Three years ago, a young man in provincial Belarus responded to an advertisement offering cash to anyone willing to donate a kidney. It was the start a harrowing journey that saw him trafficked to Ecuador and locked in a hotel room where his life was threatened if he refused to proceed with the operation.
The man, whose story was reported extensively in Bloomberg Markets Magazine, eventually went through with the operation, receiving $10,000 for providing his kidney to an Israeli woman, according to an investigation by Ukrainian police.
The case provides a rare example of a victim-donor coming forward to publicise their story, shining a light on the murky and expanding global phenomenon of trafficking in human beings for the purpose of organ removal. In many other cases victim-donors are recruited with false promises of financial reward, but in fact do not receive any payment. As Special Representative and Co-ordinator for Combating Trafficking in Human Beings at the Organization for Security and Cooperation in Europe (OSCE), the world's largest regional security organisation, I am working to prevent this crime, enhance assistance to its victims, and bring the perpetrators to justice. This month, I issued a ground-breaking research paper, Trafficking in Human Beings for the Purpose of Organ Removal, based on a number of actual cases investigated in various OSCE countries, to document this growing business and provide detailed recommendations on how to address victims' rights and strengthen the legislative framework to increase prosecutions and improve victim assistance.
The size of the global organ trafficking industry, which primarily engages in kidney transplants, remains unknown due to its clandestine nature. However, anecdotal evidence shows that it is clearly a multi-million dollar industry. Operations at a medical facility in Kyiv, Ukraine that were uncovered by law enforcement provided revenues of about $18million annually to a network of traffickers. Recipients in that case paid between $100,000 to $150,000 for a kidney, while surgeons earned $15,000 to $20,000 per transplant. Organ donors were promised just $10,000. We do not know if this small amount was actually paid to all of them. In any case, all victim-donors were deceived about the health impact of organ removal. Left in a situation of destitution, without any post-surgery and long term health care, they were not able to perform any heavy work and their health deteriorated rapidly. While my paper focuses primarily on the 57 participating states in the OSCE region, which stretches from Vancouver to Vladivostok, trafficking for organ removal is truly global in scale. As seen in the Belarusian case, victim-donors are often trafficked from one continent to another, where the transplant takes place. This creates particular complications for law enforcement officials, both in terms of identifying victims and pursuing trafficking networks.
Victims of this form of human trafficking, who generally come from the poor, marginalized elements of their own society, must not be forgotten. Very little has been done to reach out to them in terms of providing adequate and long-term physical and psychological care as well as the legal representation required for them to receive effective remedies including financial compensation. My paper includes a series of recommendations to improve the situation, including:
- Creating public awareness campaigns among potential target populations that provide information on the risks and potential consequences of selling an organ as well as on the potential risks for recipients of buying an organ.
- Increasing outreach work to identify victims and provide assistance and access to health services.
- Providing victims with access to social workers and lawyers to give them information about their legal rights.
- Providing vocational training to victims that will allow them to join the work force, taking into consideration that they are likely to be unable to work for long hours or perform heavy jobs.
Enhancing the criminal justice response is another important step to combat organ trafficking. Criminal networks are often able to operate with impunity because victims are afraid to come forward owing to the stigma associated with having lost an organ or having been cheated. Others involved, including medical professionals and organ recipients, are keen to avoid the attention of law enforcement officials. In order to increase the number of prosecutions for this crime, I am recommending a series of "next steps" for law makers that include:
- Encouraging legislators to examine if their national criminal code is currently equipped to deal with trafficking for organ removal, while also sensitising criminal justice actors to the full range of actors and abuses associated with this crime.
- Supporting training for law enforcement authorities and medical professionals on the subject of trafficking for organ removal, including relevant laws, penalties and ethical obligations and guidelines.
- Expanding international cooperation to increase prosecutions and ensure that countries where most organ recipients live recognize that the issue is not solely a problem for the countries whose citizens supply the organs.
- Developing partnerships with health care and medical professionals, ethical associations of doctors, transplant organizations and NGOs to raise awareness, promote ethical behaviour and encourage reporting the crime.
If these steps are taken, I am certain that we will begin to see increased prosecution of trafficking networks as well as greater assistance to the victims of this 21st Century crime, which is likely to increase as the global population ages and the gap between the world's rich and poor grows.
Maria Grazia Giammarinaro is the Special Representative and Co-ordinator for Combating Trafficking in Human Beings at the Organization for Security and Co-operation in Europe (OSCE) and a judge at the Criminal Court of Rome.