Illegal Organ Trafficking in South Asia and a Few Thoughts
By Lisa Zhong
We have heard a lot about states and international organizations dealing with trafficking children for labor purposes. However, the media has not paid illegal organ trafficking as much attention as it should receive. According to the World Health Organization (WHO), illegal organ trade occurs when organs are removed from the body for the purpose of commercial transactions. Many countries in South Asia and Southeast Asia are factories for human organs, such as Bangladesh and India, because the percentage of people who live in extreme poverty is relatively high in those areas, thus selling kidneys has become a way to earn a short-term living. A report by the Indian government Planning Commission in 2014 estimated that about 29.5% of the total population was living below the poverty line, which is $2.40 per day, in 2011-2012. The most common commodities in the organ trade are kidneys and livers. Unregulated transplantations also cause disease by using unhygienic equipment, and sometimes even cause death among both donors and recipients.
Research done by an anthropologist from Michigan State University named Monir Moniruzzaman shows that 78% of Bangladesh’s citizens are living within two dollars per day but the average offer of one kidney is about $1,400. This amount of moneyis a huge temptation to those who desperately need it. However, at the same time, the brokers have various excuses for not paying the promised amount of money so that they could maximize their own profits. The victims are usually cajoled to India to do the operation. Moniruzzaman interviewed 33 kidney donors in Bangladesh – many of them don’t even know what a kidney is. The brokers would educate the victims with false information about their own health and the functions of their organs in order to make them believe that they could only get better off by the “organ donation”. The strategies that brokers usually use to deceive potential donors include promising a US visa, citizenship in another country, or advocating that one of their kidneys is in dormancy – which is to say that during the transplantation, the doctors activate the dormant kidney and take out the old one for donation, and the operation is 100% safe. Brokers would also use fake documents to “prove” that the donors and recipients were somehow related as family in order to not break the law. The Indian government tried to stop illegal organ transplants with a 1994 law that made organ sales illegal but allowed "unrelated kidney sales”. Brokers and international trafficking agencies took advantage of this loophole, which only made the underground organ trafficking even more rampant. In wealthy developed countries, people who seek donor organs will pay as high as $200,000 while the actual donors from the poor developing countries would be very lucky if they could receive about $5,000 for their organ donation.
Once the donors arrived in India, their IDs such as passports are taken by the brokers to ensure the victims would be unable to escape until they finish their “donation”. Even if they realize something is wrong or change their mind, they could basically do nothing to stop the loss of their organ. The victims waited for operation in dens of criminality. After the operation, there is a high probability that they will suffer from infections due to poor sanitation, which can sometimes be fatal, like AIDS, Hepatitis B, etc.
As long as there are consumers who are willing to pay for “health at any price”, there will be available organs in the black market. The third party countriesare the producers, and the developed countriesare often the consumers. About 5,000 seriously ill people from countries including the United States, Israel and Saudi Arabia pay others to donate an organ, says Francis Delmonico, a Harvard Medical School Professor. There is a huge amount of profits in illegal organ trafficking, and the gap between supply and demand is also huge. “The US waiting list for organs has 110,693 people, and fewer than 15,000 donors are found annually,” states Michael Smith, in his “A Shadowy, Sometimes Deadly International Trade in Organs” -- The Washington Post. The gap is huge, thus it is almost impossible to eradicate illegal organ trafficking.
Here comes a question—is it true that if you are willing to buy a kidney from the black market, you are willing to exploitthe poor, and therefore doing something that is absolutely wrong and should be stopped? The answer could be yes, because the kidneys in the black market are mostly acquired from illegal channels by deceiving, coercing, coercing, and taking advantage of poverty. The answer could also be no, and that buying black market organs is understandable, because it is unfair to accuse someone who just wants to save his or her own life or the lives of the loved ones. In the “live or die” situation, most people tend to value the lives of their loved ones over a poor stranger on the other side of the world. But this derives new questions-- Do we treat the value of life equally between the wealthy people in the developed countries and the people who live in extreme poverty in South Asia and other places? How to value health and life? We always claim that all lives are equal, but deep down, we all know that all lives are not equal because we value our own lives – and the lives of our loved ones – more than we value the lives of other people. “The problem is that you have so many people who are desperate for transplants and willing to pay for one and so many people who need the money and can be exploited,” says Delmonico—it's the bargaining about life. The real answers to these real world problems are much more complicated, because humanity is involved, which has both a bright side, a dark side, and it is unpredictable.
A protocol to the European Convention on Human Rights and Biomedicine Concerning Transplantation of Organs and Tissues of Human Origin (2002) prohibits organ tissue trafficking or any financial gain concerning organ trading. It also calls on states to provide appropriate sanctions for such trafficking. However, the loopholes in laws and the overall anarchy of the world make cooperation between states more difficult. For example, if Bangladesh wants to deal with organ trafficking brokers, they flee to neighboring countries, then according to the principle of sovereignty (a state has legal and political supremacy within its territory), Bangladesh cannot get those criminals back without the assistance of India. The United Nation’s law has legal power but they cannot enforce it Thus, whether the criminals can be punished or run free all depends on the attitude of related states. All countries have the wish to reduce illegal organ trafficking, but they all hope that others would pay more effort on this issue, which makes the cooperative interaction more difficult. Thus, in order to reduce illegal organ trafficking worldwide, we should raise awareness of this issue and make people realize that no one wants a life that is both poor and sick. The United Nations could also try to make most countries legalize kidney and other organ sales, and control the market by government. For example, right now the only country that allows kidney sales is Iran. The trade is organized and controlled by two nongovernmental organizations approved by the government —the Charity Association for Support of Kidney Patients (CASKP) and the Charity Foundation for Special Diseases (CFSD). Regulation plays a significant part in organ trade. Without regulations and strong enforcement, the safety of the organ source donors and the receivers cannot be ensured. There were attempts made by countries like China, India, The Philippines to legalize organ trade, the problems were still the lack of enforcement. There are a large portion of opponents would say that it is inhumane to sell human organs like products, and it could increase the abuse of poor and make the situation worse. However, as long as the demand exist, it’s impossible to eliminate the organ trafficking—the most we could do is to cut as many illegal channels as possible and try to increase the legal organ sources so that safety of both donors and recipients is guaranteed. At the same time, the UN should also make stronger rules, seek for a stronger enforcement mechanism to monitor and prevent underground organ deals, otherwise legalization of organ trade cannot achieve the purpose of benefiting people, and would make the current situation more complicated, increasing inhumane treatments towards patients just to get more organs into the market for the interests of individuals or interest groups.