NANCY SCHEPER-HUGHES AND LAWRENCE COHEN
When the semester ends, Nancy Scheper-Hughes and Lawrence Cohen head for places where people forfeit their own body parts to strangers.
Some simply need the money and don't know what else to do besides sell a kidney. Others have so little status when they die that their bodies are mutilated without consent by state pathologists intent on harvesting human organs for profit or influence.
In Third World morgues, shantytowns, prisons and hospitals, the Berkeley anthropology professors investigate questionable cases of organ trafficking -- the finding and selling of human body parts for transplantation. In many countries, laws fail to protect organ donors from exploitation.
Scheper-Hughes and Cohen are part of a small task force of social scientists and transplant surgeons who have launched a global investigation of this practice. In the field, the two professors collect anthropological evidence they hope will, through publication in scholarly journals, help protect the world's poor from human rights abuses. At Berkeley, Scheper- Hughes is setting up an organization to monitor organ trafficking around the world.
In India, for instance, Cohen discovered poor women forfeiting a kidney to pay back money they'd borrowed to feed their families. In South Africa, Scheper-Hughes said she has witnessed the cadavers of poor, mostly black, victims of violence being "looted" for usable eyes and heart valves. In Brazil, the government declares everyone a universal organ donor at birth, she added, and people in poverty are terrified of becoming fodder for the organ trade.
"The exchanges tend to be poor-to-rich," said Scheper-Hughes. On the black market in India, added Cohen, an impoverished person's kidney, destined for an affluent Indian, can fetch $1,000.
"I call it neo-cannibalism," said Scheper-Hughes, "the notion that we can eye each other greedily as a source of spare body parts."
Organ trafficking has been denounced by all international medical and human rights groups, she said. Still, there is little surveillance over what is increasingly a black market where both doctors and the so-called "body mafia" serve as organ brokers.
Cohen and Scheper-Hughes also are exploring the terror and rumors surrounding organ trafficking. In South America, for example, allegations that children are being kidnapped and murdered for their organs have circulated for at least 10 years. For the most part, the two anthropologists believe these are urban legends based on mistrust of government and people's real fear of losing rights to their own bodies.
The professors work as a team, but half a world apart. For the past year, Cohen has been in India; Scheper-Hughes mostly in South Africa and Brazil. Three years from now, when their work is complete, they will co-author a book about their findings.
While miles divide them, both gravitate toward unpleasant situations.
Scheper-Hughes often can be found in morgues. Relying on tips off the street, she learns when the newly dead first arrive and shows up to witness if their organs are procured, and with consent. There, cornea, heart valves and other body parts often are removed while fresh enough to be used for transplants and other advanced medical procedures.
In South Africa, just before the 1994 democratic elections, she said she was present at a morgue where military pathologists eagerly eyed the bodies of youths massacred in government-instigated violence. Distraught family members also were there to identify the victims, who were gunned down for political reasons.
Already numb from watching the relatives' grief, Scheper-Hughes said she became even more disturbed observing the pathologists.
Their main concern seemed to be harvesting the organs as quickly as possible. Her eyes flashed with anger while describing how these government workers then use the organs for profit or to buy influence with agencies that sell eyes and heart valves to big medical clinics in Austria and Germany.
In South Africa, Scheper-Hughes also saw how irresistible a viable human organ can be to those performing transplants.
"The prime moment is when the living object, the kidney or whatever, is rushed into the operating room and looked at. 'Is it good, is it viable?'" she said. "The surgeon looks like he is manhandling the object. I remember an Afrikaner surgeon, a very large man, who looked like the local butcher who used to cut meats for my grandmother. He held up a human kidney with his thick hands, and there it was, I thought -- life, life for someone. How can it be resisted?"
Yet, in every debate Scheper-Hughes enters, she identifies with those who suffer.
"We are creating a type of apartheid medicine," she said. "I'm no longer neutral about these body practices that strike terror in poor people increasingly afraid of dying in the hospital. 'It won't be the bodies of the rich,' they say, 'that will be mistreated.'"
A former welfare mother who attended Berkeley as an undergraduate while raising her child alone, 54-year-old Scheper-Hughes long has been a crusader for human rights. Even as a young Peace Corps volunteer in the 1960s, she was detained and placed under house arrest in Brazil during a military investigation of her activities on behalf of a local peasant union. She subsequently was asked to leave the country.
As an anthropologist, she has studied the lives of many of society's oppressed -- schizophrenics in Ireland, apartheid victims in South Africa, Brazilian mothers who distance themselves from their dying infants because they lack medical care or resources to save them.
A diminutive dynamo, Scheper-Hughes speaks loudly, passionately, with animated gestures.
Her colleague, Lawrence Cohen, is tender and soft-spoken. He converses with people as if he were a helpful therapist or best friend. At age 37, Cohen also sounds 10 years younger, frequently using the word "cool" and wanting you to know "where he's at" with his work.
Cohen trained as a physician until the field of anthropology caught his eye. India became of interest to him by accident. In college, he wound up studying the country only when another class he wanted was too full. But since 1992, he frequently has traveled to India to study sexuality and aging.
Then, a few years ago, a conversation with an Indian man piqued Cohen's interest in studying black market organ sales.
"He talked about how he might sell his kidney to pay for his sister's dowry," said Cohen. "To him, that dowry stood for all the obligations of economics, and his kidney stood for all the horrible possibilities of survival. Here you have a family that has to give away its kidneys to give away its daughters."
Cohen and Scheper-Hughes joined forces when she asked him to fill her in on the organ trade in India.
Surprisingly, Cohen speaks lovingly about the "kidney belt" villages in India where selling one's body parts is a way of life. After seven years of working and living among the villagers, he has grown fond of and respects them.
"Don't," he said, "write one more groovy story about how gross India is."
Crippling debt, he said, has villagers in India lined up to sell kidneys to underground brokers even though it's against the law to provide a kidney to anyone but a relative. The villagers approach the brokers, usually after failing to repay a loan. When loan sharks demand repayment, villagers have no choice but to sell their own kidneys.
Cohen often hangs out in India's dialysis clinics to try and chat with patients and families. They tell him where to find black market donors and what the going price is for a kidney. As they speak, Cohen asks questions in rapid Hindi or through a translator and jots notes in English.
Investigating India's body mafia sounds frightening, but Cohen isn't easily scared.
Despite the undercurrent of fear and intimidation that accompanies organ trafficking, he said it's rare to see guns, weapons or overt violence on the streets of India. He worries only about being kicked out of clinics by wary administrators before he can collect his data.
"It's more dangerous to work in New York City," Cohen said, "than in India."
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