Body Shopping
Wealthy westerners are descending upon developing countries to purchase human organs from the poorMehru Jaffer Vienna
March 2008
A recent United Nations conference overwhelmed its participants here with endless facts and figures about the thriving international criminal activity of buying and selling human beings. The trafficking of persons for sexual or labour exploitation, and for adoption, false marriage and human organ donation is believed to be the third largest illegal trade in the world after drugs and arms smuggling.
'Human Trafficking for the Removal of Organs and Body Parts' was one of numerous workshops held at the Vienna Forum where experts appealed to policy-makers to protect the poorest in their countries from 'transplant tourism'. Human rights activists expressed frustration at the lack of information available on the illegal trade and vowed to coordinate efforts to combat the evil.
The absence of systematic data on people and organisations that buy or sell organs makes it difficult to nab criminals. According to a World Health Organisation (WHO) report, 'transplant tourism' is practised by potential recipients who travel abroad to obtain organs through the organ trade or other means that contravene the regulatory frameworks of their countries of origin. The shortage of organs has generated a desperate search for them - a search that overlooks the means by which the organs are obtained.
The worldwide scarcity provides incentives to physicians, hospital administrators and government officials in a number of countries to pursue ethically dubious strategies for obtaining organs, points out Nancy Scheper-Hughes, founder head of the Organs Watch project at the American University of California, Berkeley. Scheper-Hughes traces the promotion of international trafficking of human organs to a Zacki Shapira, former director of a hospital in Tel Aviv, Israel. Shapira performed more than 300 kidney transplants, sometimes accompanying his patients to other countries, such as Turkey.
The recipients are wealthy people with good health insurance, and the 'donors' are poor people from Eastern Europe, Philippines and other developing countries according to the medical anthropology specialist.
"We don't really know how many people are trafficked for organs," Scheper-Hughes says, adding that a conservative estimate of the number of trafficked kidneys was 15,000 each year. There are 'strong cases' documenting coercion in sale of organs in Eastern Europe, Turkey, Israel, India, and the United States. Poverty seems to be a prevailing feature in trafficking in persons for the purposes of organ removal. Human rights activists have demanded sustainable and empowering poverty alleviation programmes targeted at potential donor communities. Some would like the commercialisation of organs from living donors prohibited because legitimising the sale of organs puts the poor and vulnerable people at greater risk; they recommend the sale of organs from cadavers instead.
Research by WHO found that the economic status of the majority of kidney donors in India was below the poverty line. They were 60 per cent female and 95 per cent male, working mostly as labourers or street vendors. Eighty six per cent of the donors reported deterioration in health after donating organs while 29 per cent of male and 71 per cent of female kidney donors readily agreed to donate their organs. Ninety six percent of the donors said that they sold their kidneys to pay off debts and 75 per cent remained in debt after the donation.
There is also considerable evidence that infants and young children are kidnapped for the adoption market. At the same time, older girls and boys are sold or kidnapped (again, the relative percentages are unknown) for the sex trade. If children are abducted for adoption or for sexual exploitation, it is argued, it seems logical that they are abducted also for their organs. Although this charge has not been proven, it does contribute to a more general suspicion of organ donation and transplantation.
There is fear that the illegal trade in transplant-related health services across borders could result in the inequitable allocation of donor organs. It also raises ethical concerns, especially when this occurs in countries where the regulatory frameworks that protect live organ donors from coercion, exploitation and physical harm are not well-developed or implemented.
It is suspected that India is an organ-exporting country, where organs from local donors are regularly transplanted to foreigners through sale and purchase. Although the number of foreign recipients seems to have decreased after the enactment of a law banning the organ trade (the Human Organ Transplantation Act of 1994), the underground organ market is still existent and resurging in India. The Voluntary Health Association of India estimates that about 2000 Indians sell their kidneys every year.
In Pakistan, according to the Sindh Institute of Urology and Transplantation, approximately 2000 renal transplants were performed in 2005, of which up to two-thirds were estimated to have been performed on foreigners. In China, around 12,000 kidney and liver transplants were performed in 2005. Most of the transplant organs were alleged to have been procured from executed prisoners, a practice which alarmed the international community.
A report by Organs Watch, an organisation based at the University of California, USA, identified Australia, Canada, Israel, Japan, Oman, Saudi Arabia, and the USA as major organ-importing countries. The international organ trade is linked to the incapacity of these countries' health care systems to meet the needs of patients.
It is recommended that the growth and regularisation of the international organ trade should be regarded as a global public health issue. Health authorities are urged to update their legal frameworks - in both organ-exporting and -importing countries. Yet, they must also address the underlying problem of organ shortage by using organs from ethically acceptable sources. International cooperation may be considered to establish rules pertaining to overseas transplantation, in order to curtail the illegal international organ trade. While considerable disagreement exists over whether legally regulated markets and the use of financial rewards and incentives are ethically acceptable, international organ trade is possibly an issue on which international consensus and policy harmonisation should be effectively pursued.
Establishing a platform on which researchers, policy-makers, professional societies, and international governing bodies cooperate in gathering and sharing information may be considered an essential step towards creating a more substantial international health policy.
Describing the Forum as a "tipping point" in the global battle against human trafficking, Antonio Maria Costa, Executive Director of the United Nations Office on Drugs and Crime (UNODC), said that the Forum is just the beginning of a process. "Let us build on the momentum generated here to ensure that people's lives will not be for sale," Costa said.
Ruslana Lyzhichko, the 34-year-old pop singer from Ukraine participated in the Forum and sang that the body of human beings is not for sale. Helga Konrad, the former Austrian Minister for Women's Issues, said: "Let me remind you that when we got to the starting line, the traffickers were already far ahead in this race. Notwithstanding the progress we have made, we are still lagging behind. We cannot afford to be complacent - let us make a concerted effort to get to grips with this complex problem."
The Forum brought together 1,400 participants from 116 countries to exchange notes and to coordinate a strategy to combat human trafficking collectively.
http://www.hardnewsmedia.com/2008/03/2083