeons are calling for the legaliza-
The European Union plans to investigate allegations that Koso- tion of organ sales in order to meet growing demand.
vo’s prime minister has sold human organs on the black market.
Widhiarto, Hasyim, “When Disease Creates Demand,”
Ogilvie, Jessica Pauline, “A Kidney Market At What Cost?” Jakarta (Indonesia) Post, Oct. 25, 2010, www.thejakarta
Los Angeles Times, March 28, 2011, p. E1, articles.latimes. post.com/news/2010/10/25/when-disease-creates-demand.
com. html.
The unregulated, underground market for human organs An estimated 80,000 people in Indonesia are waiting for
in developing countries has had catastrophic effects for both kidney transplants, leading many to wonder whether illegal
donors and recipients. organ trafficking is occurring in the country.

Simon, Alina, “New Law to Plug Black Market for Organs,” Laws and Regulations
New Straits Times (Malaysia), Oct. 5, 2010, www.nst.com.
my/nst/articles/14tissue/Article/. “Relaxed Rules May Lead to More Organ Donations,”
The Malaysian Health Ministry is drafting a new law in- Yomiuri Shimbun (Japan), Aug. 11, 2010, www.yomiuri.
tended to ensure that organ and tissue transplantation is co.jp/dy/national/T100810004970.htm.
conducted without turning to the black market. The relaxation of requirements for organ donations would
raise the number of annual donors in Japan for the foresee-
China able future, according to the Japan Society for Transplantation.

“China to Launch Crackdown in Illegal Organ Transplants,” Rahn, Kim, “NK Defector in Legal Dispute Over Organ
Xinhua (China), April 18, 2011, news.xinhuanet.com/ Transplantation,” Korea Times (South Korea), May 23, 2011,
english2010/china/2011-04/19/c_13834757.htm. www.koreatimes.co.kr/www/news/nation/2011/05/113_87
The Chinese Ministry of Health is launching a nationwide 535.html.
campaign to target illegal organ transplants performed by A South Korean law designed to prevent organ trafficking
unqualified medical institutions. is preventing a North Korean defector from receiving a trans-
plant, even though he has found a donor.
Kamm, John, “Is Mercy Coming to China?” The Washing-
ton Post, Aug. 16, 2010, p. A13, www.washingtonpost.com/
wp-dyn/content/article/2010/08/15/AR2010081502150.html. CITING CQ GLOBAL RESEARCHER
The executive director of the Dui Hua Foundation, a San Sample formats for citing these reports in a bibliography
Francisco-based human rights group, says capital punishment
has reached astonishing levels in China largely to harvest or- include the ones listed below. Preferred styles and formats
gans from executed prisoners. vary, so please check with your instructor or professor.

Varma, K.J.M., “China to Amend Organ Transplant Rules to MLA STYLE


Encourage Donations,” Press Trust of India, Jan. 10, 2011. Flamini, Roland. “Nuclear Proliferation.” CQ Global Re-
China is set to amend its organ transplant regulations to searcher 1 Apr. 2007: 1-24.
build a national donation system that relies less on obtaining
organs from executed prisoners. APA STYLE
Flamini, R. (2007, April 1). Nuclear proliferation. CQ Global
Demand
Researcher, 1, 1-24.
Callahan, Maureen, “Invasion of the Body Snatchers,”
CHICAGO STYLE
The New York Post, June 12, 2011, p. 28, m.nypost.com.
The growing demand for organs such as kidneys has led Flamini, Roland. “Nuclear Proliferation.” CQ Global Researcher,
to profitable trading rings in the United States, Brazil, Egypt, April 1, 2007, 1-24.
Israel, Japan and South Africa.

www.globalresearcher.com July 19, 2011 365


Voices From Abroad:
KANCHHA BUDHATHOKI JOSE OLIVEROS ISMAIL MERICAN of money. Although it might
be voluntary, they are not aware
Garment factory worker Catholic Bishop, Philippines Health Director-General of the health risks. What’s
Nepal Malaysia more, the illegal organ trade is
Preserving dignity harmful to society as a whole.”
Misled “Human organ sale or Related donors only
trade, by its very nature, is Chinadaily.com.cn, February
“He [a fellow worker] said “If living donation is to be
morally unacceptable. It is 2011
he would find me a good carried out, it should come
job in India. When we reached contrary to the dignity of the from genetically, legally or emo-
New Delhi, we went to a human person, his or her tionally related donors. . . . Un- DENG LIQIANG
authentic autonomy and the
hospital and they tested my
essential equality of all per-
related donation is not a pre- Legal Affairs Director,
blood. Another day they gave ferred solution to increase the
me alcohol then they gave sons. The dignity of the donor pool.”
Chinese Medical Doctor
me an injection. I became un- human person as the image Association, China
of God includes not only his New Straits Times (Malaysia)
conscious and when I woke
or her soul but his or her November 2010 Illuminated
up I was in hospital and they
had already taken one of my corporeal being. Hence, our circumstances
kidneys.” body ought not to be treat- LIU RENWEN “The scarcity of available
ed as a commodity or ob- human organs is a global
Nepali Times, June 2011 ject of commerce, which
Law Researcher, Chinese
phenomenon. It is just more
would amount to the dis- Academy of Social Sciences obvious in China because of
JOHN KAMM possession or plundering of China the number of illegal organ
the human body.” trades due to poverty.”
Executive Director, Dui
Philippines News agency Harmful to society
Hua Foundation, China “Some poor people sell their
Anchorage (Alaska) Daily
July 2010 News, February 2011
own organs for a small amount
Not just a deterrent
“While many have thought H J
UANG IEFU
the death penalty is invoked Vice Health Minister
to deter crime, there is an-
other reason capital punish- China
ment reached such astonish-
ing levels in China. For years Transplants and ethics
organs were harvested from “With the amendment,
executed prisoners.” China will be a step clos-
er to building up a national
News Journal (Delaware) organ donation system,
August 2010 which is being run as a
pilot project in 11 provinces
L R
ALITHA AGHURAM and regions now and thus
Director, Multi Organ ensure the sustainable and
healthy development of
Harvesting Aid Network organ transplants and save
India more lives. An ethically
proper source of organs for
CagleCartoons.com/Ares

Only in times of need China’s transplants that is


“Ninety-nine percent of us sustainable and healthy
will accept an organ transplant would benefit more pa-
if we need one to live, but tients.”
not even one of every 10 of Press Trust of India, January
us are signed up to donate.” 2011
India Today, August 2010