TRANSPLANT TOURISM

Wealthy Westerners who don't want to wait for an organ donor are travelling to poorer countries to find the organ they need.

Every day, 17 Americans die of organ failure. In Canada, a patient can wait seven years for an organ transplant. In Israel, the average wait for a kidney transplant is four years.

As a result, many are travelling to countries like the Philippines where they can buy a kidney and have the transplant done in a modern hospital. These people are called "transplant tourists".

The illegal trade in organs is growing.

For some time the practice of luring poor people with money to sell their organs, especially kidneys, has been associated with India along with other Asian countries and Brazil.

But no more.

Egypt is a regional hub for the human organs trade. Wonder why? There are no official statistics, but this is a country where social inequality is high and a quarter of the population is believed to live under the poverty line.

The "liberation" of Iraq has opened a new market. With unemployment in Iraq at about 60 per cent, the chance to earn money by touting body parts is a more calculated risk than, say, becoming a $150-a-month rookie policeman at the mercy of suicide attackers.

While most donors who sell their organs are poor and hoping (against hope) for a better life, authorities think that not all are volunteers but are merely victims of an elaborate extortion rings that capture and forcefully remove organs which they sell to wealthy buyers.

And even considering the sacrifice, most of those who willingly sell their organs get paid peanuts while the doctors and brokers get the lion share.

Bill Berkowitz takes a look at what is the hell is going on.

The following piece appeared originally at Inter Press Service.

"Transplant Tourism" Flourishes in Developing World
Bill Berkowitz, Inter Press Service

OAKLAND, California, Apr 27 (IPS) - While stories about the illegal trade in body parts -- often obtained by traffickers for measly sums paid to the donor or for nothing at all -- may seem better suited for the big screen, episodic television or science fiction novels, they are occurring in the real world with disturbing frequency.

Nancy Scheper-Hughes, a professor of medical anthropology at the University of California, Berkeley, knows this all too well. She is the co-founder and director of Organs Watch, a project that originated in widespread rumours of body snatching and organ theft in the urban shantytowns of Brazil in the mid-1980s.

In a new essay published in the March/April 2006 edition of the Nacla Report on the Americas, titled "Biopiracy and the Global Quest for Human Organs", Scheper-Hughes says that, "U.S. or Japanese medical agents working for large hospitals abroad... abducted bodies", harvested the parts they wanted, especially eyes, kidneys, hearts, and livers, and then unceremoniously dumped the remains "on the sides of country roads or in hospital dumpsters".

Although medical professionals denied this was happening, in 1997 Scheper-Hughes began following the trail of rumours about the grim trade. Over the years, she has traveled to 12 countries and visited more than 50 scenes of illicit organs and tissues procurement.

Legislation has been passed in several countries to crack down on the trade in body parts, but Scheper-Hughes told IPS that "things are still quite unstable".

"China is preparing a new law making transplant tourism illegal. There will be no payment for organs and no foreign transplant patients," she said.

"It's too early to say whether it will stick or give rise to a shadow transplant economy. A new law was passed in Israel, making it illegal for Israeli transplant patients to be reimbursed by their national health insurance carriers for illegal transplants."

"Despite all this legislative activity, transplant tourism grows stealthily on the margins, as patients are 'voting with their legs' to solve their problems. Eventually, I see paid kidney donors becoming routine and eventually legal so that the trade will occur nationally rather than transnationally. That would be a sad outcome, but perhaps it is inevitable now that the cat is out of the bag," she concluded.

One of her more shocking realisations was that the underground body parts industry had gone from being something that "evoked shock and revulsion bordering on nausea" to becoming a "fait accompli -- an accepted medical fact defended on pragmatic grounds".

As a member of the panel on Ethics, Access and Safety in Tissue and Organ Transplant at a 2003 World Heath Organisation meeting, Scheper-Hughes witnessed an official from a private eye bank "defend the 'necessary' commercialisation of tissue banks in the developing world".

Without government support for "subsidised tissue banking", the argument went, poor countries had to resort to international trading/selling of body parts that were not being used locally and that could be transported through informal agreements to the developed world, where they are in great demand for orthopedic and other high-tech surgeries.

And, in what on the face of it appears to be a win-win situation, "In exchange, the poor donor-institutions could receive a steady supply of scarce corneas."

Organs Watch discovered a "large, unregulated, multi-million-dollar business in human tissues, taken without consent or procured from the naïve family members of brain-dead donors who believe their 'gifts' would be used altruistically to save lives and reduce human suffering".

Instead, these "gifts" were turned into commodities that were bought and sold, processed and transported, picking up additional value as they moved toward the market. Organs Watch found that bone and skin grafts were sold and processed by private biotech firms in the U.S. and turned into expensive commercial products for dentists, orthopedics and plastic surgery.

In South Africa, official documentation revealed that "human heart valves [had been] taken without consent from the bodies of poor blacks in the local police mortuary and shipped for 'handling costs' to medical centres in Germany and Austria", the group says.

In 2002, Scheper-Hughes apprised the South African Ministry of Health of a scheme originating at a national tissue bank that involved "the transfer of hundreds of Achilles tendons that were removed without consent from the bodies of the victims of township violence and shipped by the director of the tissues bank to a corrupt U.S. businessman who paid 200 dollars for each tendon".

Shipped to the U.S. via South Korea, they were ultimately repackaged and sold locally and abroad to private medical and biotech firms for 1,200 dollars each.

As is most often the case, everyone, except the poor people from whom these tendons came, benefited handsomely from the deal.

The rise in "illegal transplant tourism" -- a term coined by Scheper-Hughes -- was "developed to meet an insatiable demand for organ transplants that rises exponentially against a flat supply of organs donated through traditional and regulated means," she writes in the essay.

While donations have remained flat -- increasing only 33 percent over the past decade or so -- the number of patients on national waiting lists has increased by 236 percent.

With the increased need, poor people are recruited or entrapped into donating their body parts to satisfy the demand from rich patients who can afford to travel abroad and, Scheper-Hughes says, to break national laws and international medical regulations to get the organs and medical procedures they need.

Scheper-Hughes told IPS that she continues to be very active with Organs Watch, and is currently working with the World Health Organisation on several "black spots" in illegal transplant tourism -- China, Pakistan -- as well as with the ministry of health and the federal police in South Africa and Brazil with respect to arrests and trials of "transplant surgeon outlaws".