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DONORS ON DEMAND:

THE ILLEGAL ORGAN TRADE

Meike Brucker
Ms. Aylesworth
Independent Study Unit Issue Based
Friday, May 8, 2015

TABLE OF CONTENTS

Preface Page 1
Summary of Research Methods Page 4
Background ... Page 5
Expert .... Page 8
Role of Control .... Page 13
Logic of Evil ... Page 17
Religion/Spirituality. Page 20
Case Studies Page 23
The Role of International Organizations ..... Page 32
Canadian Connection ...... Page 36
Solutions .. Page 40
Conclusion ... Page 43

PREFACE
Trafficking in organs is a crime that occurs in three broad categories. Firstly, there are
cases where traffickers force or deceive the victims into giving up an organ. Secondly,
there are cases where victims formally or informally agree to sell an organ and are
cheated because they are not paid for the organ or are paid less than the promised
price. Thirdly, vulnerable persons are treated for an ailment, which may or may not
exist and thereupon organs are removed without the victims knowledge. 1
In every hour of every day human kidneys, lungs, livers, and corneas are sold illegally
on the black market. This is the organ trade and it is illegal because it involves an exchange of
money. The organ trade is made easier with the Internet and is growing rapidly due to a
worldwide shortage of organs available for transplantation. While it is difficult to obtain data
due to the secrecy surrounding the issue, the problem of trafficking is widespread. More than
100,000 people are on Canadian waiting lists for organs but over half of them will die before
they get a suitable organ. Every day more than twenty people in Canada die waiting for a new
organ. Each year thousands of people from developed nations travel to developing nations for
illegal organ transplants.2 This is called transplant tourism. The most popular destinations for
organ recipients to travel to in order to receive black market organs are Kosovo, Israel, Egypt,
Azerbaijan, Cyprus, China, the Philippines, Costa Rica, Panama, Ecuador, Columbia, Brazil,
and the western part of the United States of America. Most of the recipients are from Canada,
the eastern part of the United States of America, Saudi Arabia, the Gulf States, Japan, and

Kappe, C. (2013, April 8). Initiative to Fight Human Trafficking. Organ Trafficking. Retrieved February 20, 2015, from
Unger, D. (n.d.). Organ Donation. Retrieved February 26, 2015, from http://canadianbioethicscompanion.ca/the-canadianbioethics-companion/chapter-7-organ-donation/
2 Ginzel, A. (2012, August 3). Spiegel Online International. Vera's Kidney, Walter's Money: Desperation, Greed and the
Global Organ Trade. Retrieved February 24, 2015, from http://www.spiegel.de/international/world/the-illegal-trade-in-organis-fueled-by-desperation-and-growing-a-847473.html

4
Taiwan. Iran is the only country in the world where organ trade is legal but Singapore is in the
process of legalizing it. There is much debate about the organ trade, as many people believe it
should be legalized to combat organ trafficking. Approximately 10% the worlds organ
transplants are illegal and the trade makes about $1.2 billion each year.3
Everyone involved in the illegal organ trade is putting himself or herself in danger.
The donors not only risk their own lives when they donate organs but they risk the recipients
lives as well. Many of the donors who live in third world countries are not tested for diseases
beforehand, as their countries do not have the money or technology. This often results in the
donor becoming very ill or even dying once an organ is removed. It also may lead to the
recipient, who has usually traveled overseas, either not getting the organ because it is damaged
or diseased, becoming ill after the surgery, or dying. Contracting hepatitis or HIV are possible
risks each party takes. This can cause many problems for the donors, recipients, and doctors
who are involved. The doctors who perform the surgeries may be sued or arrested if anything
goes wrong.4 Unfortunately arrests do not happen as often as they should.
Organs may be taken from people in third world countries who are drugged and then
kidnapped. The victims are usually young children living in poverty or tourists who are
visiting these countries. Many of the victims are stranded by the doctors and are left to die.
Some of the donors may also be forced to agree to donate an organ.
Another problem with the illegal organ trade is that many donors are cheated and do
not receive as much money as they were promised. The organ brokers and doctors tell the
donors that they will be receiving a large amount of money, but they are not actually paid in
3

Interlandi, J. (2009, January 9). Newsweek Culture. Organ Trafficking Is No Myth. Retrieved February 23, 2015, from
http://www.newsweek.com/organ-trafficking-no-myth-78079
4 Scutti, S. (2013, July 9). Organ Trafficking: An International Crime Infrequently Punished. Retrieved February 21, 2015,
from http://www.medicaldaily.com/organ-trafficking-international-crime-infrequently-punished-247493

5
full allowing the middlemen to make more money. The doctors are often the brokers as well
and become quite wealthy. As the donors are almost always from a low-income bracket, they
are usually uneducated and seldom have contracts or the means to hire lawyers to help them
get what they are owed.5
The final category of the illegal organ trade consists of the people who become
unwitting and unwilling donors when they have surgery for something else, which may or may
not be legitimate, and then wake up with one less organ. Dishonest doctors may take organs
from patients bodies without the patients permission. The patients are told their organ was
removed for medical reasons or in some instances, they are not even told they are missing an
organ. The organ is then sold on the black-market with the doctor making a large profit and
the donor not being compensated at all.
The illegal organ trade is a significant worldwide issue that affects many people in
different ways. This issue needs to come to an end as it is destroying the lives of so many
people: the donors continue to live in poverty and may become ill while the recipients spend
thousands of dollars but do not always receive healthy organs. All people risk their lives when
they are involved in the black market. Some lives are saved, but more often lives are
destroyed.6
Despite not knowing anyone who has been robbed of an organ, personal experiences as
a child and a traveler allow a connection to be made to the illegal organ trade. The children of
the world need to be kept safe and people should not feel threatened when travelling. Life
should be valued and nobody should live in fear of being robbed of his or her future.

Ginzel, A. (2012, August 3). Spiegel Online International. Vera's Kidney, Walter's Money: Desperation, Greed and the
Global Organ Trade. Retrieved February 24, 2015, from http://www.spiegel.de/international/world/the-illegal-trade-in-organis-fueled-by-desperation-and-growing-a-847473.html
6 Griffin, A. (2007, March 10). Kidneys on demand. Retrieved February 22, 2015, from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1819484/

SUMMARY OF RESEARCH METHODS


This independent study unit discusses the illegal organ trade and how quickly it is
becoming a more prevalent world issue. Many different resources were used to collect the
information needed to complete this report. A variety of online websites were visited to obtain
facts and background information. These online websites included newspaper articles,
magazine articles, informative websites, and experts websites. The 2013 Canadian film, Tales
From the Organ Trade, provided several different case studies from around the world as well
as information from worldwide experts, and facts about both the history and the future of the
illegal organ trade. All of the sources used provided detailed information and factual evidence
that helped complete this report.

BACKGROUND
Over time the illegal organ trade has established itself as a more prominent global
issue, as it is becoming endemic in different countries. For many years, only first world
countries performed organ transplants and the only organs used were from people who were
brain-dead or non-beating-heart patients. One of the earliest live organ transplants was in
1954 in Boston, Massachusetts, when a twin baby had one of his kidneys removed so it could
be transplanted to save his brothers life.7 This is when people realized that live donor organ
donation is possible. Live donors can donate kidneys and parts of livers (as they are
regenerative) but it is only legal if there is no payment. In the 1970s, drugs were introduced to
prevent organ rejection, which meant an increase in both legal and illegal organ transplants.
The demand for organs is high so only about 23% of the people on the waiting lists get the
organs they need each year. It is not unusual to have to wait for more than three years for a
suitable organ.8 Eventually many doctors and patients turned to third world countries for the
organ transplants. However, this quickly turned illegal, as these countries did not have
anybody in charge of regulating the donors and recipients. The requirements that were not met
were background checks for the ages of the donors and the testing of donors for diseases. The
donors are also usually paid afterwards, which is illegal. As the organ trade grew, many more
people were willing to sell their organs for money. Kidneys are the most commonly donated
organs, as transplants of other organs, such as hearts and lungs, require more sophisticated

Powell, A. (2011, September 22). Harvard Public Affairs & Communications. A transplant makes history | Harvard Gazette.
Retrieved February 22, 2015, from http://news.harvard.edu/gazette/story/2011/09/a-transplant-makes-history/
8 Beshears, M. (2014, April 28). News and Analysis about Law Enforcement Issues, Careers, and Education. The Rise of
Black-Market Organ Trafficking | In Public Safety. Retrieved February 25, 2015, from http://inpublicsafety.com/2014/04/therise-of-black-market-organ-trafficking/

8
facilities not typically available in developing nations.9 Heart and lung surgeries also require
more sophisticated techniques that the doctors may not be familiar with.
Organ trafficking is becoming more prominent in poor countries such as Nepal, China,
and Mexico where many people are desperate enough to do anything for money. This is
compounded by outbreaks of war and drought as well as other natural disasters. Unfortunately,
the worse the poverty is in a country, the less money the donor receives for an organ in
comparison to a donor from a wealthier country. Consequently, the recipient then pays less for
an organ. Third world countries have the most donors and because of the conditions
surrounding the surgeries, there is a much higher risk of illness or death afterwards for both
the donors and the recipients. The risk is higher because many people have diseases they are
unaware of due to the lack of proper medical care. This results in the donors becoming ill
and/or the recipients becoming sicker after receiving diseased or damaged organs, which then
may be rejected.
There are several different facets included in the international black market trade in
human organs. The oldest and most common facet is the poor selling to the rich, a fairly quick
way for them to make money to help them get out of poverty. This is considered an illegal
donation because there is money exchanged. The second most common aspect is the
kidnapping and drugging of an unwilling donor. This is common in developing nations such as
China, Nepal, Bangladesh, and India. There is widespread drug usage as well as human
trafficking in these countries, so it is relatively easy to kidnap people and obtain their organs
for profit. The healthiest organs are usually harvested from young children who often die
afterwards because they do not receive proper medical care or because more than one organ is

Scutti, S. (2013, July 9). Organ Trafficking: An International Crime Infrequently Punished. Retrieved February 21, 2015,
from http://www.medicaldaily.com/organ-trafficking-international-crime-infrequently-punished-247493

9
taken from their body. The third facet of the illegal organ trade is paying the willing donors
less money than the agreed upon amount or even no money at all. These people who are
cheated out of the proper payment are often not given the care they need after the surgery,
which was promised beforehand. Something that is becoming more common recently in third
world countries such as China and India is the kidnapping of tourists for their organs. These
tourists usually wake up in a bathtub of ice with one less organ then they had before. The last
facet in the organ trade is the selling of a baby before it is even born. It has only come into
play in the last few years, and so far has only been reported a few times, but it is likely to
become more rampant as the illegal organ trade increases. The organ traffickers will see this
as a new method of obtaining organs with little chance of getting caught, as it is not likely to
be reported by anyone. Once the baby is born, traffickers take the baby and allow it to live and
grow until they are satisfied with its size. Then they harvest the childs organs, let the child
die, and sell as many different organs as they can on the black-market. This is very lucrative
for the brokers but it is also puts them at the most risk of being caught and convicted. This is
because it involves babies/young children and there are many organizations around the world
that protect the rights of children.
The illegal organ trade is a global issue because it occurs in many parts of the world
and affects people everywhere, whether they live in developed nations or in developing
nations. Over the years this problem has grown rapidly worldwide. The World Health
Organization has attempted many times to suppress the illegal organ trade, as it is unfair to the
poorer groups. However, rather than slowing down, the reports of this issue are actually
increasing.10

10

(2011, January 17). Organ Removal. Retrieved February 20, 2015, from http://fightslaverynow.org/why-fight-there-are-27million-reasons/otherformsoftrafficking/organ-removal/

10

EXPERT
"Organ trafficking is a growth industry," said Jonathan Ratel, a European Union
special prosecutor. Organized criminal groups are preying upon the vulnerable on both sides
of the supply chain: people suffering from chronic poverty, and desperate and wealthy patients
who will do anything to survive." 11
Jonathan Ratel has been a prosecutor in organized crimes and corruption since March
2010. Ratel was born in Vancouver, British Columbia, Canada and is both a British and
Canadian citizen. He went to the University of Victoria in Canada where he received an
undergraduate degree in arts, sciences and law. Ratel then went to the London School of
Economics in England where he received an advanced degree in law.12
Ratel is now considered an expert in justice, security sector reform, and international
prosecutions in post conflict regions. In the past years he has worked with the Canadian
International Development Agency, the UK Foreign and Commonwealth Office, the European
Union, the UL Department for International Development, and the UK Stabilization Unit.
While affiliated with these organizations, Ratel has worked in Iraq, Kuwait, Jordan,
Afghanistan, Bosnia, Herzegovina, Serbia, Montenegro, Bosnia, Turkey, Philippines, Canada,
England, the United States of America, and in Kosovo, which is where he has done the most
research. Ratel is now the Deputy Chief Prosecutor with the Special Prosecution Office in the
Republic of Kosovo. Jonathan Ratel was appointed to this position by the European Union and

11

Bilesky, D. (2012, July 29). Pittsburgh Post-Gazette. Black Market for Body Parts Spreads Among the Poor in Europe.
Retrieved February 20, 2015, from http://www.post-gazette.com/news/world/2012/06/29/Black-Market-for-Body-PartsSpreads-Among-the-Poor-in-Europe/stories/201206290287
12 (2010, March ). European Union External Action. Jonathan Ratel appointed as new Head of SPRK. Retrieved February 21,
2015, from http://www.eulexkosovo.eu/en/news/000411.php

11
is responsible for many important issues like war crimes, organized crime including the illegal
organ trade, terrorism, and corruption in Kosovo.
In 2013 Jonathan Ratel was part of the documentary Tales From the Organ Trade,
directed by Ric Esther Bienstock. Ratel did studies on the organ trade in the Philippines,
Canada, and Kosovo. He estimated that 10-15% of organ transplants are illegal. In the
documentary, Jonathan Ratels role was to provide information about the issue and interview
people who have experience with it. Ratel also tracked down people who worked at or spent
time at one of the worlds largest organ trafficking clinics located in Kosovo, called Medicus.
He was the first person to be successful in finding information about Medicus and
interviewing people who worked/spent time there. Collecting information about Medicus was
extremely difficult because the Kosovo police shut it down in 2008 and before that, while the
clinic was in business, it was cloaked in great secrecy.
Jonathan Ratel tracked down and was the first person to interview Dr. Yusuf Sonmez
and Doctor Moshe Harel, two of the worlds most notorious doctors responsible for
performing hundreds of illegal operations. Tales From the Organ Trade was the first video
their interview appeared on.
Doctor Yusuf Sonmez, hes a very interesting individual in the sense that hes highly
intelligent, sophisticated and quite worldly. But I think its quite clear that he is a significant
international component to organ trafficking around the world, said Jonathan Ratel in Tales
From the Organ Trade.13 Doctor Yusuf Sonmez is a fifty-seven year old man from Turkey
and is currently living there. He is the most infamous doctor in the world to perform illegal
organ transplants and he is Europes most wanted man. Sonmez has been arrested at least six

13

Bienstock, R.E. (Producer) (Director). (2013). Tales From the Organ Trade [Motion
Picture]. Canada: HBO Documentary Films.

12
times and is currently a fugitive. He is also known as Doctor Vulture and Doctor Frankenstein
because of the crazy lengths he will go to perform illegal surgeries. In his interview, Sonmez
told Jonathan Ratel that he has never performed surgeries that were against peoples will or
surgeries that were illegal. Sonmez also claimed that his patients have never exchanged
money, which is illegal. However, Ratel discovered a movie of Sonmez offering a man more
than eight thousand dollars for his kidney. Yusuf Sonmez denied this and said the video was
faked, as he would never do anything he knew to be illegal. However, Ratel interviewed a man
named Raul Fain from Toronto who went to Medicus for an illegal kidney transplant. Fain
told Ratel that he met Yusuf Sonmez who performed the surgery on him.14 Raul Fain also said
that he paid Doctor Yusuf Sonmez over one hundred thousand dollars for one kidney. Sonmez
denies everything he is accused of that is classified as illegal but does not deny doing organ
transplants, as he believes these are not illegal. I dont need to ask these questions, he said,
because I do believe that people have their own authority over their own body. They are not
stealing, they are not cheating. So this is the shame of the system. Not their shame. 15
After collecting information from the Medicus clinic and Yusuf Sonmez, Ratel found
evidence that in 1999 many of the organs that were transplanted came from prisoners who
were trafficked across the Albania-Kosovo border. These prisoners were all killed for their
organs. Sonmez has not been to Kosovo since 2008 as human trafficking and trafficking
organs are both illegal there and he would be convicted. Ratel and many other organizations
are waiting for him to leave Turkey so they can arrest him.

14

Qena, N. (2013, April 29). Global News | Latest & Current News. Kosovo court gives 3
prison terms in organ-trafficking case - National | Globalnews.ca. Retrieved February 27, 2015, from
http://globalnews.ca/news/519993/kosovo-court-gives-3-prison-terms-in-organ-trafficking-case/
15 Carvajal, D. (2011, February 10). Europe. Trafficking Investigations Put Surgeon in Spotlight. Retrieved February 19, 2015,
from http://www.nytimes.com/2011/02/11/world/europe/11organ.html?pagewanted=all&_r=0

13
Doctor Moshe Harel is also from Turkey and is currently living there. Jonathan Ratel
set out to discover who was helping to run Medicus smoothly and secretively and he
concluded that it was Moshe Harel. Harels job in Medicus was to organize tissue matching
and the matching of blood types. He also arranged all of the patients flights to Kosovo and
transportation to Medicus. Another responsibility Harel had was determining how much
money (if any) the donor would receive and how much money the recipient would have to
pay. A couple of years after the police raided the Medicus clinic, Moshe Harel was found in
Israel and arrested.16 However, he was released on bail with the condition that he return for the
trial, which he did not do. Since then, he has managed to disappear somewhere in Turkey.
Doctor Moshe Harel and Doctor Yusuf Sonmez were good friends from their many years of
working together. They are very smart men who made bad decisions and broke many laws.
Both men are fugitives at this time.
The information collected by Jonathan Ratel has helped many organizations involved
with fighting the illegal organ trade. Ratel sent the Medicus case to court on November 4,
2008. Since then, there have been over 100 hearings and over 100 witnesses have testified in
the trial.17 Jonathan Ratel is a strong believer in the importance of putting a stop to this issue
before it gets worse than it already is. Ratel said, In every sense this was the cruel harvest of
the poor and weak in our society, 18
Jonathan Ratel is continuing his worldwide research into the illegal organ trade.
Currently, he is waiting for Yusuf Sonmez to reveal himself and leave Turkey so that he can
16

Carter, G. (2014, February 9). There Must be Justice. After harvesting Serbian organs, NATO & Turkish Hospitals illegally
traffick Injured Syrians Organs | There Must be Justice. Retrieved February 23, 2015, from
http://theremustbejustice.wordpress.com/2014/02/09/after-serbian-nato-turkish-hospitals-illegally-traffick-injured-syriansorgans/
17 Peci, E. (2013, April 17). Balkan Transitional Justice . Prosecutor Sums Up Kosovo Organ Trafficking Case. Retrieved
February 20, 2015, from http://www.balkaninsight.com/en/article/evidence-compressed-in-kosovo-organ-trafficking-case
18 Qena, N. (2013, April 29). Global News | Latest & Current News . Kosovo court gives 3 prison terms in organ-trafficking
case - National | Globalnews.ca. Retrieved February 27, 2015, from http://globalnews.ca/news/519993/kosovo-court-gives-3prison-terms-in-organ-trafficking-case/

14
arrest him, with the hope of decreasing the trade. Ratel is also waiting for Moshe Harel to
come out of hiding so that he too can be arrested. Without all of the information Jonathan
Ratel has collected, we would not be where we are today with the organ trade. This issue may
well have become even more prominent than it is now if it was not for Ratels efforts.
This proves beyond any doubt whatsoever that trafficking in persons has taken place in
Kosovo, he said. There is absolutely no doubt about that now. Trafficking persons and the
removal of their organs took place in this country for a lengthy period of time. 19
Nancy Scheper-Hughes is an American anthropologist who is also considered an
expert on the organ trade. She began her research in 1987 and went to Africa and South
America to interview surgeons, patients rights activists, and pathologists. Her investigation
shed light on the issue, specifically the global inequities that contribute to the organ trade.

19

Schmidle, N. (2013, April 29). An Organ-Trafficking Conviction in Kosovo. Retrieved February 25, 2015, from
http://www.newyorker.com/news/news-desk/an-organ-trafficking-conviction-in-kosovo

15

ROLE OF CONTROL
About 80% of the worlds population lives in poverty. Many of these people will do
whatever it takes to make enough money to enable them to get out of poverty. Even though
donating an organ may be against the law or against someones religion, many people will do
it for the money. People in need from developed nations go to developing nations to receive
organs, as it is much easier to get away with organized crime there. The donors and their
brokers from developing nations depend on people from developed nations who have money,
are very sick, and will do anything to survive. Without the income from the wealthy people,
the poor people would not have a market for their organs so would not make the donations. As
a result, this would no longer be a growing world issue.
The illegal organ trade depends on donors and recipients (refer to Appendix A).
However, to make this process work there must also be a doctor, or someone not actually
qualified as a doctor but with enough knowledge and skills to perform surgery, who is willing
to break many laws. These doctors, whether certified or not, are also often the brokers. These
doctors/brokers operate outside of the law have control in this issue. They decide who will be
permitted to donate an organ and who will receive that organ.20 They also determine how
much money the donor will receive for the organ and how much money the recipient will pay
for it. These doctors can also change the price at any time. They seldom care if the donor is
willing to donate or not which leads to an increasing number of people being trafficked,
kidnapped, and drugged. The result is more money going into the illegal drug industry. The
dishonest doctors willingness to take people against their will adds to this and many other
world issues. Most of these doctors do these operations solely for the large amount of money
20

Bindel, J. (2013, July 1). Organ Trafficking: A Deadly Trade. Retrieved February 24, 2015, from
http://www.telegraph.co.uk/news/uknews/10146338/Organ-trafficking-a-deadly-trade.html

16
they receive. Without these doctors, it would be impossible for this illegal system to continue
to run as smoothly as it does today or to even exist.
While traveling to a third world country may seem like the best way to receive a new
organ quickly, there are other options that are safer. Well-educated doctors who obey the law
need to take control of this issue for several different reasons. They need to overpower the
dishonest doctors so less people die in developed nations and in developing nations. This
would then lead to a decrease in the number of people being trafficked, kidnapped, and
drugged. Another reason why they need to take control is because if people no longer have
access to illegal organs, they might donate money to legal transplant organizations. This
would enable doctors to do more research on dialysis and other treatments for people who
need new organs. If people could stay on dialysis longer, the doctors might be able to come up
with other ways to save their lives. Many people who have gone to third world countries to
receive a new organ have came back sicker than they were before, thus placing an even greater
burden on their nations healthcare system. This is quite common for several reasons: there is
a lack of care for the organs while they are being transported, there is a very high risk of
receiving diseased organs, and the medical treatment given afterwards is often inadequate. For
example, a woman named Matin Khan from Toronto got pneumonia and a fever after
receiving a kidney in Pakistan in 2013. The kidney she received was not functioning and she
became sicker than she was before she went to Pakistan. Doctor Jeff Zaltzman, a kidney
specialist at St. Michaels Hospital in Toronto, said, They come right to the emergency room
requiring hospitalization. This has happened on more than one occasion. 21 The honest

21

Favaro, A. (2013, June 1). Canadians Desperate for Transplants turn to Illegal Organ Trade. Retrieved February 22, 2015,
from http://www.ctvnews.ca/health/health-headlines/canadians-desperate-for-transplants-turn-to-illegal-organ-trade1.1307227

17
doctors need to take control as soon as possible before the illegal organ trade becomes too big
an issue to suppress.
The people who should care about the international black market trade in human
organs are the patients on the organ waiting list and their families, the doctors who are trying
to find organs for their patients, people who travel to third world countries, and anyone who
cares about humanity. The people who are on the waiting lists should care because their life
depends on getting an organ. If someone who is above them on the waiting list goes to a
developing country to receive an organ, they will move up on the list and be closer to
receiving an organ in their own country. However, sometimes people who resort to traveling
to third world countries to receive an organ come back sicker than they were before. This puts
them even higher on the organ waiting list bumping other people in need down lower. This is
not fair to these people who have been bumped as they have waited patiently and obeyed the
law. The doctors who are trying to legally find organs for their patients care because the
immoral doctors doing illegal organ transplants are giving doctors a bad reputation. Doctors
like Yusuf Sonmez and Moshe Harel, who are the worlds most notorious organ transplant
doctors, give doctors like Doctor Jeff Zaltzman a bad name. Another reason why the doctors
care is because illegal organ transplants create more work for them and cost more time and
money. The doctors, who are busy with legitimate patients, have to care for these patients who
are very sick, possibly near death. They must try to find new organs for these people as
quickly as they can before it is too late. Law abiding doctors and patients find it very
frustrating when people resort to the organ black market as it complicates things and places
more of a burden on the health care system.

18
Everyone should care about the illegal organ trade, as they or someone they know
could become victims themselves. People who have traveled to developing nations have been
drugged, kidnapped, and even killed for their organs, leaving many other people devastated. In
2013, Santokh Singh Loyal and Amrit Kaur Loyal, who were the parents of eight-year-old
Gurkiren Kaur Loyal, experienced this. Gurkiren was at a clinic in India being treated for
dehydration when a nurse gave her a mysterious injection that killed her. The little girls
mother, Amrit Kaur Loyal, was there when it happened.
My baby was innocent and now I am devastated without her. Gurkiren was fine, she
was chatting to us and planned to buy some gifts for her cousins. While we were
talking an assistant came up carrying a pre-filled syringe and reached for the tube in
her hand. Within a split-second Gurkiren's head flipped back, her eyes rolled in her
head, and the colour completely drained from her. I knew they had killed her on the
spot. I knew my innocent child had been murdered.22
When Gurkirens body was flown back to Britain where the family was living, doctors
discovered that the only organs left inside her body were her eyeballs. The death of this girl
was devastating not only to her friends and family but also to many other people worldwide.
Therefore, everyone should care about this issue because organ theft can happen to anybody
and the organ trade affects the health care systems many people rely on.

22

Dixon, H. (2013, May 14). British schoolgirl 'murdered for her organs' in India, family claim. Retrieved February 28, 2015,
from http://www.telegraph.co.uk/news/uknews/crime/10055772/British-schoolgirl-murdered-for-her-organs-in-India-familyclaim.html

19

LOGIC OF EVIL
There are many different reasons why people go to the international black market to
obtain human organs. In understanding the issue, it is important to also understand the other
side of the story. The people who are willing to donate organs are almost always from
developing nations. They are so desperate for money that they are willing to do whatever it
takes. The recipients are almost always from developed nations. They are so desperate to live
that they are willing to break the law.
Imagine that you, your child, your parent, your friend, or anyone else you have a
relationship with was on the verge of dying and there was nothing that you could do to help
them. Many people all over the world face this problem. The people who are sick are so
determined to live that they will go to extreme lengths to save themselves, as will anyone who
is close to them. The sick people who are in need of a new organ may not meet the
requirements to get on the waiting list for an organ transplant in their nation: they may be too
old to receive an organ or they may have other medical conditions that prevent them from
receiving an organ. Another possibility is that they may be very low on the list if they are not
sick enough. Raul Fain, a man who went to Kosovo to receive a kidney, was told that he
would never get a kidney in Canada because he had been on dialysis for over ten years and his
body would not be able to handle the new kidney. However, Fain wanted so desperately to
live that he flew overseas despite what the doctors had told him in Canada. He was sixty-six
years old at the time he received a new kidney and it cost him over $100,000. In order to pay
for it, he sold his house and other valuable possessions. He would never have received a new
kidney in Canada because of his age and the amount of time he spent on dialysis so for him it

20
was money well spent.23 In developed nations, regulations must be met in order to receive a
new organ. The requirements of organ recipients in first world countries are that the recipients
must be in good physical and mental health, must be able to take care of themselves, must live
healthy lives, and must commit to continuing to live healthy lives. However, many people
cannot fulfill these requirements so they go overseas to receive organs. Most people value life
as we all only have so many years in which to have experiences. To live a happy life, it is
important to be healthy so some people will break the law if they feel it is necessary.
All over the world there are people living on $2.50 or less each week. People who live
in poverty are desperate for any amount of money they can get. Selling an organ in developing
nations is an option because the demand for organs far outweighs the supply. It is one of the
most popular ways to make a large amount of money fast. Eddieboy is a twenty-two year old
man from Manila, Philippines. He is a husband and the father of a little girl. He is having a
hard time finding a job that pays more money than he is currently making. Eddieboy decided
to donate an organ because he wanted to buy a farm with animals to help him get his family
out of poverty. He knows all of the risks he is facing but he is willing to take them because he
desperately wants to make things better for his family. Living in poverty is a terrible way of
life so if there is a way to get out of it, many people will take the risk. These concepts relate to
the illegal organ trade issue because one can understand someone being so desperate to
survive or to keep a loved one alive that they will do whatever they can.24
The laws play an important role in the international black market trade in human
organs. The law states that the illegal organ trade falls under the human trafficking category,

23

Press, C. (2013, April 29). Prosecutor calls for law to bar Canadians from buying human organs overseas. Retrieved
February 22, 2015, from http://www.macleans.ca/news/prosecutor-calls-for-law-to-bar-canadians-from-buying-humanorgans-overseas/
24 Bienstock, R.E. (Producer) (Director). (2013). Tales From the Organ Trade [Motion
Picture]. Canada: HBO Documentary Films.

21
which is illegal. However, Iran is the only place where organ trade for money is legal. Not
many cases are reported there because they have other issues that need to be resolved first. In
every other country in the world it is against the law to sell your organs for any amount of
money. It is also against the law to pay someone for his or her organs. However, people have
found loopholes in these laws and it has been more of an issue over the past few years. Even
though the law clearly states what is wrong and what is right, many people still break the law
without thinking of the consequences. Many of those who have sold organs have gone to jail
along with the doctors who were involved. It is a very dangerous thing to do and the law is in
place to keep people safe and to prevent them from doing this.25

25

Unger, D. (n.d.). Organ Donation. Retrieved February 26, 2015, from http://canadianbioethicscompanion.ca/the-canadianbioethics-companion/chapter-7-organ-donation/

22

RELIGION / SPIRITUALITY
Most religions support donating organs but all mainstream religions are against selling
organs. Some religions encourage the donation of organs, especially when it will save a life,
while other religions allow organ donation only when certain restrictions are met. Many
religions specifically forbid the sale of organs, while others either imply that it is wrong or do
not address the issue. Most religions agree that people should decide for themselves and
nobody should ever be forced to donate an organ or be tricked into it.
The Christians belief regarding donating organs is that it should be encouraged as it
saves lives and it is an act of charity. The Catholic Church forbids the sale of organs while
some other Christian churches do not specifically address the issue. The four major branches
of the Jewish religion agree that saving lives by organ donation is the ultimate act of
Godliness. They believe in burying a body immediately after death but will allow a delay in
order to allow for an organ donation. However, they also do not condone the sale of organs.26
The Jesus Christians, a small radical Christian group from Australia that disbanded in
2010, were known as The Kidney Cult, because half of them donated a kidney to someone
they did not know. They believed in donating organs as an act of charity so did not approve of
selling ones organs.27
The Islamic views on organ donation vary. Some Muslim leaders do not believe it
should be allowed while most strongly believe in the value of saving a human life. As long as
the human body is treated with dignity and respect, they support organ donation but require

26

(2014, February). Religious Beliefs on Selling Organs. Religious Beliefs on Selling Organs - Religion.Answers.com.
Retrieved March 18, 2015, from http://religion.answers.com/controversy/religious-beliefs-on-selling-organs
27 (2007, June 4). Australian Breaking News Headlines & World News Online | SMH.com.au. Hospital refuses to accept
kidney - National - smh.com.au. Retrieved March 20, 2015, from http://www.smh.com.au/news/national/kidney-cult-accusedof-pressuring-donor/2007/06/04/1180809387667.html

23
the donor to provide written consent in advance. When Muslim people donate an organ they
ask for forgiveness from Allah. They do not support the sale of organs.28
Buddhists believe that organ donation is an act of generosity and therefore do not
believe in the commercialization of organs. They support the donation of organs to save a life
or to relieve someones suffering. Buddhists also believe that a dying persons wish as to
whether or not they want to donate their organs after death must be upheld. Hindus believe
that organ donation is an important part of life as it is the soul that goes to heaven when
someone dies. They strongly encourage donating organs after death to save other peoples
lives. While the Hindi religion does not condone commercialization of organs, there is a
theory that many Hindu people assume that being supported in donating their organs also
gives them permission to sell their organs. The basis for this theory is that the selling of organs
seems to be more prevalent in countries with large Hindu or Buddhist populations (such as
India, Nepal, and China) where poverty is extreme.29
Jehovahs Witnesses will only receive organs if the blood from the donor is completely
washed off as their religion prohibits any blood transfusions. However, this is very difficult
when a transplant is taking place. Organs usually still have blood in or around them and often
blood transfusions are needed after surgeries. Jehovahs Witnesses do not expressly forbid the
sale of organs but it is implied.30
Christian Scientists have differing views in that they believe that our bodies are not for
sale and that nothing should be taken out of us for money. They are against any type of organ
28

Khan, F. (2014, ). Journal of the Islamic Medical Association of North America. The Definition of Death in Islam: Can
Brain Death Be Used as a Criteria of Death in Islam? | Khan | Journal of the Islamic Medical Association of North America.
Retrieved March 23, 2015, from http://jima.imana.org/article/view/4731
29 Scharper, S. (2008, February 16). Thestar.com | Toronto Star | Canada's largest daily. Many faiths find the selling of body
parts troublesome | Toronto Star. Retrieved March 22, 2015, from
http://www.thestar.com/life/2008/02/16/many_faiths_find_the_selling_of_body_parts_troublesome.html
30 Taylor, G. (2000, ). Organ Donation, Tissue Donation, Organ Transplants - The Gift of a Lifetime. The Gift of a Lifetime:
Religion and Organ Donation. Retrieved March 20, 2015, from http://www.organtransplants.org/understanding/religion/

24
trade because it is seen as too modern. They believe that only praying or meditating can heal
health problems and they are taught to avoid any type of advanced medicine or practice. This
means that they also prohibit selling human organs.31
The Shintos of Japan are also opposed to organ donation and transplantation so they
are therefore against the selling of human organs.32
Most major religions have similar views on donating and selling organs. They support
or encourage organ donation and believe it should be up to an individual to make the decision
according to their conscience. In general, the majority of religions discourage or forbid the
sale of organs while some of them simply imply that it is wrong. None of the major religions
support the commercialization of organs.

31

(2010, ). Organ Donation, Register as an Organ Donor - Finger Lakes Donor Recovery Network. Organ Donation and
Religion, Religious Positions on Organ Donation | Finger Lakes Donor Recovery Network. Retrieved March 24, 2015, from
http://www.donorrecovery.org/learn/religion-and-organ-donation/
32 Taylor, G. (2000,). Organ Donation, Tissue Donation, Organ Transplants - The Gift of a Lifetime. The Gift of a Lifetime:
Religion and Organ Donation. Retrieved March 20, 2015, from http://www.organtransplants.org/understanding/religion/

25

CASE STUDIES
CASE STUDY 1 NEPAL (NAWARAJ PARIYAR)
Organ trade in Nepal is increasing at a great pace in a direct correlation to the increase
in organ disease. This is due to the severe poverty people live in which means their diet is poor
and they do not have health insurance or health care. Many people who live in Nepal work as
labourers because they have little access to education. People not earning enough money to
live on and support their families are often willing to do anything for money, including selling
one of their organs if they believe the gains outweigh the consequences.33
The organ that is in the highest demand on the black market is the kidney as it can be
harvested from a live donor. Many organ traffickers scout out the Nepalese who look
desperate enough to part with an unneeded organ for money. Others are tricked into selling an
organ. The traffickers promise the recipients that everything will go well and they will receive
a great deal of money. The trafficker usually takes the recipient to India, as it has better
technology for the surgery. India also allows people to donate their organs to someone they
are related to or to someone they know. Indian regulations have loopholes and forged
documents allow the traffickers to beat the system. In Nepal people can only donate their
organs to those who are blood relatives and there is strict government screening. Language
barriers complicate the matter as most Nepalese only speak Nepali, while the organ traffickers
and the doctors speak English, Tamil, or Hindi. The Nepalese do not understand what is going
on but they agree to have the surgery. Afterwards, the trafficker gives the recipient a small
portion of the money that was promised to them. The recipients are told the rest of the money

33

Gurubacharya, B. (2014, November 15). The Scotsman. Poor Nepalese selling their organs for transplants - The Scotsman.
Retrieved March 28, 2015, from http://www.scotsman.com/news/health/poor-nepalese-selling-their-organs-for-transplants-13605904

26
will be delivered to them shortly, but it never arrives. Most of these people face medical
problems after the surgery. They cannot afford to see a doctor so their condition worsens.
These people are then too ill to work which makes life even more difficult for them. Nepal has
one of the highest rates of kidney trafficking in the world.34 It is possible that this stems from
more than just the severe poverty in Nepal. It has been suggested that the Nepalese humanity
and generosity of spirit is being targeted and taken advantage of.
Nawaraj Pariyar, a forty-year-old Nepalese man, survived being tricked into selling
one of his kidneys. When he was in his early twenties (about fifteen years ago), he traveled to
Kathmandu, Nepal to look for construction work, as he was not well educated and it was very
hard for him to find a stable job. While Pariyar was there, a man approached him and offered
him thirty lakhs (around $30,000.00 U.S dollars) for a hunk of meat from his body. The man
told him that it would grow back and he assured him that the surgery that was needed would
not harm him. Pariyar was given food and clothing and the man took him to a movie. Pariyar
agreed to the surgery as it was good money and he believed he had nothing to worry about
with his body. The man, who turned out to be an organ trafficker, brought him to a hospital in
Channai, India. The trafficker forged a document with a false name for Pariyar and told
Pariyar to pretend that he had a relative at the hospital that needed his hunk of meat. Pariyar
told the doctors that the girl who was getting his hunk of meat was his sister. While Pariyar
heard the trafficker and the doctor say the word kidney several times, he did not understand
English so it did not mean anything to him. When the surgery was over, Pariyar was sent
home with only $300.00 U.S. dollars. The trafficker promised Pariyar that the rest of the

34

Gurubacharya, B. (2014, November 15). The Scotsman. Poor Nepalese selling their organs for transplants - The Scotsman.
Retrieved March 28, 2015, from http://www.scotsman.com/news/health/poor-nepalese-selling-their-organs-for-transplants-13605904

27
money would be delivered to him shortly but it never was. After I came back to Nepal, I had
a doubt. So, I went to the doctor. That's when I found out I am missing a kidney," Pariyar said.
He was very surprised and quite devastated to learn this information and now has urinary
problems as well as constant back pain from the surgery. Pariyar sells cows milk and does
seasonal labour jobs on nearby farms but does not receive much money. He cannot afford to
both feed his family and go to a doctor to get the medical treatment he needs to live a healthy
life. He chooses to feed his wife and his two young children. Pariyar can feel his body getting
weaker and sicker each day and is afraid that he is going to die soon. He is worried about his
family and what will happen to them, "If I die I can only hope for the government to take care
of my two children. I don't know if I will die today or tomorrow. I'm just counting my days."35
Organ trafficking is growing quickly in Kavre, where Pariyar is currently living. Kavre
is often referred to as the kidney bank of Nepal. There are daily reports about organ
trafficking and people are warned about it, but it continues to spread and is very hard to
control. The Forum for Protection of Peoples Rights, a Nepalese non-profit human rights
organization, is attempting to track the numbers of illegal organ transplants performed each
year but documentation is difficult. Many victims are hesitant to come forward for fear of
retaliation by traffickers who may become violent. The victims are also concerned about the
social stigma if people find out because they do not want to be shunned by others in the
village. They may be ashamed of having broken the law, or embarrassed about being tricked
or taken advantage of. Media attention helps and the government is tightening its policies.
However, when the Nepalese police start to make some arrests, the criminal rings just move to

35

Pokharel, S. (2015, June 30). Breaking News, U.S., World, Weather, Entertainment & Video News - CNN.com. Nepal's
Organ Trail: How traffickers steal kidneys - CNN.com. Retrieved March 23, 2015, from
http://www.cnn.com/2014/06/26/world/asia/freedom-project-nepals-organ-trail/

28
another village. Any progress made by relevant authorities against organ traffickers is
diminished by the promise of easy money.36

36

Bensch, F. (2010, December). ABC - Australian Broadcasting Corporation. Organ traffickers luring Nepal's poorest to
India - ABC News (Australian Broadcasting Corporation). Retrieved March 24, 2015, from
http://www.abc.net.au/news/2010-12-29/organ-traffickers-luring-nepals-poorest-to-india/1889428

29
CASE STUDY 2 CHINA
Another country where the illegal organ trade is an endemic issue is China. It is legal
in China for people to donate organs but the donor must not be paid to do so. In 1984, China
made it legal for the organs of executed prisoners to be donated to nearby hospitals with the
permission of the prisoner or of the prisoners family. Since the demand for organs is
increasing with Chinas aging population, the trade of organs for large amounts of money is
also increasing. Many executed prisoners organs are being sold to the black market rather
than being donated to hospitals. Often prisoners are executed just for their organs. It is
estimated that approximately 65,000 prisoners were killed for their organs between 2002 and
2008 (refer to Appendix B). This information was gathered from Chinese doctors and police
officers that were forced to help with the surgeries. Some of the surgeries performed were on
living prisoners as the organs are healthier if they come from a live donor. All prisoners were
examined when they entered prison to see if they would be good candidates to be organ
donors. 37
Many of the executed prisoners were only convicted of crimes of conscience rather
than capital crimes. These people were members of the Falun Gong movement, a Buddhist
morality system that is perceived as a threat by the Communist party. Many of their arrests
were made during peaceful demonstrations. China has been called out by several countries for
the large number of organs they are trading. However, Chinese officials insist that all of the
organs are from organ donors after planned executions and are all donated, not sold.38

37

Kelleher, G. (2014, December 4). VICE | Canada | The Definitive Guide to Enlightening Information. China's Illegal
Organ Harvesting Trade Is Still Booming | VICE | Canada. Retrieved March 22, 2015, from
http://www.vice.com/en_ca/read/china-are-still-harvesting-prisoners-organs-329
38 Getlen, L. (2014, August 9). New York Post. Chinas long history of harvesting organs from living political foes | New
York Post. Retrieved March 19, 2015, from http://nypost.com/2014/08/09/chinas-long-history-of-harvesting-organs-fromliving-political-prisoners/

30
Zhang Fengying, an ex-prisoner from a Chinese prison, underwent a medical
examination when she first entered a prison in Beijing. She said, "None of us knew what these
blood tests were for." The examiners did not tell the prisoners what they were doing as it
would get them into trouble with their superiors. Fengying had parts of her body close to
organs examined and her hair examined. She also underwent eye tests and blood tests. It was
confirmed that more than 500 other prisoners also went through similar examinations. The
prisoners whose bodies were found to be the most suitable were forced to have surgeries to
remove their organs.39
Dr. Enver Tohti, a Chinese ex-surgeon, was coerced to perform illegal surgeries on
both executed prisoners and live prisoners. Tohti once had to operate in Xinjiang at the
Western Mountain Execution Grounds, where political dissidents were killed. He operated on
a man who was shot instead of being given anesthesia. The man was alive throughout the
surgery and all of his organs were harvested.40
China is also accused of drugging and kidnapping people for their organs. Traffickers
in China target young children, women, and the poor. These people are not usually tested
beforehand to see if their body is healthy enough to undergo surgery. Many of them die during
surgery as it is not done properly and they do not receive any medical attention afterwards.
Most of these organs are sold to Westerners but wealthy Chinese people are also buying them.
In 2013 a six-year-old boy named Guo Bin was removed from the front yard of his
home in Shanxi, China. He was taken to a nearby field and had his corneas removed. When
his parents noticed that he was missing they organized a search party to find him. Hours later
39

Kelleher, G. (2014, December 4). VICE | Canada | The Definitive Guide to Enlightening Information. China's Illegal
Organ Harvesting Trade Is Still Booming | VICE | Canada. Retrieved March 22, 2015, from
http://www.vice.com/en_ca/read/china-are-still-harvesting-prisoners-organs-329
40 Getlen, L. (2014, August 9). New York Post. Chinas long history of harvesting organs from living political foes | New
York Post. Retrieved March 19, 2015, from http://nypost.com/2014/08/09/chinas-long-history-of-harvesting-organs-fromliving-political-prisoners/

31
they found him lying in a field. Bins father told a Chinese news agency, He had blood all
over his face. His eyelids were turned inside out. And inside, his eyeballs were not there. We
didnt notice his eyes were gone when we discovered him. We thought he fell from high.
They later found his eyeballs nearby without any corneas. Bin was kidnapped by a woman
who told him, Dont cry, and I wont gouge your eyes out, before she drugged him. Bin was
very lucky to have been found so soon as many other people in this situation die from blood
loss. While his parents are very happy that Bin is alive, they are devastated that this happened
to him and there was nothing they could do to prevent it.41

41

Fan, J. (2011, January 10). The New Yorker. Can China Stop Organ Trafficking? - The New Yorker. Retrieved March 26,
2015, from http://www.newyorker.com/news/news-desk/can-china-stop-organ-trafficking

32
CASE STUDY 3 MEXICO
Mexicos issues with the illegal organ trade mainly involve small children. With
regard to organ trafficking, children are the most vulnerable sector of the population as
they are usually the healthiest and it is harder for them to protect themselves against
adults. Many organs stolen in Mexico are sold to the United States of America as it is
nearby allowing for fast and easy access. The border between the United States of
America and Mexico is a very dangerous place to be as it is where many children are
killed for their organs. These young children are kidnapped, drugged, and killed by
Mexican drug gangs. 42
In Mexico almost all of the people who are kidnapped have all of their organs
taken rather than just one organ. These people are usually found dead with almost all of
their organs missing. The surgeries are rarely done correctly as they seldom take place in
a hospital or clinic. Most illegal surgeries are performed in houses, cars, or fields. Even
when they do take place in a hospital or clinic, there are usually problems, as the doctors
do not always have the knowledge or the technology required to perform the surgeries.
None of the doctors have been caught or identified yet. After the surgeries are complete,
the traffickers must have a recipient nearby to receive the organ. Since the victims of
organ theft have not planned to donate organs, they have not had any tests beforehand
to see if they are suitable donors and healthy enough to survive the surgeries. The tests
that should be carried out before the organ removals are blood tests as well as other
tests to see if the donor has any diseases that they did not know about. However, none of
42

All, J. (2014, March 18). Al Jazeera English. Mexico cartel member held in organ theft case - Al Jazeera English. Retrieved
March 29, 2015, from http://www.aljazeera.com/news/americas/2014/03/mexico-cartel-member-held-organ-theft-case201431821815141191.html

33
these tests are performed so the traffickers are not only risking the victims lives but the
lives of the recipients as well. All those involved are also at a higher risk of infections
such as HIV and Hepatitis B. Once the organs are removed, they must be transplanted
into a recipient in less than twenty-four hours. If recipients cannot be found within this
timespan, the organs may still be used, which could cause serious complications for the
recipients.43 This happens not just in Mexico but in other parts of the world as well.
Mexico has a very large criminal organization called the Knights Templar Cartel
who have managed to commit many crimes without being convicted for them. In March
2014, some people connected to the Knights Templar Cartel were caught harvesting
organs from young children. They are now under investigation for the death of minors,
whose organs were extracted to be sold. The police searched several of their houses
found to be filled with medical equipment for use in organ transplants. They also found
large amounts of money, crystal methamphetamine, and other drugs in cars around the
houses. When they searched nearby vans, they discovered large refrigerators with the
bodies of young children inside. A couple of nights before the bodies were discovered, a
group of children from a Mexico City School were reported missing. Dr. Jose Manuel
Mireles, the leader of a civilian self-defence group said, "They were inside a refrigerated
box, tightly wrapped in blankets, all children from the same Mexico City School." This case is
still in trial and they do not yet know where the organs were sold.44

43

Radford, B. (2014, March 20). Discovery News. Organ Theft Rumors Surface in Mexico Arrests: Discovery News.
Retrieved March 22, 2015, from http://news.discovery.com/human/psychology/organ-theft-rumors-surface-in-mexico-arrests140320.htm
44 Romero, H. (2014, March 17). CBC News. Child organ trafficking ring busted by Mexican police - World - CBC News.
Retrieved March 24, 2015, from http://www.cbc.ca/news/world/child-organ-trafficking-ring-busted-by-mexican-police1.2576492

34

THE ROLE OF INTERNATIONAL ORGANIZATIONS


"The international trade in human organs is on the increase fueled by growing demand
as well as unscrupulous traffickers," WHO said in a statement. "The rising trend has
prompted a serious reappraisal of current legislation, while WHO has called for more
protection for the most vulnerable people who might be tempted to sell a kidney for as
little as US$ 1000." 45
The international community has recognized the international organ trade as a
significant health policy issue. The World Health Organization (WHO) is one of the largest
organizations involved in attempting to end the illegal organ trade. They have ongoing
investigations in many countries, into which organs are the most in demand, and into the
number of organs sold each year. WHO calculated that on average 66,000 kidney transplants,
21,000 liver transplants, and 6000 heart transplants are performed globally each year (refer to
Appendix C). They have not determined how many of those were illegal transplants.
Not all patients have access to organ transplantation however as the cost of health care
may be prohibitive, the technology may not be available, and there is always a universal
shortage of organs. WHO estimates that only 10% of global needs for organs are met each
year. As a direct result of the organ shortage, the international organ trade has flourished.
WHO determined that organ brokers charge between $100,000 and $200,000 to organize
transplants for wealthy recipients. Unlike organ waiting lists, how much money a person has,
rather than their medical condition, is the determining factor in how long a person must wait
for a black market organ. WHO coined the term transplant tourism which is when people
travel to other countries to buy organs for transplant from organ brokers (refer to Appendix
45

Lo, B. (2013, February 19). CCTV News. WHO: 10,000 illegal organ trade operated each year. Retrieved March 28, 2015,
from http://english.cntv.cn/program/bizasiaamerica/20130219/103301.shtml

35
D). Aside from the medical risks, there are ethical issues with transplant tourism as it is
usually in opposition to the laws in the tourists country of origin.46
One solution that this organization has attempted is finding and arresting the organ
traffickers and organ doctors. This has been unsuccessful for the most part because these
people are very hard to track down as they keep their own identities safe while also protecting
their patients identities. When they are able to find the criminals involved, the brokers and
doctors deny everything and insist that the transplants were legal. Other solutions to this
problem are the development of a better system of organ donation after a person dies and
encouraging altruistic live donor kidney donations. However, even in developed countries,
where deceased organ donation and living kidney donations are more common, there is still a
shortage of organs. Some of the organ donation organizations in Canada are the Canadian
Transplant Society, the Kidney Foundation of Canada, and the Canadian Society of
Transplantation. The organizations in the United States include The American Board of
Transplant Coordinators, the American Organ Transplant Association, and the American
Foundation for Donation and Transplantation. In addition, WHO is helping to find ways to
prevent and treat diseases, such as diabetes and hepatitis, that will eventually cause organ
failure and create the need for organ transplants in the future. The World Health Organization
was the first to declare that the selling of organs was illegal as it violated many rights in the
1987 Universal Declaration of Human Rights. WHO aims to create and implement more laws
that ban organ trafficking. All of these goals sound good but are in fact very difficult to
accomplish.

46

Simazono, Y. (2015, ). WHO World Health Organization. WHO The state of the international organ trade: a provisional
picture based on integration of available information. Retrieved March 30, 2015, from
http://www.who.int/bulletin/volumes/85/12/06-039370/en/

36
Another organization that is against the illegal organ trade is Stop Organ Trafficking
Now. This is a non-profit organization based in Washington D.C. in the United States of
America. This organization seeks to address two issues. First, members are devoted to making
it easier for American living organ donors to feel financially secure when donating organs.
Their second goal is to help curb the illegal organ trade by solving the American organ
shortage. Stop Organ Trafficking Now wants to make organs more accessible to people in need
so they do not have to expose themselves to danger by resorting to the black market. They are
also concerned with implementing stricter penalties for those convicted of illegal organ
trafficking.47
The Coalition for Organ-Failure Solution (COFS) is a non-profit international health
and human rights organization. They work to end worldwide organ trafficking through
programs in outreach and advocacy, research, and raising public awareness. COFS spreads
awareness about organ trafficking worldwide by educating the groups of people who are the
most targeted, publishing or sharing their collected information with the media, and creating
multi-media materials such as documentary films. They educate people in Yemen,
Bangladesh, Egypt, the United Arab Emirates, Nepal, Kuwait, Bahrain, India and Pakistan.
The Coalition for Organ-Failure Solutions also carries out preventative measures and
advocates for victims of the organ trade. They have health services, health education,
counselling, peer support, legal services, and employment assistance. These solutions have
made a difference for victims and potential victims of the organ trade.48

47

Suchkov, M. (2014, ). Leaders in the Living Organ Donor Rights Movement. Stop Organ Trafficking Now! . Retrieved
March 30, 2015, from http://www.stoporgantraffickingnow.org
48 (2015, ). COFS Working towards an ethically responsible world. WHAT WE DO: COFS Working towards an ethically
responsible world. Retrieved March 19, 2015, from http://cofs.org/home/what-we-do/

37
The Council of Europe, a multi-national human rights organization based in
Strasbourg, France, with 48 countries as members, is determined to ban the criminal practice
of organ trading. They have proposed a convention against human organ trafficking that any
country is welcome to sign. It would recommend punishments for those who purchase organs
or force people to part with their organs. It would also address the problem of transplant
tourism by targeting corrupt surgeons and the middlemen involved in the trade. Dr. Yusuf
Sonmez and Dr. Moshe Harel are among the many corrupt surgeons making a great deal of
money on the black market, though it has never been determined just how much. They believe
that security, police, transport companies, and hospitals are all profiting from the organ trade.
Each country that signs the convention will be expected to adapt the agreement to align with
their domestic laws. The goal of the Council of Europe is to protect human dignity while
recognizing that the convention may not actually slow down the illegal trade in human
organs.49

49

Fscher, H. (2013, November 22). Top Stories. Europe aims to clamp down on human organ trade | Globalization | DW.DE
| 22.11.2013. Retrieved March 26, 2015, from http://www.dw.de/europe-aims-to-clamp-down-on-human-organ-trade/a17246703

38

CANADIAN CONNECTION
Canada is a very wealthy and developed country that continues to be involved in
difficult issues that do not have obvious solutions. Canada is just one of the many developed
countries that is entangled in the illegal organ trade. It is also considered to be a world leader
in the field of organ transplantation. The Canadian organ donation and transplantation system
is governed by Health Canada through the Safety of Human Cells, Tissues and Organs for
Transplantation Regulations.50
More than 5,000 Canadians are currently on the organ transplant waiting list and less
than 2,000 of these Canadians will receive an organ this year. Over 300 Canadians from the
waiting list will die each year. With people living longer, the number of people on the waiting
list increases each year, while the number of people receiving organs decreases each year. As
in most parts of the world, the organ that is in the most in demand in Canada is the kidney.
The average wait for a Canadian patient needing a kidney is approximately six years. About
38,000 Canadians are living with chronic kidney failure and require dialysis to survive.
Canada does not have a national organ system, which means that they do not share organs
between provinces and territories. Many Canadians who were once on the waiting list and
received an organ are very likely to need another organ transplant in the future. Almost 90%
of the Canadian population supports organ donation but only 25% of those people have
created plans to donate.51
The organ trade is a prevalent issue in Canada because many people from the waiting
lists in Canada have resorted to travelling abroad to obtain an organ from the black market.
50

Nickerson, P. (2015,). Health. Blood, organ and tissue donation. Retrieved March 27, 2015, from
http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/donation-contribution-eng.php
51 Picard, A. (2011, March 5). Health and Fitness. Transplant waiting lists and dialysis costs grow as kidney supply lags
behind - The Globe and Mail. Retrieved March 30, 2015, from http://www.theglobeandmail.com/life/health-andfitness/transplant-waiting-lists-and-dialysis-costs-grow-as-kidney-supply-lags-behind/article569465/

39
These Canadians feel that their time is running out due to the shortage of organs, and they
worry that they may not ever receive an organ at home. Even though buying and selling
organs is illegal and they are risking their lives, they do it because they are desperate. Buying
an organ overseas can cost over $10,000.00 and the organ that they buy may not function as
expected (refer to Appendix E). Canadians are risking their money and their lives when they
buy an organ from the black market but knowing this does not always stop them.52
Another reason that this is an important issue in Canada is that some Canadian tourists
are being kidnapped for their organs while travelling in other countries. Traffickers in third
world countries where organ theft is on the rise often target foreigners. Foreigners are easy
targets because they do not know the country, the language, or the people as well as the
residents do. The foreigners organs are desirable because their bodies are considered to be
healthier than the residents due to their superior lifestyle, nutrition, and medical care.53
The illegal organ trade affects many people in Canada including all those who are on
the transplant waiting list. If people go to a third world black market for an organ and that
organ does not work, they return to Canada in worse condition than they were when they left.
If their health has deteriorated significantly, they may be moved to the top of the waiting list.
This pushes others who were patiently waiting down closer to the bottom of the list and is very
unfair to these people who followed the rules. This creates more work for the doctors and it
costs additional money to keep these sick people alive on dialysis. The organizers also have
more work to do in finding the right organ for the person in need before it is too late.54

52

Nickerson, P. (2015,). Health. Blood, organ and tissue donation. Retrieved March 27, 2015, from
http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/donation-contribution-eng.php
53 Bindel, J. (2013, July 1). Organ Trafficking: A Deadly Trade. Retrieved February 24, 2015, from
http://www.telegraph.co.uk/news/uknews/10146338/Organ-trafficking-a-deadly-trade.html
54 Picard, A. (2011, March 5). Health and Fitness. Transplant waiting lists and dialysis costs grow as kidney supply lags
behind - The Globe and Mail. Retrieved March 30, 2015, from http://www.theglobeandmail.com/life/health-andfitness/transplant-waiting-lists-and-dialysis-costs-grow-as-kidney-supply-lags-behind/article569465/

40
A Canadian woman named Matin Khan felt that the waiting list was not working for
her so she had no choice but to turn to the black market to obtain a kidney. Khan was on
kidney dialysis for many years while waiting for an organ in Toronto, Ontario, Canada.
However, she felt that her time was running out so she went to Pakistan to purchase a kidney
for over $10,000.00. When she returned to Canada, she went to see a doctor because she knew
something was not right. I had pneumonia and a fever, she said. And I went to the hospital
and they found out that the kidney was not functioning anymore. Dr. Jeff Zaltzman, who is a
kidney specialist at St. Michaels Hospital in Toronto, said that people who go overseas for
any kind of organ are putting themselves at risk. He said, They come right to the emergency
room requiring hospitalization. This has happened on more than one occasion. Matin Khan
went back on dialysis and was placed close to the top of the waiting list. Even when near the
top of the list, it may take a very long time to get a kidney. Khan worried that it would take too
long and she was determined to prolong her life so she decided to go back to Pakistan for
another new kidney. This time she received a functioning kidney as expected and her health
quickly improved. She risked her life twice as she was desperate and she believed it was the
only way she would survive. It is not uncommon for transplant tourists to make more than one
trip abroad for an organ.55
Canadas role to play in the illegal organ trade is to help prevent its continuation.
Canada is promoting organ donation to address the organ shortage so that Canadians do not
have to put themselves at risk by going to the black market. Some Canadian campaigns
promoting organ donation include 65 Red Roses, Organ Donor Awareness, Give2Live, and

55

Favaro, A. (2013, June 1). CTV News. Canadians desperate for transplants turn to illegal organ trade | CTV News.
Retrieved March 31, 2015, from http://www.ctvnews.ca/health/health-headlines/canadians-desperate-for-transplants-turn-toillegal-organ-trade-1.1307227

41
#GiftofLife. Canadas national organ donor awareness week is the last full week of April.
Global News helped to educate the public with their #48in48 initiative when they attempted to
sign up 48,000 Canadian donors in 48 hours. The Trillium Gift of Life Network seeks to
support Ontarians in making informed decisions regarding organ donation. Clinics and
hospitals also promote organ donation through advertisements, informative pamphlets, and
talking to families when a patient has died or is close to death. When Canadians get their
drivers licences, they are given the opportunity to sign a form agreeing to donate their organs
should they die. (refer to Appendix F) They also have the option of going to beadonor.ca or
liveon.ca to electronically register their consent for organ and tissue donation. Doctors are
warning their patients who need organs that they are better off waiting for organs in Canada
and that there can be serious consequences if they go overseas to purchase organs.

42

SOLUTIONS
Finding solutions to abolish the illegal organ trade is very difficult but quite necessary.
Increasing organ donation awareness worldwide is the key to success. Most developed
countries encourage residents to register to be an organ donor because having more organs
available will make the wait lists shorter which will save lives. Spain currently boasts the
highest organ donation rates in the world as they use an opt-out system of consent (where
anyone who has not refused to donate is automatically a donor). Developed nations are also
creating more organ donor registries across each country for easier access, with the goal of
convincing more people to be organ donors. Developed countries are using the media to make
people aware of the need for organs. The hope is that if people know that one person can save
eight lives and help over seventy-five people after they die, more people will register to be
donors. National health care systems are trying to institute more lifesaving organ transplant
units around the world to help keep people with failing organs alive longer.
While these steps to increase organ donations will be helpful in developed countries,
different measures need to be taken in third world countries to end the illegal organ trade. In
order to eliminate the human organ black market, people living in poverty need to stop selling
their organs and must learn how to protect themselves from organ theft. The key to this, as
with many global issues, is education. People in poverty all over the world are denied
education and are illiterate, hindered by language barriers, and unaware of the existence of the
lucrative business of stealing and selling organs. Without this knowledge, people who are
desperate to feed their families will fall prey to organ traffickers if they think it is an
opportunity for easy money.56

56

(2014,). Canadian Transplant Society. Retrieved March 24, 2015, from http://www.cantransplant.ca/home/

43
Another solution is one that many disagree with: legalizing the organ trade. Those
making an effort to legalize it argue that everyone has the right to decide what they do with
their own body, before and after death. Some people in the medical field believe that allowing
organs to be sold will eliminate the shortage of organs. This issue is much debated around the
world.57
These solutions can help because they would decrease the number of people who die
while on the waiting lists. There would be more organ donors willing to donate their organs
while they are living or after they die (refer to Appendix G). There would also be fewer people
in third world countries at risk after donating organs because there would no longer be a
market for their organs. The black market would crash because people would be taken care of
at home and there would no longer be a need for transplant tourism.
All of these solutions have been attempted but not all of them have been successful.
This is because there is still not enough people who have signed up to be organ donors as
compared to the amount of people who are on the waiting lists. It is very difficult for some
people to agree to give an organ to someone they may not know. People are worried that in the
future they may need the organ or someone who is close to them may need it. As a result of
the scarcity of organs, people lose confidence in the system and resort to the black market to
prolong their lives. Furthermore, the problem of the lack of education for people living in
poverty in third world countries is a global issue of its own without an easy solution.
Another solution would be to grow organs from stem cells. This is a very complicated,
costly, and time-consuming process. In 2013, scientists created a rat kidney from a stem cell.

57

Martin, D. (2012, June 1). The Conversation: In-depth analysis, research, news and ideas from leading academics and
researchers.. Action to stop thriving global organ trade must start at home. Retrieved March 31, 2015, from
http://theconversation.com/action-to-stop-thriving-global-organ-trade-must-start-at-home-7333

44
Currently very small organs for animals can be made and stem cells are being used to create
windpipes for patients. Scientists expect that in the future they will be able to grow full-sized
replacement organs for humans. However, even when this time comes, it is very likely that
this will only be an option for very wealthy people needing organs, as it will be too expensive
for the majority of the population.
The best solution to putting an end to the illegal organ trade is to combine the efforts of
the many different human rights groups. Cooperation is essential to understanding the problem
and instituting change. The media must do their part to increase public awareness. New
willing donors must be found and people must be proactive and willing to make sacrifices in
order to make a difference. Global leaders must recognize the problem in order to make the
necessary changes in laws and they must ensure that the laws are enforced. They also need to
provide foreign aid so the various organizations involved are equipped to deal with the
problems that arise.

45

CONCLUSION
The global issue of the illegal organ trade is well established worldwide and will take
many years to eradicate. It is highly unethical and it is robbing people of their future everyday.
New markets are constantly emerging and the relevant authorities must play a role in helping
to curb organ trafficking. Public advocacy is absolutely essential as it is almost impossible to
convince desperate people that they will be better off if they take the proper channels to organ
transplantation. With perseverance and time, interventions can be successful and the organ
trade will be abolished. Global citizens must do all that they can to protect the rights of those
who cannot help themselves.

46

APPENDICES
APPENDIX A

(Online Image). Retrieved March 25, 2015, from http://www.spiegel.de/international/world/the-illegaltrade-in-organ-is-fueled-by-desperation-and-growing-a-847473.html

47

APPENDIX B

(Online Image). Retrieved March 25, 2015, from http://falundafalasvegas.blogspot.ca/p/organharvesting.html

48

APPENDIX C

(Online Image). Retrieved March 25, 2015, from http://newint.org/features/2014/05/01/organtrafficking-keynote/

49

APPENDIX D

(Online Image). Retrieved March 25, 2015, from http://newint.org/features/2014/05/01/organtrafficking-keynote/

50

APPENDIX E

(Online Image). Retrieved March 25, 2015, from http://juliannalindahill.weebly.com

51

APENDIX F

52

APPENDIX G

(Online Image). Retrieved March 25, 2015, from http://www.economist.com/node/12380981

53

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