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A brutal reality: How poverty fuels the organ trade in the Arab world

A brutal reality: How poverty fuels the organ trade in the Arab world

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Life Basic Rights

Tuesday 22 November 202206:44 pm
إقرأ باللغة العربية:

"أعرض أعضائي للبيع من أجل أن آكل"... كيف يغذّي الفقر سوق تجارة الأعضاء في المنطقة؟

The war destroyed his home in Damascus, so Ayman Yassin (pseudonym) decided to leave Syria and immigrate to Iraq a year ago, in search of a new life and in the hope of rebuilding his house and treating his young child's heart disease. After the 30-year-old collected 10 thousand dollars in Iraq, he was robbed by his employer. But he could not report it because he feared getting held legally accountable, especially since his residency permit had expired and he had not renewed it. Ayman found his answer in donating one of his kidneys for 10 thousand dollars, so that he would not return to his family empty-handed.

Ayman, a kitchen chef currently residing in Baghdad, tells Raseef22, "I decided to donate my kidney. It is true I’m still young and what happened wasn’t my fault, but it's my fault that I brought children to this life. God granted me my body and I want to make people happy with this body. I want to make my children and wife happy, as well as whoever will take my kidney and his/her family. I will be the reason for the happiness of many people".

He adds, "I had no other alternative, so I donated my kidney to an Iraqi patient in Erbil in exchange for money that turned out to be forged". Ayman recalls the theft he was subjected to, "If I ever thought to report it to the authorities, I would be shot by a bullet that would end my life. If I complained, I would go to jail, pay a big fine, and go back to my country. Donating my kidney is easier for me than me and my family living with no money at all".

Ayman met the broker a while ago, and he underwent all the necessary tests and examinations in the span of 12 days to make sure that his body would be a match. They had agreed to receive 10 thousand dollars from the patient one hour before the operation, through a third party who would receive it on his behalf. Only after the operation did the horrified realization of what had really happened set in, "After I sold my kidney, it turned out I had actually received fake money. I only found out after the operation when I tried to spend some of it".

Pages for organ sale

Many people in need in the Arab world believe that they've found their way to a better life by offering their organs up for sale through groups and pages on social media sites like Facebook and the famous chat application "Telegram", all led by brokers who do not show their true identities. Some of these pages are under titles like, "Donating Kidneys and Livers for Money", "Kidney Donors in Exchange for Money", and "Buying and Selling Human Organs". The sale of livers and kidneys is the most popular in this field, with page owners communicating with donors through encrypted applications.

"I had no other alternative, so I donated my kidney to an Iraqi patient in Erbil in exchange for money. After I sold my kidney, it turned out I had actually received fake money. I only found out after the operation when I tried to spend some of it"

According to what Raseef22 discovered within the pages and groups for this trade, a donor in Turkey, for example, receives 16 thousand dollars for the donated organ and its fees, and the total cost of an organ transplant reaches 26 thousand dollars, while donors in Egypt receive an amount of 100 thousand Egyptian pounds, and those in Iraq get 10 thousand dollars or a little more.

These networks are spread in most of the countries of the region. In Egypt, for example, many human organ trafficking gangs have been caught in recent years, perhaps the most prominent of which is the international network that the members of the Administrative Control Authority (ACA) were able to seize in 2020. The network, which consisted of 8 individuals led by a Palestinian woman, had worked to fabricate and falsify documents attributed to government agencies, and attracted foreign patients wishing to perform illegal kidney transplants.

According to the World Health Organization (WHO), "Illegal organ trade takes place when organs are removed from the body for the purpose of commercial transactions." In 2007, the World Health Organization assessed, based on data from member states around the world, that 5 to 10 % of kidney transplants are performed annually with organs from commercial donors, and that 5% of all beneficiaries have participated in the illegal trade. Also, according to a report by the Global Financial Integrity (GFI) organization, the illegal global trade in human organs generates profits between $600 million and $1.2 billion per year.

An Egyptian trying to save himself

In Egypt, Raseef22 met a young man who used to work as a photographer and lived in Dakahlia governorate. The 32-year-old had signed up to sell his kidney for 100 thousand Egyptian pounds so he could help his children following his wife's death. Mohammed (pseudonym) says, "A year and a half ago, I bought household appliances, but after the death of my wife, my life turned upside down. I fell into depression, took my children, and moved to another governorate. I could no longer work or live in the place where I had lost my partner".

He adds, "We racked up a substantial amount of debt over 6 months, and I didn't know how to pay it off until I saw an ad on Facebook about donating organs for money, so I contacted the page and met more than one broker. I never imagined being in this situation and having to deal with people who play with human lives in such a way."

Mohammad underwent numerous tests and examinations, and each time the result did not match the required specifications of the person he would donate to, until he was recently found "compatible" with a patient from the Bahwat region. Mohammad recounts how the man's broker promised him a fixed government job and 100 thousand Egyptian pounds in exchange for donating a lobe of his liver to him.

According to a report by the Global Financial Integrity (GFI) organization, the illegal global trade in human organs generates profits between $600 million and $1.2 billion per year

Mohammad says, "All the necessary arrangements and agreements were conducted through his broker, who never shows himself to the donors. He has extensive experience in this field, and his mission is to supply donors to financially capable patients who need a transplant in return for money, a small amount of which goes to the donor, while the largest amount goes to the broker and the networks that work with him. This broker deals with donors through WhatsApp messages while money transfers are done via Vodafone Cash. After some back and forth between us, I agreed with him to perform the operation in one of the largest hospitals in Egypt.”

Official threat

A few days before the operation, Mohammad decided to no longer go through with it. He felt the danger of the situation and feared losing his life, but things did not end there. He says, "After a month and a half of continuous medical check-ups to make sure my tissues were compatible with the patient's, I ran away from the broker without getting paid, and he started threatening me with my children. I lived in constant state of terror because he is not just a broker, but us also a gang leader with ties to senior officials, and he apparently had received a hefty amount of money from the patient before the operation."

"I cannot forget the threat the broker gave me after I tried to back out of the operation after the results of the tests came back compatible. He told me: 'What nonsense are you saying now? You underwent tests and x-rays for 25 thousand pounds. I will get you even if you try to escape from me!' And thus I decided to run away. I felt that this broker might take all my organs and throw me away. All he cared about was the money and that's why I ran away from him," he adds.

According to what's posted on the groups we have monitored, the costs of the medical examinations for the donor range between 25 and 30 thousand Egyptian pounds, paid by the recipient, whereas the price of a kidney ranges between 40 and 50 thousand pounds, while a liver's price in the market ranges from 100 to 120 thousand pounds received by the donor.

Mohammad points out that "the broker and his wife specialize in bringing in liver donors, and they finish the necessary paperwork through official proceedings, especially since the operation takes places in a governmental hospital and costs about one million pounds, of which the hospital alone charges 650,000 pounds, and the operation is performed by the most famous doctors in this field in Egypt."

A broader market

The market for human organ trafficking is not limited to a specific Arab country. Last August, the Iraqi Ministry of Interior intercepted a number of sale operations of human organs between Iraq and Ukraine. The director of the Anti-Human Trafficking Investigation Authority in al-Karkh area in western Baghdad, Brigadier General Wissam Nassif al-Zubaidi, said during a televised interview on Iraqi state television, that "the price of one testicle outside Iraq reaches 80 thousand dollars, and the price of a kidney reaches 33 thousand dollars.”

He also added that, "The trafficking operations of human organs in Iraq is focused on the sale of kidneys," confirming that they have caught the sales of testicles between Iraq and Ukraine and arrested the suspects involved. Al-Zubaidi pointed out that human organ trafficking is widespread in every hospital that performs organ transplants, and the ministry is combating this crime, as operations to capture the gangs that practice this profession have increased recently.

"I'll never forget the threat the broker made when I tried to back out of the operation. He said: 'What nonsense are you saying? I will get you if you try to escape from me!' So I decided to run away. I felt that he might take all my organs and throw me away"

Furthermore, the judicial authorities in Tunisia in November 2021 uncovered an international criminal network active in the field of human organ trafficking between Tunisia and Turkey. As a result, the public prosecution launched an investigation against 10 individuals who worked by luring their victims and taking advantage of their need for money in order to remove their organs, as evidenced by reviewing the flights between Tunisia and Turkey through Carthage Airport. The investigations further revealed that a Tunisian was in charge of attracting those who wish to sell their organs and communicating with foreigners wishing to obtain a kidney. The surgeries are performed inside private clinics in Turkey for 15 thousand dollars.

In 2020, the first step that led to uncovering the network took place when a Tunisian resident of the Zaghouan countryside sold his kidney for 16 thousand dollars, equivalent to 48,600 Tunisian dinars. Signs of sudden wealth appeared on him just months following his trip to Turkey after he, through social media, met members of an international gang that specializes in organ trading and attracts its victims through the internet.

Escape and bargaining

Amer Hamdan (pseudonym) left his country, Syria, following an arduous journey to escape and reach a safer country for him and his family after his father was killed in the clashes with the regime. Before the 33-year-old escaped, he had borrowed 700 dollars from someone to be able to reach Turkey, but things were not as easy as he thought.

Speaking to Rasseef22, Amer says, "As soon as I arrived in Turkey, I was surprised by the person I had borrowed money from suddenly threatening me with my family members back home: Either I pay him back immediately or he would hurt my four brothers, all of whom are younger than me. I found no other way but to put my kidney up for sale in order to pay off my debts. And I did offer it for sale through groups dedicated for this trade on social media, specifically on Facebook."

Last August, the Iraqi Ministry of Interior intercepted a number of sale operations of human organs between Iraq and Ukraine.

He adds, "I only managed to pay off $200, and I still have $500 worth of debt. Since I fled Syria, my mind has not yet calmed down. I live in a state of worry for my family, which no longer has a provider other than me. Now, I live in even greater suffering in Turkey, and I cannot use my identity since I entered illegally, which makes it difficult for me to move around."

Amer dreams of nothing other than securing money in order to pay his debts and smuggle his family out of Syria, where they live under a multi-layered siege. If they try to move, the creditor will carry out his threat and hand them over to the Syrian regime. Amer surfs pages dedicated to selling organs on a daily basis to find someone to sell his kidney to.

Refugee rights

Salah Bakhit, a lawyer in the Court of Cassation in Egypt, says that, "According to international and national law, an immigrant who has been subjected to blackmail or extortion has the right to file a complaint with the Public Prosecutor personally, as there is a specialized department to combat international crime against those who illegally blackmailed and displaced him/her, if he/she resides in the country the blackmailer resides in. If the victim resides in the country he/she was displaced from, then he/she can inform the competent authorities where the embassy or consulate is located, so that they may carry out their legal proceedings against the blackmailer."

Bakhit believes that, "Illegal immigration is one of the phenomena that has exhausted governments in taking measures and strategies in order to combat it and reduce its economic, social, political, health, and security impacts, as it has led to the emergence of serious crimes such as human trafficking, terrorism, and other crimes".

He points to the integration of national efforts to combat this issue. It has even come to implementing accountability for the purpose of guaranteeing the rights of illegal immigrants to reduce the crimes they are exposed to. We find that Egyptian law, for example, punishes those involved in the illegal immigration of these people with imprisonment for up to 5 years, and a fine of not less than 50 thousand pounds and not more than 200 thousand pounds. He adds, "These can be applied in case an immigrant in any Arab country is subjected to extortion, human trafficking, or any of these crimes directed at him if he/she immigrates illegally."

International crime

International law lawyer, Ashraf Milad, tells Raseef22, "The International Convention for the Prevention of Human Trafficking criminalizes the sale of organs, which falls under the name of 'human trafficking cases', and criminalizes the sale of any organ of the human body, but there is no international protection for a person unless he/she files a report in the country where the operation was carried out, and accuses a party or person of forcing him/her to do this. Only then does the case take on a legal character through which the person or party involved can be held accountable."

Amer dreams of nothing other than securing money in order to pay his debts and smuggle his family out of Syria, where they live under a multi-layered siege. Amer surfs pages dedicated to selling organs on a daily basis to find someone to sell his kidney to

He adds: "The parties involved in the incident are held accountable in accordance with the national law of the country in which the crime took place, and if an immigrant in any country is subjected to extortion, he/she must go to the International Organization for Migration, which is responsible for holding the perpetrator accountable. In the event that a person commits the crime of selling one of his/her organs by his/her own will, and the law of the country he/she is residing in allows people to do so in exchange for a money, he/she shall not be punished, but if the law of the country he/she resides criminalizes this, such as Egypt and Turkey for example, the perpetrator of the incident shall be subject to legal accountability." Here, Milad points out that the case of the young man who had sold one of his organs and got counterfeit money in return is similar to that of a person who had paid a bribe and did not receive the intended service. He cannot file a report against those who committed the incident as long as the law of the country where the incident had taken place criminalizes it.

Regarding the use of social media platforms like Facebook and Telegram to promote organ trafficking, the lawyer indicates that "this falls within the scope of cybercrime, as promotion in itself is a motive for committing the crime of organ trafficking as long as it is stated in the law of the state that the method used is a crime". He points out the need for an international convention signed by all countries that criminalizes human organ trafficking. As for the exploitation of doctors in governmental hospitals to perform organ transfers in exchange for money, it "is a legally criminal offense. The only case this type of operation is allowed in hospitals is when the donation is completely free of charge and comes from a donor who is a first-degree relative to the recipient."

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