Monster or Savior? Doctor Draws New Scrutiny

[okarol]

February 3, 2011
Monster or Savior? Doctor Draws New Scrutiny

By DOREEN CARVAJAL

ISTANBUL — For a surgeon wanted by Interpol and suspected of harvesting human organs for an international black-market trafficking ring, Yusef Sonmez, was remarkably relaxed as he sipped Turkish red wine in a bustling kebab restaurant facing the wind-whipped Sea of Marmara.

Dr. Sonmez, refreshed from a ski trip to Austria, spoke last month while on a break from business trips to Israel and operations on cancer patients here.

He boasts about the satisfaction of his kidney transplant surgeries, more than 2,400 by his count. He keeps friends (and, incidentally, investigators) up to date on his life via a blog and his Web site listing contact details. And in his seaside villa on the Asian side of Istanbul, he treasures a framed copy of a signed letter in 2003 from the Ministry of Health in Israel commending him for his life-saving aid to “hundreds of Israeli patients who are suffering from kidney diseases and awaiting transplants.”

Yet Interpol is circulating an international red-alert notice for the Turkish surgeon’s arrest with a mug shot of him in a surgical scrub cap. The Turkish authorities have shut down his private hospital. The local press has labeled him “Dr. Frankenstein.” And an expert who monitors the lurid and lucrative global trade in human organs says Dr. Sonmez has been arrested at least six times in Turkey.

“There are two Yusufs, one my family and friends know and the one created in the press who is a monster— this is a drama, a tragedy,” said Dr. Sonmez, 53, a trim, angular man with intense, gray-green eyes and a graying goatee. “Up to now, I didn’t kill anybody. I didn’t harm anybody, counting donors or recipients. I have not committed any kind of social harm to anyone. This is the main thing that I am proud of.”

Of his surgical skills, he added, wryly, “I am the best in the world as long as my fingers aren’t broken.”

The illicit trade in human organs is a multimillion-dollar business built on paying desperately poor people to extract their organs— mostly kidneys. These organs are then sold and transplanted to wealthier people facing long waits on government-approved lists for legal transplants.

Dr. Sonmez is wanted with regard to one of the most troubling prosecutions to emerge recently— a European Union investigation into trafficking in Kosovo in which seven people, mostly prominent local doctors, have been charged with illegal kidney transplants in a private clinic. Dr. Sonmez has not been charged in Kosovo, but the prosecution contends he played a central role in the ring.

That case has become intertwined with a volatile two-year Council of Europe inquiry that made links between the Kosovo prime minister, Hashim Thaci, and a criminal enterprise of some former Kosovo Liberation Army fighters accused of executing Serbian prisoners in 1999 and 2000 for their organs.

Dr. Sonmez has denied wrongdoing in either situation, but a Turkish immigrant who lost consciousness at an airport in Kosovo after a kidney removal, and the patient who investigators say received his kidney, both identified Dr. Sonmez as part of the operating team. He says he was only in the operating room offering advice to others.

Investigators have focused on the role of Dr. Sonmez in 2008 as a surgeon for the Medicus private clinic in a rundown neighborhood in Pristina, Kosovo’s capital, where they said kidneys were removed from impoverished immigrants recruited on false promises of payment that they never received. The organs were transplanted to wealthy patients from Canada, Germany, Poland and Israel who paid up to €90,000, or $122,000.

In Turkey, he was not really seen as a hero in the traditional sense but as someone who stood up against the establishment because he kept operating even though he was exiled from one hospital to the next, said Aslihan Sanal, an anthropologist who has researched the activities of Dr. Sonmez in Turkey and found that patients measured him by their ability to survive.

Dr. Sonmez has been detained and released repeatedly in Istanbul during investigations of illegal transplants and money exchanges between donors and recipients. The son of an English teacher and a dentist, he said he trained at an Istanbul medical school and studied transplant surgery in Paris. He said the five-year survival rate for his kidney transplant patients was 84.7 percent, above Western standards, though it was not clear how many of the donors he had seen again.

By his estimate, most of the thousands of transplants he has performed since he began in 1992 involved live, unrelated donors. He said his survival rate was high because he presided over the removal and transplant of kidneys, monitoring patients side by side for 48 hours.

“This is amazing,” he said of the transplant process. “I love it — to watch the changes with the new organ, the changes in the body, to move with the changes, to make changes in the medication.”

Typically, he said, he requires donors and recipients to submit signed, notarized statements to declare that money has not been exchanged.

How does he know that desperately poor kidney donors are not being exploited by a murky world of brokers, fixers and wealthy donors with lavish insurance?

“I don’t need to ask these questions,” he said, “because I do believe that people have their own authority over their own body. They are not stealing, they are not cheating. So this is the shame of the system. Not their shame.”

Given his legal problems, he said he has not performed a kidney transplant in two months, he said, since an operation in a country he declined to identify.

The surgeon’s travails in Kosovo began after Yilman Altun, a Turkish man, 23, collapsed while waiting for a flight out of Kosovo in November 2008. Customs officials found a fresh scar in an arc across his abdomen and both Mr. Altun and a 74-year-old Israeli, Bezalel Shafron — who paid €90,000 for a kidney transplant — identified Dr. Sonmez as participating in the surgery.

Unable to operate his own hospital — which was shut after the Turkish authorities accused it of illegal transplant surgeries in 2007, an action he is appealing— Dr. Sonmez said he was invited by a Kosovo urology professor to work at Medicus. He offered a document from the Kosovo Ministry of Health that gave him a temporary appointment in 2008 as a general surgeon, along with the condition that the clinic obtain a license, which it lacked.

At least 20 kidney operations, according to the charges, were performed at the rose-colored private clinic near a dirt track, including those involving Mr. Altun and Mr. Shafron. Dr. Sonmez said he participated simply as an adviser for the men’s transplant surgery.

“I was standing there among the other physicians,” he said, adding that he left the clinic after two days, and arguing that he would have stayed until the patients were discharged if they were his responsibility.

But in a district court in Pristina in December, the E.U. prosecutor Jonathan Ratel argued that Dr. Sonmez played a central role in transplants that took place in 2008, along with 11 other suspects, including a former secretary of health in Kosovo, and an Israeli doctor.

The court is expected to decide this week whether to press forward with a trial against seven people charged so far in the case, in which Turks, Russians, Moldovans and Kazakhs were allegedly lured to Pristina with false promises of payments for their kidneys.

In recent weeks, the Medicus clinic case has become linked with the much more explosive organ trafficking case, dating to Kosovo’s war of independence in 1998 and 1999, that has stirred tensions between Serbia and Kosovo.

The Parliamentary Assembly of the Council of Europe — an organization of almost 50 nations that investigates human rights issues — adopted the report of a two-year inquiry that alleges that some members of the Kosovo Liberation Army held Serb prisoners in detention centers in Albania and executed them with gunshots to the head to extract organs for shipment to Istanbul.

The report — based on intelligence reports and witness interviews — contends there is a link between that ring and Medicus with the same international channels and people doing surgical operations. The report, prepared by a Swiss senator, Dick Marty, contended that the earlier case is tied to the Pristina clinic, “through prominent Kosovar Albanian and international personalities who feature as co-conspirators in both.”

Dr. Sonmez denies being in Kosovo during the earlier period, and says he would never transplant a kidney that he had not removed himself.

Others contend that Dr. Sonmez’s role goes far beyond Kosovo and Turkey, that he has played a key part in the globalization of trade in human kidneys, particularly for matching paid donors with patients from Israel, where for religious reasons there is a shortage of kidney donors and where health insurance plans pay for transplants abroad.

“I have covered his tracks,” said Nancy Scheper-Hughes, a professor of medical anthropology at the University of California at Berkeley and director of Organ Watch, which researches the organ trade and follows ailing and destitute kidney donors. “He is a transplant surgeon who has worked for years in many parts of the world with brokers who bring together donors with recipients. He is wanted in many countries and he knows what he is doing is illegal.”

In the next few weeks, Dr. Sonmez and his lawyer are poised to head to Kosovo to give his statements.

“They want information about bigger fish,” said Murat Sofuoglu, an old friend and lawyer for Mr. Sonmez, who has been shuttling between Istanbul and Pristina to negotiate terms for the doctor to give a statement to prosecutors.

“Not me,” Dr. Sonmez said, picking at a honey-drenched piece of baklava. “I am not the big fish.”

http://www.nytimes.com/2011/02/04/world/europe/04iht-organ04.html?scp=5&sq=kidney&st=cse