Organ Trafficking and Transplant Tourism

Interview granted to the Romanian newspaper Adevarul

Q. Do you think there are huge networks of traffic in organs that operate in Romania? How many Romanians it is estimated, in your opinion, annually sell organs?


A. “Huge” would be an exaggeration. Globally, about 10,000 organs are illegally harvested and transplanted each year. Donors in Moldova receive c. $3000 per kidney and in Romania – double this amount. There are c. 600 known donors in Moldova and no figures available for Romania. Still, it would be safe to assume that more than 2000 Romanian citizens have sold their organs in the last decade. Each year, about 100 Romanians sell kidneys to Israeli brokers who work with South-African hospitals and another 200-300 sell organs, mostly kidneys, to criminal rings and networks with connections to Turkey, Brazil, Italy, and the USA. Romanian organs are expensive and so organ harvesting has shifted to Asia and parts of Latin America.


Organ sellers – euphemistically called “donors” – are mainly poor, unemployed, and Roma. Romanians who want to emigrate or are in debt sometimes end up selling their organs or brokering such sales from prisoners, soldiers, and even adolescents. It is easy to find advertising related to organ trafficking on the Internet and even in the daily papers.


Q. What method is used more often in the case of Romania? Romanians who want to sell their organs are taken abroad to have their organs removed? Or, they are operated in Romania, then the organs are removed from the country? Or both methods are used?


A. Actually, organ sellers are often flown from other countries (even from Israel) INTO Romania. The organs are then harvested in Romania. Rarely, the organs are transplanted in Romania using fraudulent affidavits claiming that the donor and recipient are relatives. More frequently, the organs are flown to other countries, such as South Africa and Turkey, where the operations take place.


Many people are involved in these networks: from petty criminals to politicians and from medical doctors to businessmen. In Romania, the typical organ broker is a donor: someone who sold his kidney. Small-time criminals are also involved as well as officials in Customs and Immigration and, to a lesser extent, the Police and the Airports. Even hospital directors are in on the take.


A typical patient pays c. $120.000 per transplant, so there is a lot of money to divide. It is no wonder that Romania was the only country not to attend the conference that yielded the Istanbul Declaration against organ trafficking and transplant tourism!


Generally speaking: trafficked organs are either sold domestically, or exported to be transplanted into patients from the US, Europe, the United Arab Emirates, Saudi Arabia, and especially Israel.


Q Have you heard or seen cases in which the Romanians sold their organs?


A. Yes, and so have you: Robert Mihaly in 2005.


Q. What are the organs most commonly trafficked from Eastern Europe?


A. Kidneys are the most sought after, extracted, sold, and transplanted. Harvesting a kidney poses few risks to the donor. Kidneys are tiny and easy to conceal and smuggle. About 10,000 kidneys are harvested illegally each year.


Q. Are the rumors about harvesting organs from adopted children true?


A. No, they are not. Children’s organs are often ill-suited for transplantation for histological and immunological reasons. So, the stories about Israeli adoption agencies which work in tandem with Israeli doctors to extract organs from Romanian children are nonsense and merely the latest version of the medieval anti-Semitic blood libel. Still, I am ashamed to say that Israeli doctors are very prominent in the organ trafficking and transplant tourism business.

Interview granted to El Pais

Q. Why do Israelis buy more organs for transplantation than other nations?

A. Because Israeli doctors and businessmen (and, more generally, Jewish doctors in places like South Africa) are heavily involved in the trade. Jewish religion forbids the donation of organs from a living person. So, in Israel, there is an enormous shortage of organs coupled with a sizable purchasing power. It is simply easier for an Israeli to find the right connections as all the roads lead to Tel-Aviv.

Q. Which countries provide the most donors?

A. In Europe: Moldova, Romania, Belarus, Ukraine, and, to some extent, Albania, Kosovo, and the former republics of Yugoslavia (Serbia, Bosnia-Herzegovina, Macedonia). In the Americas: Mexico, Haiti, Bolivia, Peru. In Asia: Indonesia, Philippines, Malaysia, and Vietnam. In Africa: Nigeria and the countries of sub-Saharan Africa. But there are donors who hail from rich countries as well: even from Israel. Still, demand gravitates to where supply is abundant and cheapest. In Moldova and Turkey donors sell a kidney for 200-500 euros; in Romania, Romas sell the same organs for double or triple that; while Israeli donors demand up to 10,000 USD per kidney. Normally, buyers prefer Moldovan or Turkish donors.

Q. How does a person how want to buy an organ find his way?

A. Predominantly through his doctors. In a few cases, he may know someone who has had a similar procedure. There are even Internet chat rooms, bulletin boards, and forums where such information is exchanged.

Q. How many organs have been bought in the last 2 years in the Middle East?

A. Arab patients in the Gulf States, Israelis, Egyptians, Iranians and Turks are the most numerous clients for such operations. But the surgical procedures themselves – harvesting the organs and then transplanting them – take place in other locations: Kosovo, Turkey, South Africa, Morocco. In total, about 12,000 organs are illegally traded every year the world over. Middle Eastern patients account for c. 2400 of these.

Q. Has the organ trade decreased or increased in the last 10 years in this area?

A. Increased dramatically as the business has been taken over by organized crime networks, aided and abetted by businessmen, financiers, hoteliers, truck operators, politicians, customs officers, local doctors, judges, police officers, and other officials, including representatives of the international community. Everyone has been corrupted by this scourge.

Q. How much can an organ cost? (let’s say a kidney)

A. The patient pays between 100-150,000 USD for a kidney transplant, including two weeks of convalescence in a five-star hotel for him and his immediate family.

Q. How much does the donor /seller receive?

A. Donors typically receive between 1000-2000 USD per kidney (about 1-2% of the cost to the recipient patient). Many donors in distress or those who want to emigrate sell organs for much less. Retinas, hearts, lungs, even bone marrow are also harvested and sold.

Q. How much does the doctor get? How much does the clinic and the stuff performing the operation? How much the mediators?

A. A typical operation involves 2 surgeons, 1 anaesthesiologist, 2 nurses, and 1 specialist (cardiologist, nephrologist, etc.) The surgeons receive 20,000 USD each; the specialist (who only monitors the patient and serves as a consultant) about 10,000 USD; the anaesthesiologist about 5000 USD; and each of the nurses about 2000 USD per operation. The rest goes to the long chain of mediators involved. The brokers pay off everyone else: truck drivers, receptionists at the hotels; customs officers; judges; policemen; and midlevel politicians.

Q. What is the role of Turkey in all this? Are Turkey’s clinics or doctors into this illegal business?

A. Turkey is a major junction in the trafficking of illicit organs. Turkish doctors work closely with Israeli and Jewish doctors the world over. They operate on both donors and recipients. They run illegal clinics all over the world, including in Turkey, where many transplants take place as part of a phenomenon of “transplant tourism” (mostly next to Antalian resorts). They recruit donors. The whole business would be unimaginable without the Turks. Recently, Israeli and Turkish networks have started to infiltrate Russia (with the help of the Russian mafia) and the Turkic former republics of the USSR as well as Kazakhstan and through these, China. This is the next “growth market”.




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