International trade in human organs shown to thrive on contributions by living donors
Berkeley anthropologist tracks ‘transplant tourism’ to its sources abroad
| 05 May 2004
A Berkeley medical anthropologist is helping authorities in Brazil, Israel, and South Africa investigate what she calls a shocking new “slave triangle” in which the poor are being taken to distant cities by criminal syndicates and coerced into selling their organs for use in illegal transplants.
“For the first time in investigations of trafficking, doctors are being arrested and hospitals cited,” said Nancy Scheper-Hughes, director of Organs Watch, a campus-based documentation and research organization. “These arrests have traffickers very nervous.”
To explore the ring that enticed poor Brazilian men to South Africa to sell their kidneys for the benefit of well-to-do Israeli, European, and American transplant recipients, Scheper-Hughes visited the slums of Brazil and the big cities of South Africa and Israel. There she tracked both small- and big-time organ brokers, some of them surgeons, others corrupt businessmen and money launderers. She interviewed donors, brokers, and others involved in the syndicate that, she says, proves the poor are becoming body banks for the rich.
Authorities familiar with her ethnographic and advocacy study of organs trafficking in 12 countries in the past eight years last year enlisted Scheper-Hughes to start to untangle and understand the workings of the ring. “Her knowledge of the subject is extremely thorough,” said Capt. Louis Helberg of the project investigation team for the white-collar-crime branch of the South African Police. “Her information will help us a lot as we continue the investigation.” Scheper-Hughes was invited to South Africa by the government to use her connections and knowledge of organs trafficking to help police investigators and the Ministry of Health in the state of Kwa-Zula Nala.
In Recife, Brazil, Deputy Raimundo Pimentel of the Parliamentary Inquiry Commission said that Scheper-Hughes has provided the investigation there with “a rich and valuable report about [the] world’s reality of human organs trafficking and especially the focus on Brazil’s situation.”
When Scheper-Hughes and others launched Organs Watch nearly four years ago, illegal transplants were largely the stuff of urban legend. But today they are increasingly common in a world where, she says, even though laws require donors to be relatives of the recipients, sick patients can buy themselves a new kidney if they have enough cash and health insurance, and the right connections.
Scheper-Hughes says that despite recent high-profile arrests, organs trafficking is a difficult tide to stem. So, she says, if the world is ready to accept what she terms the growing “commodification of the body,” she will campaign for recognition of the human rights of organ donors, examination of the long-term health risks they face, and institution of regulations such as national and international registries of living donors, mandatory medical follow-ups, and reporting of the related health assessments.
With mandatory reporting of the medical conditions of donors and follow-up exams, Scheper-Hughes says, “We’ll be able to solve the question of whether, in fact, organ donation is as risk-free as the transplant community would like us to believe.
“If it turns out that the world is moving in the direction of using living people, especially poor ones, to serve the needs of more affluent people, at a minimum that means recognizing the donor as a patient who has certain needs and to whom the medical community has certain responsibilities that have not been articulated yet.”
The medical community may be shifting its positions on organs trafficking, Scheper-Hughes said. On Jan. 23, the World Health Organization (WHO) — which she served in 2003 as an adviser on organ and tissue transplants — officially recognized the “ethical and safety risks” of transplants and the need “to take measures to protect the poorest and [most] vulnerable groups from ‘transplant tourism,’” borrowing Scheper-Hughes’s term. The latter was “a very big step” because WHO previously had considered transplant tourism a deviant, isolated practice that required no response from the medical community at large.
Alexander Morgan Capron, director of WHO’s Department of Ethics, Trade, Human Rights and Health Law, called Scheper-Hughes “a passionate investigator into this phenomenon” and said her advocacy “has done a great deal to publicize this subject.”
When she tried to spread word about the problem in Eastern Europe to the Council of Europe about a year ago, Scheper-Hughes was met with laughter, some hisses, and even boos from an audience composed mainly of doctors. But after her presentation the council did investigate her claims, and a transplant ring operating in Moldova, Turkey, and Israel was halted.
Others paying attention to Scheper-Hughes include journalists who rely on her background knowledge and access to the illicit organs-trafficking world. Some reporters repeat her statements on the front pages of their newspapers or in their broadcasts.
“In a field where urban myth and uncorroborated third-hand accounts are frequently quoted, Scheper-Hughes is rigorous in her commitment to quote only provable and demonstrable facts,” said Brian Woods, producer of “The Transplant Trade,” a documentary in production for The Discovery Channel and Channel 4 in the United Kingdom.
Scheper-Hughes is the author of at least 30 academic articles on organs transplant and trafficking, including one for the journal Lancet. She also co-authored an article on the topic for the New England Journal of Medicine. Her latest book, The End of the Body: The Global Traffic in Organs, is due out later this year. Her earlier research topics have included child abuse, AIDS and human rights in Cuba, and the death squads and extermination of children in Brazil.