Latin American is taking increased measures to counter organ trafficking, with a group of states recently agreeing on minimum penalties for the crime. However, so long as a gap exists between waiting list candidates and donors, along with an endemic level of poverty in the region, the opportunity will continue for organized crime to profit from the trade.
At a meeting of judicial officials from Central America and the Dominican Republic last month, representatives from all countries agreed to set a minimum penalty for the crime of organ trafficking, reported La Prensa. While the agreement doesn't set limits on the sentences each country can hand down -- Honduras, for example, recently passed a revised human trafficking law that sets the minimum penalty for organ trafficking at 15 years -- it lays out that anyone guilty of involvement in the illicit trade should be punished with no less than five years in prison.
The accord marks a significant step in tackling organ trafficking, an often overlooked facet of human trafficking and one that has long afflicted Latin America.
Though not comparable in size to other forms of human trafficking, such as forced labor and sexual exploitation, organ trafficking still represents a highly lucrative trade for criminal gangs. Organs Watch, an NGO that tracks illegal organ sales, estimates that up to 20,000 kidneys alone are sold worldwide each year on the black market where they can fetch a price of around $150,000. Gangs are able to profit from this primarily through acting as brokers, linking buyers who typically originate from the western world and the Middle East to impoverished communities where people are willing to sell their organ in the hope of achieving some financial security. Though prices vary considerably around the world, a 2005 study found that on average a kidney would sell for $10,000 in Peru and around $6,000 in Brazil, offering brokers a potential profit margin of over 1000 percent. What's more, there is no guarantee the seller will receive the promised amount in full.
Victims may also be coerced into selling their organ with gangs luring them through the offer of a well-paid job before ultimately kidnapping them and threatening them with death if they don't comply. However, while such cases exist, they are isolated, according to a report by the CQ Global Researcher.
Despite the popular urban myth that victims often find themselves post-operation in a bath of ice, having had an organ removed by criminals, this is a common misconception. The role of organized crime is typically only that of facilitator, not surgeon. As Dr. Gabriel Danovitch stated, "People don't take out kidneys on kitchen tables. For transplants to happen you need a decent hospital and well-trained surgeons."·
In addition to the required complicity of hospitals and surgeons, there are cases where a medical tourism company will be used to "shop" for professionals willing to undertake the transplant surgery. In an article last week for Examiner, Kristin Eckland, a nurse practitioner from the US, found a US company named Planet Hospital trying to recruit a surgeon in the Mexican border city of Mexicali to carry out a lung transplant for a European patient, despite there not being adequate facilities in the city for such an operation. The sum offered to the surgeon was in the region of $200,00, or ten times the average salary.
While Latin America is known to be a key site for organ traffickers, determining the size of this trade in the region is problematic since no reliable statistics exist that track continental variation in organ trafficking. However, the endemic rate of poverty in the region --·31.4 percent -- makes it an attractive source for organ traffickers looking for victims who they can easily exploit economically. A number of cases have come to light in recent years that underscore the region's importance as both a source and site for the black market.
In January, a Proceso report found that online advertisements recruiting potential sellers was flourishing in the Mexican state of Jalisco where the poverty rate is 41 percent. Additionally, impoverished residents were actively offering their organs, with one 25-year-old man selling his kidney at around $18,000. As he told Proceso, "It's no good to me to keep both kidneys and remain with my debts."
Despite receiving 36 reports of organ trafficking in the last six years, Mexico's Attorney General's Office has to date only opened preliminary investigations into four cases, showing that much work still needs to be done to effectively address the crime.
Other examples draw attention the highly organized and amorphous nature of the trade. Unlike drug trafficking, for example, there appears to be no set of rival criminal networks competing with each other for a share of the market. Alliances are made on an ad·hoc basis depending on which region can be used as a site for the operation and who the buyers are. In 2004, 30 Brazilians sold their kidneys for between $3,000 and $10,000 to an Israeli funded trafficking ring that had the transplant operations carried out in South Africa.
Conversely, there have been examples of Latin America as a transplant site, as well as a source. A 2010 Bloomberg investigation discovered that a Belarussian man who answered an advertisement to sell a kidney for $10,000 was eventually flown to Ecuador for surgery to transplant the organ to an Israeli woman. When locked in a Quito hotel room, he pleaded with his traffickers to let him go, stating he had changed his mind. They refused, threatening to kill his family if he didn't go through with the procedure.
What ultimately drives this trade is the worldwide shortfall between legitimate, registered organ donors and those awaiting transplants. Waiting lists around the world are continuing to grow while the number of donors largely flatlines. The US is just one example. As the graph (adapted from here, see below) illustrates, though supply and demand were close 25 years ago, the gap between donors and those in need of donations has widened dramatically.
While organ trafficking is deemed to be illegal in almost every country in the world, the lack of a legal international framework is preventing governments from cracking down on the trade more effectively, according to Dr. Francis Delmonico, president-elect of The Transplantation Society (TTS). Delmonico has worked with governments around the world to combat organ trafficking. "There is no good international treaty on [organ trafficking]. And, governments have not really contended with it greatly because, at the moment, it doesn't constitute a major human rights abuse ... [therefore], governments have not been enthusiastic to address it."
International measures have been taken, such as the 2008 Declaration of Istanbul on Organ Trafficking and Transplant Tourism which proposes the prohibition of transplant commercialism because of its exploitation of the poor. But such efforts fall short of any binding framework. Therefore, Delmonico stated, "we need a treaty."
For now, at least, agreements like the recent one between Central American nations will have to suffice. This development is certainly a welcome one, particularly with the case of Nicaragua. Only three years ago, the country remained the only Latin American state without legislation prohibiting organ trafficking, leading some to warn of the country's vulnerability to organ traffickers taking advantage of the legal vacuum.·
However, as long as Latin America continues to suffer from high poverty rates and the gap continues to widen between organ donors and waiting list candidates in the developed world, organ traffickers will look for ways to circumvent the law, and Latin America will remain an appealing market to prey on.