Bodies without passports: 'Transplant tourism' flourishes in developing world
Nov 17,2006 00:00 by Bill_Berkowitz

Nancy Scheper-Hughes opens her provocative essay entitled "Biopiracy and the Global Quest for Human Organs," with a scene taken from Stephen Frears' film "Dirty Pretty Things." Okwe, an illegal Nigerian immigrant doctor, framed in his homeland and forced into exile in London, discovers that the hotel where he works is one stop along the grisly trail of illegal body parts trafficking.

In a late-January episode of the CBS television program "Numb3rs" -- a detective series built around the conceit that crimes can often be solved through the application of sophisticated mathematical formulas -- four Indian girls from Chennai were duped and brought to the United States by body-parts traders. The young immigrants were forced to sell their body parts in order to repay those who brought them to the country.

While stories about the illegal trade in body parts -- often obtained by traffickers for measly sums paid to the donor or for nothing at all -- may seem better suited for the big screen, episodic television or science fiction novels, they are occurring in the real world with disturbing frequency.

Scheper-Hughes, a professor of medical anthropology at the University of California, Berkeley, knows this all too well. She is the co-founder and director of Organs Watch, a project that originated in widespread rumors of body snatching and organ theft in the urban shantytowns of Brazil in the mid-1980s.

In her essay published in the March/April 2006 edition of the Nacla Report on the Americas, Scheper-Hughes says that "U.S. or Japanese medical agents working for large hospitals abroad... abducted bodies," harvested the parts they wanted, especially eyes, kidneys, hearts, and livers, and then unceremoniously dumped the remains "on the sides of country roads or in hospital dumpsters."

Although medical professionals denied this was happening, in 1997 Scheper-Hughes began following the trail of rumors about the grim trade. Over the years, she has traveled to 12 countries and visited more than 50 scenes of illicit organs and tissues procurement.

Legislation has been passed in several countries to crack down on the trade in body parts, but Scheper-Hughes told me in a telephoned interview that "things are still quite unstable."

"China is preparing a new law making transplant tourism illegal. There will be no payment for organs and no foreign transplant patients," she said.

"It's too early to say whether it will stick or give rise to a shadow transplant economy. A new law was passed in Israel, making it illegal for Israeli transplant patients to be reimbursed by their national health insurance carriers for illegal transplants."

"Despite all this legislative activity, transplant tourism grows stealthily on the margins, as patients are 'voting with their legs' to solve their problems. Eventually, I see paid kidney donors becoming routine and eventually legal so that the trade will occur nationally rather than transnationally. That would be a sad outcome, but perhaps it is inevitable now that the cat is out of the bag," she concluded.

One of her more shocking realizations was that the underground body parts industry had gone from being something that "evoked shock and revulsion bordering on nausea" to becoming a "fait accompli -- an accepted medical fact defended on pragmatic grounds."

As a member of the panel on Ethics, Access and Safety in Tissue and Organ Transplant at a 2003 World Heath Organization meeting, Scheper-Hughes witnessed an official from a private eye bank "defend the 'necessary' commercialization of tissue banks in the developing world."

Without government support for "subsidized tissue banking," the argument went, poor countries had to resort to international trading/selling of body parts that were not being used locally and that could be transported through informal agreements to the developed world, where they are in great demand for orthopedic and other high-tech surgeries.

And, in what on the face of it appears to be a win-win situation, "In exchange, the poor donor-institutions could receive a steady supply of scarce corneas."

Organs Watch discovered a "large, unregulated, multi-million-dollar business in human tissues, taken without consent or procured from the naive family members of brain-dead donors who believe their 'gifts' would be used altruistically to save lives and reduce human suffering." Instead, these "gifts" were turned into commodities that were bought and sold, processed and transported, picking up additional value as they moved toward the market. Organs Watch found that bone and skin grafts were sold and processed by private biotech firms in the U.S. and turned into expensive commercial products for dentists, orthopedics and plastic surgery.

In South Africa, official documentation revealed that "human heart valves [had been] taken without consent from the bodies of poor blacks in the local police mortuary and shipped for 'handling costs' to medical centers in Germany and Austria," the group says.

In 2002, Scheper-Hughes apprised the South African Ministry of Health of a scheme originating at a national tissue bank that involved "the transfer of hundreds of Achilles tendons that were removed without consent from the bodies of the victims of township violence and shipped by the director of the tissues bank to a corrupt U.S. businessman who paid 200 dollars for each tendon."

Shipped to the U.S. via South Korea, they were ultimately repackaged and sold locally and abroad to private medical and biotech firms for 1,200 dollars each.

As is most often the case, everyone, except the poor people from whom these tendons came, benefited handsomely from the deal.

The rise in "illegal transplant tourism" -- a term coined by Scheper-Hughes -- was "developed to meet an insatiable demand for organ transplants that rises exponentially against a flat supply of organs donated through traditional and regulated means," she writes in the essay.

While donations have remained flat -- increasing only 33 percent over the past decade or so -- the number of patients on national waiting lists has increased by 236 percent.

With the increased need, poor people are recruited or entrapped into donating their body parts to satisfy the demand from rich patients who can afford to travel abroad and, Scheper-Hughes says, to break national laws and international medical regulations to get the organs and medical procedures they need.

Scheper-Hughes told me that she continues to be very active with Organs Watch, and is currently working with the World Health Organization on several "black spots" in illegal transplant tourism -- China, Pakistan -- as well as with the ministry of health and the federal police in South Africa and Brazil with respect to arrests and trials of "transplant surgeon outlaws."