Organ Trade: I Buy Kidneys, Pay Cash!

According to Jewish chronology, the first organ transplant took place in paradise in the middle of October, 3761 BC. Yahweh removed a rib from Adam in order to make him a wife. For the next 5,644 years, nothing much happened. Then, in AD 1883, Theodor Kocher from Bern transplanted human thyroid tissue under a young man’s skin and into his abdominal cavity. 71 years later, in 1954, the first successful kidney transplant took place, in America. The donor was the recipient’s identical twin. In 1967, Christiaan Barnard suddenly became world famous after carrying out the first human heart transplant. The recipient may well have only survived for 18 days, but the heart transplant business started to boom: between December 1967 and September 1970, 164 hearts were transplanted (albeit with only 20 recipients surviving up to that date). Even so, 88,023 heart transplants worldwide have been recorded up to June 201. Taking the statistics up to the present day, we can estimate that around 95,000 hearts have been transplanted from brain dead bodies into the critically ill, who gain an average ten extra years of life.1

Every organ has its price. China executes condemned prisoners when their organs are needed.

These days, the real action isn’t in hearts, but kidneys: up to 2012, more than half a million kidneys had been transplanted worldwide. No surprise, then, that according to the American news network CNN the organ trade is the second most profitable globally – behind weapons but ahead of drugs. The market is driven by the scarcity of donor organs, ,and the profit margins are huge. In summer 2012,2Der Spiegel news magazine reported the case of a German industrialist who paid €82,000 for an illegal kidney transplant in Kosovo. The donor, a Russian emigrant to Israel named Vera, received just €8,100 for her kidney. If she could have her time over again, she would never agree to the unfair exchange: the pain in her remaining kidney being like “agonising toothache” – even four years after the operation. Most of the time, she felt as weak as a kitten; hospital aftercare had been too expensive for her. The paltry €8,100 she received for her kidney was gone in three months. And she’s not alone: according to Der Spiegel, nearly all organ donors reported that “their health significantly worsened after the risky deal”. The man who received Vera’s kidney has now, four years afterwards, developed skin cancer.

Around 66,000 people worldwide receive a new kidney each year. More than 20,000 get a new liver, and around 5,300 receive a new heart. The WHO estimates that an additional 10% of illegal organ transplants take place each year, probably an underestimate given that the UN reckons that at least 10,000 illegal kidney transplants take place annually. Some researchers estimate the true figure to be nearer to 20,000.3
Many more parts of the human body can be transplanted than just the kidneys, including the pancreas, lungs, cornea, femur and small intestine. All kinds of tissues can be taken too (heart valves, blood vessels, bones and tendons), as well as stem cells, limbs (hands, for example), and even the face. Right now, experiments are being carried out on animals to transplant wombs.

Organs Through Execution

Now, let’s presume that those involved are motivated on the one hand by the desire to help, and the desire to live at all costs on the other (especially those who can afford ‘all costs’). In the case of a kidney, that would amount to $115,000 for a new, illegally procured organ. A heart, lung, or liver would cost more: currently around $225,000, including travel and lodging, and the cost of the operation itself. A worldwide network of illegal organ trading connects poor donor countries such as India, Pakistan, Brazil, the Philippines, Moldova, Romania, or Ukraine to wealthy recipients in the Middle East, as well as China and India. Lesser demand exists in North America and Europe, where most people are wary of travelling abroad to have an organ from a completely different culture implanted. This global trade has at times an almost Franken­­­­steinian face: when you discover, for example, that 65% of all Chinese organs come from executed prisoners who are put to death when organ recipients arrive in the country.4

The Salzburger Nachrichten (an Austrian broadsheet) reported on January 10th 2000 the story of the American surgeon Dr David Rothman, who was invited to attend a heart transplant operation in China. When he asked whether or not a donor heart was likely to be available on the date set for the operation, he was told that a suitable execution would be organised. In the Middle Kingdom, death sentences can be passed for trifling offences, all in aid of increasing the number of bodies from which organs can be ‘harvested’. So-called ‘death vans’ drive from prison to prison, with the condemned prisoners inside being killed and their organs removed to the accompaniment of gentle background music. High-level Chinese officials admit that prisons are used as human spare parts depots, which the authorities can resort to as and when necessary.

China is also home to practitioners of Falun Gong. Officially, they are classified as members of a sect, but are in reality nothing of the sort. These are people who “eat healthily, meditate, and are persecuted in the most brutal manner by the Chinese state”, according to Wolfgang Weirauch writing in the Flensburger Hefte. “In 1999 they had 17 million members, one million more than the Chinese Communist Party, and since then they have faced massive state persecution. Huge numbers of these people are used to supply organs. They are imprisoned and treated almost like caged animals; used as living stores of organs and tissue as the need arises. They are killed in their thousands, because their organs are big business.”

More than 3,500 Falun Gong adherents are recorded as having died, with the number imprisoned estimated to be many times that. In 2006, Canadian human rights lawyer David Matas, along with fellow Canadian (former MP and Secretary of State, Asia-Pacific) David Kilgour, brought out a 50-page “Report into Allegations of Organ Harvesting of Falun Gong Practitioners in China”. According to their information, if organs were needed prisoners would have theirs removed whilst they were still alive. They were ideal donors: they were generally young and didn’t smoke or drink. The bodies were subsequently incinerated to destroy the evidence.

An equally horrifying state of affairs was uncovered on the Sinai Peninsula by CNN. Members of the Sawarka tribe waylay refugees fleeing Ethiopia, Eritrea, or Sudan for Israel, capturing them just before they reach the border and demanding a $2,000 toll before letting them proceed. Most of those taken hostage had already given everything they had to people smugglers at the start of the journey. No problem: the Bedouin are happy to accept another form of payment, namely a pound of flesh in the form of kidneys, livers, and other organs. Doctors from Cairo appear as if from nowhere, operate on the refugees, and take the removed organs back to Cairo (or elsewhere) in refrigerated vehicles. Most of the victims are simply patched up and left in the desert, where they die miserable deaths. For each organ, the tribe receives between $1,000 and $20,000. Police forces responsible for northern Sinai told CNN that the organ trade on the Israeli border existed, but claimed to have no idea who controlled it, and to be powerless to put a stop to the evil.

Organs Through Violence

Israel occupies a special role in the international organ trade: in no other country is the organ donation rate so low and demand so high. Nancy Scheper-Hughes is Professor of Medical Anthropology at the University of California, Berkeley, and founder of medical human rights project Organs Watch. She places Israel “at the forefront” of the world organ trade. “Its tentacles reach across the world.” Israeli organ dealers are the best organised, with brokers, bank accounts, recruiters, translators, and travel agencies which take care of visas. The academic tried to discover the motivation driving the Israeli organ traders. “For one thing, there’s greed,” she says. The other motivation is rather more disconcerting: “Revenge, reparations – compensation for the Holocaust.” She describes a conversation she had with an Israeli dealer who explained to her that it was a case of “sort of an eye for an eye, tooth for a tooth. We’re after every single liver and kidney and every heart that we can get our hands on. The world owes us.” Israeli doctors also expressed similar sentiments.

For many years, the Israeli government has supported the “transplant tourism” of its citizens abroad with contributions of $80,000. A large portion of the remaining costs can often be recovered from state-subsidised health insurance. The Israeli Defence Ministry was also directly involved in the affair. Scheper-Hughes uncovered an international syndicate. Connected via a local business to a leading transplant surgeon working out of a medical centre not far from Tel Aviv, the syndicate maintained business relations with transplant surgeons in Turkey, Russia, Moldova, Estonia, Georgia, Romania and New York.

A BBC report from 2001 revealed that: “Hundreds of Israelis have set up a production line that begins in the villages of Moldova, where the men now go around with only one kidney.” In Brazil, a parliamentary commission discovered that at least 30 (possibly as many as 60) Brazilians from deprived areas had sold their kidneys to an organ-buying ring controlled by Israelis. Almost all the organs were delivered to Israeli citizens and the Israeli government shouldered most of the costs. The syndicate had already made inquiries into other organs from poor Brazilians – lungs, livers and corneas.

The Israeli newspaper Haaretz re­­ported in 2007 that two Israelis had admitted to convincing mentally disturbed or retarded Palestinians to sell one of their kidneys for cash. According to Haaretz, the Israelis never handed over the money after taking the kidneys; it was also not uncommon for coercion to be used.

Rabbi Levy Izhak Rosenbaum, an organ dealer from Brooklyn in New York, was reportedly in possession of a rifle when arrested by the FBI in July 2009 in New Jersey. If it looked like a potential organ donor was trying to back out, Rosenbaum would mime a shot to their head with his finger. He belonged to a ring of dealers consisting of rabbis, politicians and public servants, which for years had illegally traded organs and laundered money. Rosenbaum testified to buying organs from the poor for around $10,000, then selling them on to desperate patients in America for $160,000. The legal waiting list for a kidney lasts nine years – too long for the seriously ill.

Der Spiegel also reported the use of coercion in the procurement of organs. “We have also identified cases of victims being forcibly restrained. It went so far that they [the organ donors, Ed.] were held prisoner until the operation took place”, reported EULEX Special Prosecutor Jonathan Ratel. “After the operations, the sums promised often never materialised, and human beings were simply discarded.” Yet the purchase and sale of organs is subject to a worldwide ban – they may only be freely donated!