I recently visited a refugee camp in East Africa, where refugees and NGO staff told me about the dangers of journeying through the desert. Some of the refugees from South Sudan, Eritrea, and Somalia who are fleeing violence, conflict, and poverty attempt the risky passage from East Africa to Israel through the Sinai Desert. Others try to make it to Libya, where their goal is to take boats to Europe.

While I was already aware that females were at risk for sex trafficking en route, this was the first time I’d given more thought to a lesser-known form of trafficking: organ harvesting. While very little is known about the scope of human trafficking for the purposes of organ removal (known by the acronym THB/OR), stories from around the world are beginning to emerge.

Travelling across the wilderness is perilous and difficult, which is why many hire a smuggler to help get them to their destination. But this also has its risks. Smugglers sometimes turn out to be traffickers, and some refugees find themselves being held against their will in desert camps until their family is able to cough up a ransom payment for their release. In these camps refugees often experience torture and rape, and some have their organs removed. While some survive the ordeal, others succumb to their injuries.

Medical professionals with mobile clinics can store the organs for six to eight hours and resell them in places like Cairo.

Why is this happening? Because desperately ill people who have money are willing to pay for an organ on the black market. Traffickers will advertise to people who have been on organ waiting lists for a long time, taking advantage of their desire to get well. On the other side, they take advantage of poverty by convincing vulnerable people to give up an organ in exchange for money. Money they may never see.

Currently, the demand for organs – specifically kidneys –  is much higher than than the supply available for transplants. According to global estimates, the number of transplants may only cover about 10% of the global need. While some people willingly sell their organs on the black market (not considered human trafficking), some are coerced, forced, or deceived into doing so, which qualifies as human trafficking.

But the Sinai isn’t the only place where trafficking networks operate for the purpose of organ removal. Countries where the practice has been identified most often include Brazil, Pakistan, India, China, the Philippines, Egypt, the Gulf States (Kuwait, Saudi Arabia, Bahrain, Oman and the United Arab Emirates), Israel, Turkey, Colombia, and Moldova.

What distinguishes THB/OR from other forms of trafficking is that it requires “white collar crime.” An organ transplant has to be done by a medical professional, so an organized network has to be in place to facilitate the process. An OSCE report highlights the people involved in the process:

The International Broker

AKA the mastermind of the operation. They determine the target population from where to recruit victim-donors, scout out hospitals or private clinics where the surgery can take place, identify surgeons who are willing to perform the procedure, control the funding stream, and act as the point of contact for the organ recipient. They also set up a “fee-per-transplant” arrangement at a medical facility (which entices clinics that are strapped for cash).

The Local recruiter

Also referred to as “kidney hunters,” local recruiters  go into communities to find victim-donors. Sometimes they are former donors themselves. They seek out people who are impoverished, unemployed, poorly educated, and have no travel experience. Those with no basic medical knowledge can easily be persuaded to donate an organ in exchange for money. No information is given about potential medical complications. Recruitment is done through word of mouth or internet ads.

The Minder

The minder travels with the victim-donor to the medical facility (which is often in a different country), providing guidance to the donors and recipients regarding the false statements, misrepresentation or other fraudulent actions necessary to clear immigration or other government controls. They are also responsible for ensuring that the donor goes through with the organ donation. If the person changes their mind, the minder may exert physical force and coerce them to sign the medical contract.

The surgical team:

This can include transplant surgeons, anesthesiologists, nurses, and other medical staff. They are the ones who carry out the transplant surgery. They may also be involved in helping a prospective organ recipient to find an organ through illegal channels. While some doctors are intentionally complicit in the crime, others simply turn enough of a blind eye and don’t ask questions so they can feign ignorance.

 

The donor typically doesn’t get paid until after they return home. Some only receive a portion of what they were promised and some don’t get paid at all. They’re put on a plane within a few days of the surgery, with no follow up or post-op instructions. As a result of complications as well as the new reality of living without an organ, many victims are unable to work due to deteriorated health, plunging them into even deeper poverty than they experienced before.

The CNN Freedom Project covers the story of a Nepalese man who was told that if he let doctors cut a “chunk from his body,” he would receive $30,000 USD. Like many other victims, he never saw the money.

“He assured me nothing would happen, and that the meat would grow back. Then I thought, ‘If the meat will regrow again, and I get about $30,000, why not?'”

Victim, CNN Freedom Project

Here’s the breakdown how one network split the funds:

• Recipients paid between $100,000 and $150,000 (USD)
• Victim-donors were paid $10,000
• The transplant surgeons were paid $15,000 to $20,000 per transplant
• The rest was used for other costs and trafficker profit

Solutions for this form of exploitation are in their infancy, due to the fact that human trafficking for organ removal is a fairly new phenomenon. But there are a few things that can be done.

Increase legal, voluntary donations

Since part of the problem is a shortage in organ donations, governments should encourage more people to become organ donors legally. In Wales, organ donation is now opt-out versus and opt-in. As of December 2015, everyone who has not actively opted out of being a donor will be treated as having no objection to donating any of their organs. Here’s the rationale:

“Many people haven’t recorded their decision about donation or discussed it with their families. The UK has amongst the highest number of family refusals to organ donation in Europe. When families don’t know their loved one’s donation decision, they’re more likely to say no. This is why in Wales we’re bringing in a soft opt-out system for organ donation, to make it easier for people to become a donor.”

Organ Donation Wales Website

Public awareness

Awareness campaigns that provide information on the risks and potential consequences of selling an organ may help vulnerable individuals from being deceived. An awareness campaign targeted at healthcare professionals – covering ethics, risks, and potential fines or other consequences for engaging in illegal organ transplants – may also be helpful.

For More Reading

• Organ snatchers of the Sinai desert: The doctors harvesting body parts stolen from live donors to sell to rich patients in Cairo by Daily Mail
• Selling desperate Syrian refugees’ body parts for profit: Israeli man arrested in Turkey for organ trafficking by Salon.com
• ISIS Might Be Harvesting Organs To Finance Operations, Iraqi Envoy Tells UN by International Business Times
• Nepal’s Organ Trail: How traffickers steal kidneys by CNN Freedom Project 
• OSCE Trafficking in Human Beings for the Purpose of Organ Removal in the OSCE Region (Report)

Feature photo: Sinai Desert, Creative Commons via Wikimedia Commons