Transplant Surgery abroad is not the same in every country

[mitchorganbroker]

We see articles and posts describing the the negative from all those other countries, with hardly
any distinction between the individual countries. That's like calling all Transplant Surgery in Cal.
sub standard because of a few mess ups and the Kaiser nonsense.
   Except for Pakistan I have been to the countries mentioned below.
     China (mainland) They harvest all the organs while alive on the O R table. They say they get
consent before and compensate the family. The guy dies when they remove the heart.
     China (Taiwan ) Good Surgeons but you bring your own related donor. Must be proved as close relative
 at their Embassy in the US, with real documents.
    Cambodia- Not done, they refer to Thailand.
     Thailand- Not doing foreigners nor living brain dead donor, since 2001 when police arrested 5 of the best Transplant Surgeons saying that by taking the kidney from a brain dead donor with a beating heart, donor was still alive according to the Thai police.
    India- passed laws against selling a kidney and they do enforce the law. Their Transplant Surgeons are top notch but only doing related live donor Transplant. New Dehli has some good Transplant hospitals and the sightseeing is good. The Taj Mahal is about 2-3 hours away. The streets are safe and the people are friendly.
    Singapore - One good transplant Surgeon. No cadaver list and only does related donors . Expensive too.
    Hong Kong- Only with Related donors but quality Surgeons. Expensive by Asian standards.
   
   Philippines- They were under US control and have medical schools modeled after those in the US. Their     
   Transplant Surgeon train in the US or with American Transplant Surgeons.  They have a National Cadaver
  waiting list set up in 1988 by the George Town Medical school. However now cadaver transplants are less
 than 5 % of the total transplants in the Philippines. The donors are young men in their twenty's for the most
part.  The hospital does not find the donors, since it would be a conflict since the have an Ethics committee to
interview the donor. The Transplant Surgeons are NOT hospital employees as they are in the US . Since the Transplant team needs to approve the donor medically , it is someone with the team who knows of the donor
and not myself. The logic is that I can not buy anything in this country at a lower price than the Filipinos can.
     So, what I do is to find the ESRD patients who prefer a transplant. I also keeps the Surgeons from changing prices by playing off one from the next Surgeon. I throw around the names of their competitors to let them know i can do this. They are very experienced Surgeons as well as experienced at prying extra money from the foreigner.
   Since I give people a fixed price, I can't allow the Surgeon to demand what ever he likes, so I switch when
needed. The donor gets free followup forever ,whenever.

[Epoman]

Dear Members,

After several attempts by this member creating new accounts even after I banned several of his accounts and because of him I had no choice but to disable automatic registration, which means I must approve all new members prior to them posting for the first time, which is something I do not like but he left me no choice. We after several bans he sent me emails asking me to give him a chance. I made a deal with him that if I allow him one thread to state his case and have his say, he promised not to spam the site anymore. I set the ground rules to him, that he is ONLY allowed to post in this thread ONLY and he must not engage in a "Flame" war with another member. He must remain calm and act professionally. One of the rules was that he must create a new account with the member "mitchorganbroker" so the members would now that this is indeed the same person who was previously spamming the site.

He was given this chance on D&T (Dialysis & Transplant City) now he will have his chance here. If the members want me to just delete this thread and ban him yet again just let me know, the majority rules.

So please lets all remain calm and tell him why you are against his practices, or maybe you believe in what he does which in my opinion is a "Kidney Broker". So let your voice be heard. What is your opinion?

- Epoman
Owner/Admin

[Sara]

Organbroker,

I think it is disgusting how you and your associates take advantage of people in poor situations, manipulating them into selling their organs, and try to convince chronically ill patients that they will receive a high standard of care from ethically questionable providers.  I am particularly incensed as my husband has family in the Philippines, and they could possibly be some of the poor people you exploit.  You need to go away, and go knowing that you will get your comeuppance sooner or later.  Karma's a bitch.

[kitkatz]

Now if you would please check your use of the grammar in the English language in your post, you might be taken more seriously.  I for one do not care for your posts and feel that they lead to a lot of heartache for people who choose to go that route and end up with subservice medical care in a foreign country. In spite of the long wait list I will choose to stay on the U.S. transplant list and choose to have the transplant and care here with people who know what they are doing.

[Rerun]

Organ Broker.  I will stay in the United States to wait for my transplant.  I would buy a kidney HERE if that was legal and if I could afford it.  Since it is not, I will wait. 

What do you do if the person cannot pay? 

Just how much business do you do in a year?

[angieskidney]

Hmmm.. seems to bring more insight as to why those countries want live donors over cadaver. With seeing their laws it makes more sense why. For me I am poor and am only covered in my own country as it is (Canada) even though I would love to be on the American transplant list (their list is shorter than in Canada. .. Well except Alberta .. which is the best place in Canada to get a transplant) but I would have to pay out of pocket for that .

The hospital does not find the donors, since it would be a conflict since the have an Ethics committee to
interview the donor. The Transplant Surgeons are NOT hospital employees as they are in the US . Since the Transplant team needs to approve the donor medically , it is someone with the team who knows of the donor
and not myself. The logic is that I can not buy anything in this country at a lower price than the Filipinos can.
 So, what I do is to find the ESRD patients who prefer a transplant. I also keeps the Surgeons from changing prices by playing off one from the next Surgeon. I throw around the names of their competitors to let them know i can do this. They are very experienced Surgeons as well as experienced at prying extra money from the foreigner.
 Since I give people a fixed price, I can't allow the Surgeon to demand what ever he likes, so I switch when
needed. The donor gets free followup forever ,whenever.

Ah I was wondering what you do.

He was given this chance on D&T (Dialysis & Transplant City) now he will have his chance here.

If anyone is interested, that link is here.

I do have some concern about the young men who you say:

The donors are young men in their twenty's for the most
part.  The hospital does not find the donors, since it would be a conflict since the have an Ethics committee to
interview the donor.

I would like to know more about that since I can't help but be concerned for their welbeing.

[meadowlandsnj]

IF anyone is interested here's an article that was in the New York Times a few years back about organ brokes and how the organ selling system truly takes advantage of the poor in other countries. 

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C0CE0DD163EF930A15756C0A9629C8B63

Copy and paste it into your browser. 

Donna

[slothluvchunk]

That's weird, I didn't realize China was a democracy!
They get consent eh?

I would really encourage anyone even considering such a thing to think long and hard about it.
It's not even a matter of just making the "right decision" and doing due diligence.  It's much more than that.  It's the possibility of supporting a very questionable practice taking place in countries that we already know rank pretty low in terms of human rights.

It's not even really a matter of "quality".  Many of these doctors are trained in the U.K. - and I'm sure that in many cases, they're successful in their practices.  The issue though, is one of consistency.  I'd personally not want to be transplanted in one country, and followed up with, in another.  Perhaps I see this having had a transplant, and knowing what comes afterward in terms of followup care.

I'd like to be able to have the person doing the work be the one looking me in the face in the future.  I think that personal connection on the physician's part says a lot about their personal passions and motivations, and I think that comes through in their delicate work.

Still though - people will get suckered into this.  People don't like to wait, and having a way to get the transplant NOW is attractive to many.  I'd wager they're people who haven't done it yet.
I personally am thankful for the last 4 years on dialysis, and wish I'd have been forced to have a year or two of dialysis prior to transplant.  I think it's important for people to see the transplantation process as another treatment, and another set of compromises - not a cure, or an "end" to any of the woes of ESRD.

Just my $.02 of course

[angieskidney]

VERY well said slothluvchunk!! 
I feel much the same way as you!

[Zach]

I've said this before ...

In 1989, I served as reporter, and teamed up with award-winning director Ilan Ziv (Consuming Hunger; People Power) and Icarus/Tamouz Media for a investigative health documentary about the international trade in human organs. The program was produced in association with the BBC (for their program Antenna), RTL+, VARA and the Canadian Broadcasting Company.

Transplants in the Philippines ain't so great. I've been to Manila. You can get a kidney from a prisoner locked up in the national penitentiary, Mantelupa.  For their donation, they have their sentences commuted.

I was in Guangzhou, China. They shoot prisoners and give you one of the kidneys.  Maybe one of those prisoners is a former student from the Tiananmen Square protests?

The doctors at the hospital/prison I visited in China tried to convince me that a Hep B positive kidney that was available would not cause me to contract Hep B myself.  Does a doctor in China or the Philippines really care about an American's health after the transplant has been paid?

In India, I wouldn't want it on my conscience how a young girl of seventeen or eighteen years of age, was forced by her family to give me a kidney.

Having surgery in these countries is in fact buying a kidney.  The money may go to a surgeon, but it's still buying a kidney ... we can't spin this any other way.  And what if the kidney fails in three months, do you get your money back?  This is not like buying a cellphone.

When money talks, ethics walk.   

[geoffcamp]

I am curious, is this legal??  Can this person be a broker of organs for transplantation in other countries??  Are there no laws on the books stopping him from profiting on people who are desperate to find an organ?  I personally am not sure that our system in the USA is perfect but I do believe that the people who developed it did the best they could.  I do think that anyone who profits from suffering people who are desperate to find organs to save their lives should be arrested and thrown in a foreign jail so he/she can wonder when they are going to cut him up for his organs!  That is my take on this.
Geoff

[stauffenberg]

The ethics and laws relating to buying an organ for transplant were determined by a population consisting primarily of healthy people who have absolutely no idea of the terrrible suffering and high death rate we renal patients have to endure while waiting for a transplant.  Nor do they understand how long the wait can be, and how serious the permanent medical disabilities can be from the long waiting times imposed.  Does anyone doubt for a minute that if 50% of the American population suddenly needed renal dialysis, it would immediately become legal to buy an organ in a foreign country?  If this is so, then the current laws against this have to be regarded as the product of a form of racism, of prejudice and misunderstanding directed against the sick by healthy people who do not comprehend our situation and yet feel free to impose life-and-death rules on us.

People consist of two dimensions -- time and space.  It is perfectly legal to sell yourself as time, which is what we all do by putting in time at work to get a salary.  So why is it so immoral to sell yourself in your spatial dimension, giving up part of your body for money, if that is what seems right to you?

The desire of people in foreign countries to sell an organ to make money comes from the dire poverty in the Third World, which is largely the result of the world economic system, in which the United States with only 5% of the world's population consumes 60% of its resources. Since the whole foreign policy of the country, since the whole power projection capacity of the armed forces and the CIA is devoted ultimately to keeping that imbalance of resources intact, why is the same country which is so eager to create and maintain this desperate poverty so opposed to people sellling their organs to escape it?  Is it because the imbalance benefits the healthy majority, while organ buying only helps a despised minority of sick people?  The U.S. supports American companies investing abroad and has no laws against them employing foreigners for starvation wages, but then, when these starving third world workers sell a kidney to save themselves from these low wages, the U.S. declares this to be illegal exploitation of the worker by the transplant purchaser!  Shouldn't the U.S. also have laws to prevent the problem at its roots, by requiring U.S. companies investing abroad to pay decent wages so no one is forced to sell an organ?

Why is the organ buyer called an exploiter, since he is helping someone who is already being exploited by someone else to escape that exploitation?  The guilty one is the original person, the foreign company or the World Bank or the international capitalist system, which put the foreign worker in his desperate situation by exploiting his labor for low wages, and not the person who offers an opportunity for the worker to buy his way out of a trap someone else has made for him.

If the foreign organ seller determines that he would prefer to sell a kidney rather than starve, is it a moral act to let him starve by refusing to 'exploit' him by cooperating with the contract he wants to make?  In the Philippines the kidney donor must be medically qualified, he is given free hospital care for the surgery, and he is paid US $7000 for his kidney, which represents 2.5 years salary in a country where 25% of the population is unemployed.  Is this exploitation for him or liberation, especially given that he has sized up the alternatives and decided that selling his kidney is to his benefit?  Also, in the Philippines hospital ethics committees consisting a a nephrologist and a Roman Catholic priest have to interview the transplant donor first to determine that he is not acting under duress and that he understands the medical consequences of what he is doing.  If this is a moral procedure by the standards of the Philippines, isn't it cultural imperalism on the part of the U.S. to call his illegal when an American citizen goes to the Philippines and abides by the local laws and moral customs?  In the Philippines almost all transplants are provided by paid donors, for foreigners and local residents alike.

Finally, in the desperate plight of the renal patient on a transplant list, he is confronted with the tragic situation of having to impose on someone.  If he waits on the list he shirks his duty to his own body and life by becoming constantly sicker, by losing the continuity of his career and life plans, and by running an ever increasing risk of death.  Also, by waiting on the list he deprives any immediate family members he may have of financial support, to say nothing of not being able to be a normal companion for them, and of constantly threatening them, through his plight, with his own decline and death.  If he takes a cadaver transplant, he could be said to exploit the other people on the waiting list, because by his taking a kidney he forces others to continue waiting, and their wait may cause them to suffer worsening health problems, to become medically ineligible for transplant, or even to die.  Isn't this a worse exploitation than he imposes on the voluntary kidney donor who is selling his organ?  The donor is willing to make this trade, but the person who takes a transplant from the cadaver list does not get the permission of the other people on the waiting list whom he forces to wait even longer.  He says, in effect, I am taking this organ even if my having it now means that you will die waiting.  In contrast, if he goes abroad and buys an organ, he takes himself off the cadaver waiting list in his home country and thus makes the wait for other patients shorter than it would otherwise be.  So it seems that buying an organ is more moral, not less, than getting one from the list!

[mallory]

Stauffenberg, you are clearly a genius or something and I, in contrast, am a fairly uncomplicated person.  But this is the way I see it; no, it isn't alright for American companies to exploit foreign labor and pay them starvation wages.  We should all make every effort not to support companies that use any type of exploitive practice. 

But, that doesn't make selling or buying organs right, either.  At some point, there has to be a code of human behavior that says we are not willing to take certain actions for money.  There's a reason prostitution is illegal in most places.  You may argue that those women are just "selling themselves spatially", but I would say that we cannot take advantage of another human beings plight because we have money and they need it.  It's wrong, and Mitch the Organ Broker is wrong.  He is the ultimate exploiter; exploiting not only the people selling the kidneys, but the desperate kidney recipients that use his services. 

The world is not a perfect place.  The U.S. is not a perfect country, and we need to do more to balance the resources and ensure that all people, across all countries, have opportunities.  If you have an answer as to how we can do that, I'm willing to listen.  But I hardly think that marketing organs will resolve the world's issues. 

[Sluff]

In a nice way Later Dude. Thats my vote.

[geoffcamp]

You know I am not one to judge or get into debates on these boards but in this case I am going to speak my mind.

stauffenberg, you seem to be a highly educated smart man.  However, after reading your post all I really have to say is BULLSHIT!!  Anyone who profits by taking advantage of people be it for economic, health or status reasons is WRONG.  End of story in my book.  As much as I would like a kidney I would NEVER use one of these "brokers".  If it was done ethically (not sure how that could be accomplished), by a not for profit organization, maybe then I would consider "buying" or supporting the organization.  We all have choice in our lives as to what we think is right and wrong, and I believe this is absolutely wrong.  I have a sister who wants to donate a kidney.  I am against it because she is young not married yet and wants to have children in the future, so I am holding off on that until I believe it is in her best heath intrests.  How could I possibly know that it was in the best heath intrests of one of these donors that a "broker" uses??  How do I know they are not taking advantage of a situation that seems to only profit them??  Forget about the fact that I have no idea about the ethics and experience of these so called "doctors".  So I guess I will have to agree to disagree with you on this.  I suggest you go ahead and give it a try for yourself and let us know how it goes!  Good luck!
Geoff

[geoffcamp]

Oh yea by the way stauffenberg do realize the the BIGGEST FOR PROFIT dailysis centers in the US are run by a foreign company?  It is Fresinous out of Germany.  So it is NOT only American companies that profit from those of us with renal failure!

[livecam]

I was gonna comment but think I'll stay out of the fray. 

[stauffenberg]

When two people in comparably desperate circumstances caused by neither one of them meet and come to an agreement which rescues each of them from his plight, and which each of them considers to be an advantageous cost/benefit bargain, can it really be said that one of them exploits the other, or that they both take unfair advantage of the other's dire need?  The relationship between them is too reciprocal for that.  One of them has money which the other needs but would never be able to get otherwise, while the other has a spare kidney which the first one needs but may never be able to get otherwise.  Couldn't it just as easily be said that the kidney donor exploits the foreign renal patient by charging him $7000 for the kidney rather than just donating it to the patient altruistically, especially since the need of the renal patient, if not met, will much more readily lead to further disease or death than the poverty of the foreign donor will?

[Sara]

Whatever the paltry sum is, it does not relieve the poverty the donor faces every day.  Plus the donor can not work during recovery.  That plus the risk of complications and probable lack of aftercare leaves the donor open to infection, illness, even death. 

[mitchorganbroker]

Sara,
  Don't pay a paltry sum. Instead take the donor back with you, sponsor his visa to enter
the US and get him a job at 7-11 or something that gives him health insurance with a salary
which is higher than a Philippine Nephrologist. BTW Sara with all those poor Philippine relatives
of your husband, why aren't you saving them ?
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Kitkatz,
  Thanks for the tip on Grammar. As to your comment about sub service medical , do you have any facts
that you can quote about the Philippines compared to American Transplant Hospital. How about California
and Kaiser wasting organs.
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Rerun,
  Three Philippine indigent patients were were transplanted at no cost to them. The husband (Mike Arroyo) of Philippine President Gloria Arroyo paid for it out of his pocket by his generosity. I don't charge Philippine patient a centavo.

[mitchorganbroker]

Zach,
   Your story is ancient history from 1989. The Philippine transplant program only started in 1988.
Nowadays prisoners are not used. Since 2002 they have Hospital Ethics committees.
--------------------------------------------------------------------------------------------------------------------
Geoff,
   You say you would not use a Broker. Good news, Brokers don't exist. It's a make believe word . You say you want a non profit to help you. You're in luck again. There are 100 in the US, just get on the end of the 5 year line.
BTW Geoff, don't you know that the non profit hospitals pay out very large salaries and double dip medicare ?
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Morality and ethics are a product of religion and geographic area. It appears that Muslim countries do not have cadaver waiting lists .Does that make them more moral than you all  ?

[Sara]

BTW Sara with all those poor Philippine relatives
of your husband, why aren't you saving them ?

We already do our part to help the family, thank you.  That has nothing to do with how wrong you are.

[stauffenberg]

I spoke to one Philippine organ donor a few years ago, and he even showed me his operation scar to prove his story.  He told me he received US $7000 for his kidney, which is hardly a 'patry sum' in the Philippines, where the average yearly income is US $2000, and where 25% of the working age population is unemployed.  Assuming the average salary in the US is about $40,000, the amount that Philippine donor was paid was equivalent to $140,000 in the United States.  If you were extremely poor and unemployed in the US, would you consider it reasonable to donate a kidney for that much money?  The donor with whom I spoke explained that, because fees are charged in the Philippines to send children to primary school, this was going to give him the chance to save his two children from inheriting his poverty, in effect, since otherwise they would not have been able to attend school and would thus have been condemned to unemployment.

There is a tendency to exaggerate the medical risks of having only one kidney.  In fact, many people are born with only one kidney and never know it, and it is only first discovered at autopsy.  In every sense the second kidney is really a surplus organ to protect the body against those rare accidents in which one kidney could be hurt by trauma, but in the modern world where we are no longer cavemen fighting sabre toothed tigers, this protection is no longer necessary.  The medical fate of kidney donors has been extensively studied and they have been found to live just as long as people with two kidneys, since the functional capacity of the nephrons in the one kidney expands to compensate, fully, for the lack of a second kidney.

At the end of the day, after a Philippine organ transplant the donor is happy because he and his family have been rescued from a poverty which would otherwise have crushed them all; the organ recipient is happy because he has been saved from the living death of dialysis, he has avoided further decline in health during dialysis, and his life expectancy has been greatly extended; the Philippine doctors are happy because they have received a fee for their services which is much higher than they usually get; even the organ broker is happy because he has earned his commission.  So given that all these people have been made happy in their different ways, where is the immorality in this exchange?!

[geoffcamp]

I personally am not sure that our system in the USA is perfect but I do believe that the people who developed it did the best they could. 
Geoff

I am aware that our system may not be perfect.  There is always room for improvement.  There will always be someone ready willing and able to take advantage of any situation.  What is the "official" title of someone who does this kind of deal?  If you let me know I will use your terminology.  I am in the process of getting on the list here in the states, my final meeting is tomorrow at a foundation called Lifelink.  This will be my second transplant.  My first transplant I only waited 3 1/2 months for.  So it seems there are times when the list works and it even works fast.  Granted this does not seem to be the overall consensus. 

stauffenberg, I still disagree with you.  But I will ask again... If you believe that this will solve your health issues and truly be a help to all the other parties involved then are you going to take action yourself and pay to receive a transplant??  I would like to see "in action" all these benefits you are taking about put into motion.  Let's use you as a trial case and document every aspect of the social, economic and health benefits this can offer.  Then we can put it out to all the people (the donors, doctors and patients) and see what everyone really thinks.  I say put up or shut up!

[angieskidney]

If you were extremely poor and unemployed in the US, would you consider it reasonable to donate a kidney for that much money?

Actually I know for a fact that I would not risk my health like that. And I AM poor... never earned more than 9G a year in my life! (Sucks being sick since birth .. and then just as I was working my way up the ladder .. BAM! Had to claim bankruptcy because I am back on dialysis...)

There is a tendency to exaggerate the medical risks of having only one kidney. In fact, many people are born with only one kidney and never know it, and it is only first discovered at autopsy. In every sense the second kidney is really a surplus organ to protect the body against those rare accidents in which one kidney could be hurt by trauma, but in the modern world where we are no longer cavemen fighting sabre toothed tigers, this protection is no longer necessary.

It is something how the part that gets exaggerated is the part the benefits the one speaking.

You can say it is just an extra organ ... big deal .. la de da! And then you turn around and say dialysis is death when it is the great invention that is keeping us ALIVE!

I will ask again... If you believe that this will solve your health issues and truly be a help to all the other parties involved then are you going to take action yourself and pay to receive a transplant?? I would like to see "in action" all these benefits you are taking about put into motion. Let's use you as a trial case and document every aspect of the social, economic and health benefits this can offer. Then we can put it out to all the people (the donors, doctors and patients) and see what everyone really thinks. I say put up or shut up!

I want to know as well! All we want is proof! You have to understand that right??