"Long before it's in the papers"
March 13, 2012

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Old-fashioned ripoffs common in organ trade: study

March 13, 2012
Courtesy of Mich­i­gan State Uni­vers­ity
and World Science staff

Black-mar­ket or­gan traf­fick­ing is even more in­sid­i­ous than com­monly as­sumed—not just ex­ploit­ing the poor, but of­ten di­rectly cheat­ing them, at least in one coun­try, a study re­ports.

Much pre­vi­ous crit­i­cism of or­gan traf­fick­ing has fo­cused on con­cerns that the poor are ex­ploited and de­grad­ed when their very body parts be­come com­mod­i­ties that they feel com­pelled to trade for fi­nan­cial se­cur­ity.

Now, an an­thro­po­l­o­gist is re­port­ing that this pic­ture in­volves an even dirt­i­er el­e­ment, old-fash­ioned ripoff­s—at least in his na­tive Bang­la­desh, where he in­ter­viewed 33 kid­ney sel­lers. The re­search­er, Monir Mon­i­ruz­za­man of Mich­i­gan State Uni­vers­ity, found they typ­ic­ally did­n’t get the mon­ey they were prom­ised. They al­so suf­fered se­ri­ous health prob­lems that pre­vented them from work­ing, along with shame and de­pres­sion.

Moniruz­za­man spent more than a year in­fil­trat­ing the black mar­ket for hu­man kid­neys. His work is be­ing called the first in-depth study de­scrib­ing the of­ten hor­rif­ic ex­pe­ri­ences of im­pov­er­ished or­gan traf­fick­ing vic­tims. 

The stu­dy, published in the journal Med­i­cal An­thro­po­l­ogy Quar­ter­ly, de­scribes a grow­ing world­wide mar­ket for body parts that in­clude kid­neys, parts of liv­ers and even cor­ne­as.

Moniruz­za­man said most sel­lers don’t in­de­pend­ently choose to get in­volved, but are ma­ni­pu­lated and pres­sured by un­eth­i­cal bro­kers and re­cip­i­ents, of­ten Bang­la­deshi-born for­eign na­t­ion­als in wealth­i­er coun­tries. Be­cause or­gan sell­ing is il­le­gal, the bro­kers forge doc­u­ments claim­ing the re­cip­i­ent and sell­er are re­lat­ed and the act is a family dona­t­ion. Doc­tors, hos­pi­tal of­fi­cials and drug com­pa­nies turn a blind eye be­cause they prof­it too, said Moniruz­za­man, who ques­tioned many of the peo­ple in­volved.

Most of the Bang­la­deshi sel­lers in his study had a kid­ney re­moved across the bor­der in In­dia. Gen­er­al­ly, the poor sell­er and the wealthy re­cip­i­ent met at a med­i­cal facil­ity and the trans­plant was per­formed then, he said.

“This is a se­ri­ous form of ex­ploita­t­ion of im­pov­er­ished peo­ple, whose bodily or­gans be­come mar­ket com­mod­i­ties to pro­long the lives of the wealthy few,” said Moniruz­za­man. He cit­ed the case of Mehedi Ha­san, a 23-year-old rick­shaw puller who sold part of his liv­er to a wealthy re­cip­i­ent in the Bang­la­desh cap­i­tal of Dhaka. Like many poor Third World res­i­dents, Ha­san did­n’t know what a liv­er was. The bro­ker told him the sale would make him rich.

The re­cip­i­ent died soon af­ter the trans­plant. Ha­san re­ceived only part of the mon­ey he was prom­ised and is now too sick to work, walk long dis­tances or even breathe prop­er­ly, Moniruz­za­man said.

Or­gan bro­kers typ­ic­ally snag un­wit­ting sel­lers through de­cep­tive ad­ver­tise­ments, Moniruz­za­man added. One ad, in a Bang­la­deshi news­pa­per, falsely prom­ised to re­ward a kid­ney sell­er with a vi­sa to the Un­ited States. Moniruz­za­man col­lect­ed more than 1,200 si­m­i­lar news­pa­per ads for the stu­dy.

The or­gan trade thrives in Bang­la­desh, a coun­try where 78 per­cent of res­i­dents live on less than $2 a day. The av­er­age quot­ed price of a kid­ney is about $1,400 – a fig­ure that has grad­u­ally dropped due to abun­dant supply from the poor ma­jor­ity, Moniruz­za­man said. One Bang­la­deshi wom­an ad­ver­tised to sell a cor­nea so she could feed her fam­i­ly, say­ing she needed only one eye to see. That trans­plant did­n’t hap­pen, but Moniruz­za­man said there have been cases of cor­ne­as be­ing sold.

To com­bat or­gan traf­fick­ing, he rec­om­mends, among oth­er steps:

• Glob­al gov­ern­ance. The U.S. State De­part­ment should play an ac­tive role in put­ting pres­sure on na­t­ional af­fairs and for­eign gov­ern­ments to ac­knowl­edge the prob­lem and in­sist­ing on crack­downs on bro­kers, re­cip­i­ents, doc­tors and businesspeo­ple in­volved in the trade.
  

• Trans­par­en­cy and ac­count­abil­ity. The State De­part­ment should en­sure all med­i­cal cen­ters have a trans­planta­t­ion reg­is­try and ver­i­fy the rela­t­ion­ship be­tween re­cip­i­ents and donors.
  

• Ca­dav­er­ic dona­t­ion. Coun­tries such as Bang­la­desh that do not have a sys­tem in which peo­ple can do­nate or­gans when they die should im­ple­ment these sys­tems. The Un­ited States should pro­vide aid and en­cour­age ca­dav­er­ic or­gan dona­t­ion through educa­t­ional in­sti­tu­tions, news me­dia and re­li­gious cen­ters, he says.
  

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Black-market organ trafficking is even more insidious than commonly assumed—not just exploiting the poor, but often directly cheating them, at least in one country, a study reports. Much previous criticism of organ trafficking has focused on concerns that the poor are exploited and degraded when their very body parts become commodities that they feel compelled to trade for financial security. Now, an anthropologist is reporting that this picture involves an even dirtier element, old-fashioned ripoffs—at least in his native Bangladesh, where he interviewed 33 kidney sellers. The researcher, Monir Moniruzzaman of Michigan State University, found they typically didn’t get the money they were promised. They also suffered serious health problems that prevented them from working, along with shame and depression. Moniruzzaman spent more than a year infiltrating the black market for human kidneys. His work is being called the first in-depth study describing the often horrific experiences of impoverished organ trafficking victims. The study, which appears in Medical Anthropology Quarterly, describes a growing worldwide market for body parts that include kidneys, parts of livers and even corneas. Moniruzzaman said most sellers don’t independently choose to do it, but are manipulated and coerced by unethical brokers and recipients who are often Bangladeshi-born foreign nationals in wealthier countries. Because organ selling is illegal, the brokers forge documents claiming the recipient and seller are related and the act is a family donation. Doctors, hospital officials and drug companies turn a blind eye because they profit too, said Moniruzzaman, who questioned many of the people involved. Most of the Bangladeshi sellers in his study had a kidney removed across the border in India. Generally, the poor seller and the wealthy recipient met at a medical facility and the transplant was performed then, he said. “This is a serious form of exploitation of impoverished people, whose bodily organs become market commodities to prolong the lives of the wealthy few,” said Moniruzzaman. He cited the case of Mehedi Hasan, a 23-year-old rickshaw puller who sold part of his liver to a wealthy recipient in the Bangladesh capital of Dhaka. Like many poor Third World residents, Hasan didn’t know what a liver was. The broker told him the sale would make him rich. The recipient died soon after the transplant. Hasan received only part of the money he was promised and is now too sick to work, walk long distances or even breathe properly, Moniruzzaman said. Organ brokers typically snag unwitting sellers through deceptive advertisements, Moniruzzaman added. One ad, in a Bangladeshi newspaper, falsely promised to reward a kidney seller with a visa to the United States. Moniruzzaman collected more than 1,200 similar newspaper ads for the study. The organ trade thrives in Bangladesh, a country where 78 percent of residents live on less than $2 a day. The average quoted price of a kidney is about $1,400 – a figure that has gradually dropped due to abundant supply from the poor majority, Moniruzzaman said. One Bangladeshi woman advertised to sell a cornea so she could feed her family, saying she needed only one eye to see. That transplant didn’t happen, but Moniruzzaman said there have been cases of corneas being sold. To combat organ trafficking, he recommends, among other steps: Global governance. The U.S. State Department should play an active role in putting pressure on national affairs and foreign governments to acknowledge the problem and insisting on crackdowns on brokers, recipients, doctors and businesspeople involved in the trade. Transparency and accountability. The State Department should ensure all medical centers have a transplantation registry and verify the relationship between recipients and donors. Cadaveric donation. Countries such as Bangladesh that do not have a system in which people can donate organs when they die should implement these systems. The United States should provide aid and encourage cadaveric organ donation through educational institutions, news media and religious centers.