Organ Trafficking : The Red Market

Organ transplantation is one of the most incredible medical achievements of the past century. Since the first successful transplants, which took place in the 1950s, organ transplantation has saved the lives of hundreds of thousands of people worldwide. The transplantation of healthy organs into persons whose own organs have failed, improves and saves thousands of lives every year. But demand for organs has outstripped supply, creating an underground market for illicitly obtained organs. Organ trafficking, also defined as ‘illegal organ trade’, ‘transplant tourism’ or ‘organ purchase’ describes the phenomenon of trafficking in persons for the purpose of organ removal, a grim reality even in the 21st century. A global shortage of organs has driven the industry, relying on poor populations to be donors and wealthy foreigners to be recipients.

Organ Trafficking: The Unseen Form of Human Trafficking

Organ trafficking, a lucrative global illicit trade, is often a lesser discussed form of human trafficking among anti-human trafficking stakeholders due to its intricate and often stealth nature. Trafficking sex and/or labor are the more commonly thought of forms of human trafficking among public policy leaders and general awareness campaigns. However, organ trafficking holds a critical place with transnational organized crime groups due to high demand and relatively low rates of law enforcement.

Organ traffickers profit in the shadows, while their destructive medical footprint is the only thing that is felt. It leaves vulnerable populations, aka “donors,” and first world beneficiaries, aka “recipients,” open to severe exploitation and a lifetime of health consequences.

Low Supply, High Demand

Over 114,000 people are on the organ wait list in the United States, and a new person is added every 10 minutes (American Transplant Foundation, 2018). On average, 20 people die every day waiting for an available organ in the United States alone (American Transplant Foundation, 2018). The legally available organs for transplant only satisfy about 10% of the global organ transplant need. The long wait lists and grim results of waiting too long drive a lot of people to participate in transplant tourism and organ trafficking. Organ trafficking is the practice of stealing or buying organs through exploitation to be sold on a black market for profit, and transplant tourism is traveling to another country for the purpose of buying, selling, or receiving organs.

About INDIA: In India, around 200,000 people need a kidney every year, but only around 3% of the demand is met, says Dr Sunil Shroff, managing trustee of the Mohan Foundation, a Chennai-based non-government organization working on organ donation. “There is a demand and supply problem. Of these 200,000 in need of a kidney, around 15,000 can afford treatment but only 7,000 of these can afford transplants," says Shroff. Even if one can afford a transplant, finding a matching donor is difficult. Besides, under the law, only some people related to the person in need are allowed to donate, and this further shrinks the number of prospective organ donors.

The supply-demand gap for donor organs paves the way for illegal transplant and trade of human organs.

Targets of Organ Trafficking

Organ trafficking victims, as with most human trafficking victims, are generally poor, vulnerable populations. There are rare instances where victims are put under anesthetic and wake to find their organs missing or are murdered for their organs. As a whole, coercion of living donors is more common. It is most common for victims of organ trafficking to be recruited through brokers, who are individuals who recruit organ suppliers and connect them with organ recipients. Recruiters/brokers are usually people who may be from the same communities or ethnicity of a vulnerable population so as to build trusting relationships easier. The recruiters then make promises to the organ suppliers like large sums of money or release from debt, and convince them that the organ is not needed. Specifically, in the case of kidneys, the most commonly harvested organ from living donors, recruiters will tell victims that the kidney will grow back, having two kidneys is unnatural, or that they have a large and a small kidney and removal of the small kidney is harmless. Victims rarely receive the full amount of money promised, if they receive any compensation at all. In some cases, the post-removal healthcare costs for a living organ trafficking victim add to their previous debt and worsen their financial situation.

Hiding in Plain Sight

Once obtained, trafficked organs can be transplanted to recipients in the most reputable of hospitals in major cities throughout the world but makeshift operating rooms in houses have often been the clandestine locations for such transplants.

Traffickers orchestrate the recruitment of the donor often from a place of vulnerability, and victims are not necessarily properly screened for their qualifications to be a healthy donor. Desperate patients in need of an organ may fall prey to a trafficker who could be posing as a “reputable” representative of an altruistic organ matching organization. Financial exploitation plays a key part in both sides of this scenario. In addition, organ traffickers could also be involved in other forms of human trafficking, such as sex and/or labor trafficking. Cases are emerging where an organ donor may have been a victim of sex trafficking and/or labor trafficking as well as a victim of organ trafficking, creating a multi-level equation of exploitation. The term “transplant tourism” is often utilized in describing this crime, as defined by the Declaration of Istanbul:

“…travel for transplantation that involves organ trafficking and/or transplant commercialism or if the resources (organs, professionals and transplant centers) devoted to providing transplants to patients from outside a country undermine the country’s ability to provide transplant services for its own population.”

                

Illicit organ trafficking Case Studies in India and Kosovo

                                                               INDIA:

The multi-billion rupee Gurgaon kidney scandal came to light in January 2008 when police arrested several people for running a kidney transplant racket in Gurgaon,an industrial township near New Delhi, India. Kidneys from most of the victims, who were the poor hailing from the nearby western Uttar Pradesh, were transplanted into clients from the United States, United Kingdom, Canada, Saudi Arabia and Greece. The police raid was prompted by complaints by the locals from Moradabad about illegal kidney sales. The man accused of the scandal, Amit Kumar, was arrested in Nepal on 7 February 2008 and has denied any hand in criminal activity. According to the Gurgaon police, the scandal at a local clinic was going on for six to seven years. The donors were lured with offerings of about Rs. 30,000 for kidney removal. First, they were lured to the clinic on the pretext of job opportunities. They were instead asked for donating their kidneys for the fee and all those who resisted this were drugged against their will and subsequently operated upon.

KOSOVO:

 During and after the 1999 war, accusations were made of people being killed in order to remove their organs to sell them on the black market. Various sources estimated that the number of victims ranged from a "handful", up to 50, between 24 to 100 to over 300. The victims were believed to be of Serbian nationality, killed by perpetrators with strong links to the Kosovo Liberation Army  in 1999. Claims were investigated first by the ICTY who found medical equipment and traces of blood in and around the house. They were then investigated by the UN, who received witness reports from many ex-UK fighters who stated that several of the prisoners had their organs removed.

THE  RED MARKET:

More than a dozen countries have agreed to enforce laws to fight trafficking in human organs, a business that exploits the world’s poorest people and earns criminals up to $1.2 billion in illegal profits every year. India can be rightly proud of its status as one of the world’s fastest growing economies but there’s an infamous label that refuses to go away. Despite the country’s best efforts to destroy the black market for illegal organ trade, India retains its reputation as an easy place to buy organs such as kidneys and livers. With around 60% of its population still living in villages, the practice of organ donation remains unknown.The worth of this red market in India worth in crores .The major donors are from rural India who are helpless by their poverty and social burden.

LAWS AGAINST ORGAN TRAFFICKING:

INDIA: 
Before 1994, India had no legislation banning the sale of organs. Low costs and high availability brought in business from around the globe, and transformed India into one of the largest kidney transplant centres in the world. However, several problems began to surface. Patients were often promised payments that were much higher than what they actually received. Other patients reported that their kidneys were removed without their consent after they underwent procedures for other reasons.

In 1994, the country passed the Transplantation of Human Organs Act (THOA), banning commerce in organs and promoting posthumous donation of organs. The law's primary mechanism for preventing the sale of organs was to restrict who could donate a kidney to another person. In particular, the THOA bars strangers from donating to one another; a person can only donate to a relative, spouse, or someone bound by "affection." In practice, though, people evade the law's restrictions to continue the trade in organs. Often, claims of "affection" are unfounded and the organ donor has no connection to the recipient. In many cases, the donor may not be Indian or even speak the same language as the recipient. There have also been reports of the donor marrying the recipient to circumvent THOA's prohibition.

THE PHILIPPINES:

Although the sale of organs was not legal in the Philippines, prior to 2008 the practice was tolerated and even endorsed by the government. The Philippine Information Agency, a branch of the government, even promoted "all-inclusive" kidney transplant packages that retailed for roughly $25,000. The donors themselves often received as little as $2,000 for their kidneys. The country was a popular destination for transplant tourism. One high-ranking government official estimated that 800 kidneys were sold annually in the country prior to 2008, and the WHO listed it as one of the top 5 sites for transplant tourists in 2005.

In March 2008, the government passed new legislation enforcing the ban on organ sales banned the sale of organs. After the crackdown on the practice, the number of transplants has decreased from 1,046 in 2007 to 511 in 2010. Since then, the government has taken a much more active stance against transplant tourism.

AMERICA:

 In the United States, there have been 26 pieces of legislation passed aimed at regulating organ transplanting and donation (Health Resources and Services Administration . These regulations range from what constitutes being dead, to what constitutes consent for organ donation, to national honors for organ donation. In 1984 the United States passed the National Organ Transplant Act (NOTA), which banned the buying and selling of organs for transplant, created a task force on organ transplanting, and created an administrative unit in the Department of Health and Human Services to manage a registry of organ donors and recipients.

MODELS OF LEGALIZATION:

Erin Harris Model

Ethicists Charles A. Erin and John Harris have proposed a much more heavily regulated model for organ transactions. Under this scheme, would-be sellers of organs do not contract with would-be recipients. Instead, a government agency would be the sole buyer of organs, paying a standard price set by law and then distributing the organs to its citizens. This safeguard is designed to prevent unscrupulous buyers from taking advantage of potential donors and to ensure that the benefits of the increased organ supply are not limited to the rich. Moreover, participation in the market would be confined to citizens of the state where the market is located, to prevent the unilateral movement of organs from developing nations to the developed world. Erin and Harris's model has been endorsed by a number of prominent advocates of organ markets.

Free Market Model

Many scholars advocate the implementation of a free market system to combat the organ shortage that helps drive illegal organ trade. The organ trade's illegal status creates a price ceiling for organs at zero dollars. This price ceiling affects supply and demand, creating a shortage of organs in the face of a growing demand. According to a report published by the Cato Institute, a US-based libertarian think tank, eliminating the price ceiling would eliminate the organ shortage In the Journal of Economic Perspectives, Nobel laureate Gary Becker and Julio Elias estimated that a $15,000 compensation would provide enough kidneys for everyone on the wait list. The government could pay the compensation to guarantee equality. This would save public money, as dialysis for kidney failure patients is far more expensive.

CONCLUSION:

With the growing need of human organs, there is exponential rise in the size of red market. The organs are sold in the black market which are afforded by riches. The organs are donated by poor of developing countries who are helpless. In some cases, the organs are forcibly removed from the suitable donor. Only victims of this inhuman activities are poor. Many organizations stood up against the crime but the roots are so deep that they never capture the masterminds. Innocent lives are ended to fulfill the growing need. This global network illegal market worth in billions. International laws need to be meant; international organizations need to be stand to stop this global malpractice.