[NYTr] Keen demand fuels global trade in body parts

[All the News That Doesn't Fit]

sent by Tom Simonds (activ-l)

Reuters - Aug 6, 2007
http://www.reuters.com/article/healthNews/idUSL0111097620070806

Keen demand fuels global trade in body parts

By Tan Ee Lyn

HONG KONG (Reuters) - Paul Lee got his liver from an executed Chinese
prisoner; Karam in Egypt bought a kidney for his sister for $5,300; in
Istanbul Hakan is holding out for $30,700 for one of his kidneys.

They are not so unusual: a dire shortage of donated organs in rich
countries is sending foreigners with end-stage illnesses to poorer
places like China, Pakistan, Turkey, Egypt, Colombia and the Philippines
to buy a new lease of life.

Lee, a 53-year-old chief subway technician in Hong Kong, was diagnosed
with liver cancer in January 2005 but doctors denied him a transplant
because they feared the tumor would spread.

A friend told him about a transplant hospital in China's north eastern
Tianjin city and he signed up for a place. That April, he paid 260,000
yuan (US$34,380) for a transplant -- surgery that saved his life.

"The hospital has connections with a lot of prisons," Lee told Reuters.
"Mine came from an executed prisoner from Heilongjiang. I thank the
donor deeply."

The World Health Organisation estimates that 21,000 liver transplants
are carried out annually, but medical experts put annual worldwide
demand at at least 90,000.

Demand for kidneys also exceeds supply, and that has given rise to organ
trafficking and a black market for rich people and "transplant tourists"
who travel to poor countries to buy body parts from people with few
other routes to a better living.

A donor in South Africa receives $700 for a kidney compared with $30,000
in the United States. A lack of transparency and little protection for
donors has spurred calls by international bodies to crack down on, or at
least regulate, the trade.

But even where the trade is banned, laws are often muddled or laced with
loopholes, which are sometimes defended by vested interests.

EASIER

And the unregulated route is much less complicated for the recipient.
Any transplant procedure involving a living donor carries risks for the
donor -- especially for liver transplants which involve removing part of
the donor's liver.

The complications can include bleeding, infection, even death.

In the transplant trade, the recipient need not worry about, for
example, exposing a living relative to that risk.

"It is cheaper and your next of kin is not taking the risk and you don't
have to care for someone you don't know. Once you pay, it is discarded
in a way, it is dispensable," said Luc Noel, a Geneva-based coordinator
for Clinical Procedures at the World Health Organisation.

China recently banned the sale of human organs and restricted
transplants for foreigners, saying it must first meet demand at home for
2 million organs a year.

Only 20,000 transplants are carried out in China each year. Of these,
3,000 are liver transplants and 95 percent of them use livers from dead
donors.

China defended its use of organs from executed prisoners, saying consent
was obtained from convicts or their families. A transplant operation
using the liver of a dead donor costs around $33,000 in China.

"What is important is the transparency, it has to be open to scrutiny
.. if China makes its current system open to scrutiny and very
transparent, that would do good," said the WHO's Noel.

"KIDNEY BAZAAR"

In Asia, a cultural obsession with keeping the body of the deceased
intact has stymied public organ donation programs.

Excluding China, Asia has fewer than 200 livers donated by people ahead
of their death each year, said Lo Chung-man, professor of hepatobiliary
and pancreatic surgery at the University of Hong Kong.

Pakistan, where trade in human organs is not illegal, is turning into a
"kidney bazaar", said the chief executive of Pakistan's Kidney
Foundation, Jaffar Naqvi.

There are no confirmed figures for the number of foreigners coming to
the country for new kidneys but Naqvi said there were 13 centers in
Lahore alone which reported more than 2,000 transplants last year from
bought kidneys.

Patients, mostly from Europe, Saudi Arabia and India, pay about 500,000
rupees ($8,500) for a new kidney, he said. Donors are paid $300 to
$1,000 and often get no medical care after the surgery.

There is no consent in some cases. In May police arrested nine people,
four of them doctors, for abducting people, drugging them and stealing
their kidneys for transplant operations.

In the pipeline is a draft law aimed at banning the trade, but a
powerful lobby bent on preserving it is trying to ensure it allows
kidney donations for a non-relative, with no payment. Such a clause
allowing "altruistic" organ donations will ensure the trade continues
with secret payment to donors, Naqvi said.

15 DAYS

Stories of people selling their organs, especially kidneys, are not
uncommon in Egypt, where more than 30 percent of a population of more
than 73 million people live below the poverty line.

Karam, who asked to be identified only by his first name because organ
trading is illegal, said it took him only 15 days to secure a kidney for
his sister who was suffering from kidney failure. He said a doctor found
him a man willing to sell his kidney for 30,000 Egyptian pounds
($5,300).

"The fees of the doctor were 5,000 pounds. Both his money and the fees
of the hospital were deducted from the money the 'donor' received," said
Karam.

He said doctors usually help in finding people willing to sell their
organs from their patients' lists.

Abdel-Kader Hegazy, head of the disciplinary committee at the Doctors'
Union, said Egyptian law lacks clear punishment for those involved in
illegal transplants, making it easy for doctors to repeat the offence.

"The law says it is illegal to trade in organs but does not specify the
punishment. We at the union suspended many doctors and closed their
practices, but they have appealed before courts and won their licenses
back," he told Reuters.

"It is an annoying and a regrettable situation. Well-known doctors and
professors are doing this. They are rich people but they do it because
they have no moral values."

The union has been pushing for legislation to regulate organ
transplants, with a draft bill including heavy fines and a prison
sentence for those involved and a ban on transplants between people of
different nationalities.

But the draft law has been languishing in parliament for several years
because of differences between doctors and senior Muslim religious
leaders on whether Islam allows organ transplants in the case of
clinical deaths.

INTERNET POSTINGS

In Turkey, students, unemployed young men and struggling fathers post
adverts on the Internet selling their kidneys, listing their drinking
and smoking habits and blood type.

These would-be donors say they have had enquiries from Germany, Israel
and Turkey with asking prices going up to 50,000 lira ($38,760).

Hakan, a 27-year-old security guard in Istanbul with two young children
who also requested only his first name be published, told Reuters he
received five or six offers from Turkey and Germany, offering
10,000-15,000 lira ($11,600), but he's holding out for 40,000 lira.

"Of course it's frightening but there's nothing else to be done," he
said, adding he hadn't told his wife as he knew she would object.

"I'm doing it because of my family, if I was alone it wouldn't matter.
I've got two children ... there's nothing else I can do for them."

(Additional Reporting by Emma Ross-Thomas in Istanbul, Robert Birsel in
Islamabad and Alaa Shahine in Cairo)

) Reuters 2006. All rights reserved.