Organ trafficking turns into trending market; victims are Syrians

Enab Baladi – Ghossoun Abou Dahab

Through brokers operating in Syria and the countries of asylum, human trafficking gangs take advantage of the economic crises and the deteriorating living conditions of the Syrians to entrap the vulnerable among them to trade in their human organs, such as kidneys, testicles, and the cornea of ​​the eye, and sell them on the black market, through fraudulent methods that may cost the victim his/her life.

What is known as “organ trafficking tourism” has emerged with the fragile economic situation in Syria, as patients who need to replace their organs arrive, with talk about the availability of organs at cheaper costs from “donors,” who are mostly people who sell their organs for a purely financial purpose.

Enab Baladi monitored several cases of people, including those who sold their kidneys and others who offered parts of their bodies for sale, some of whom agreed to publish their story, with reservations about mentioning their names, while others refused to cooperate and publish.

Slow death to secure sons’ future

Salem (pseudonym), 37, sold his kidney in November 2021 and is now offering the lobe of his liver for sale on a Facebook page specialized in selling organs.

He told Enab Baladi, “The living situation in Damascus is very difficult, and there is no work, and in the winter, things get worse.” He continued, “Half of the Syrian people want to donate,” meaning to sell.

“I have no problem with dying if I can guarantee my children’s future. I die a thousand deaths a day because I cannot secure their demands,” he adds.

Salem works in the field of electrical installations and plumbing, but he has been without work for a long time.

“I am unable to secure a loaf of bread because wages are low. I used to work in a shop for a daily wage of ten thousand Syrian pounds, but today the family in Damascus needs 150 thousand pounds, between cooking and household expenses, as a minimum,” he estimated.

I have no problem selling all my body parts so that my children do not starve. Salem, the man who sold his kidney and wanted to sell the lobe of his liver, but was scammed.

A mediator contacted Salem after seeing his comment on Facebook, offering to sell his kidney, the two parties agreed on the price, and the necessary analyzes were carried out, and Salem went to court and signed a waiver of his kidney, then the operation was performed at al-Assad University Hospital.

Salem, who received 37 million SYP (about 9000 USD) for his kidney, is still suffering from the operation.

The kidney price that Salem received mostly went to brokers who deceived him under the pretext of sending him out of Syria to sell his liver lobe after he sold his kidney.

“They asked for money for analyzes and examinations, hospital approvals, and opening a medical file, and it turned out later that all of this was a lie and a fraud,” he told Enab Baladi.

Official secrecy and pointing fingers at “terrorists”

The official narrative of the Syrian regime blames the phenomenon of organ trafficking on those it describes as “terrorists” and tries to label areas outside the regime’s control with such charges, coinciding with the absence of any data or figures from the Ministry of Interior or official institutions in Syria explaining the extent of this spread.

In a research conducted by Enab Baladi on the digital platforms of the Ministry of Interior, the issue of organ trafficking is only mentioned in one piece of news, in 2020, in which the Ministry said that the army units, in cooperation with local people, found a large number of human organs preserved with chloroform inside one of the “dens of terrorists” in the village of al-Ghadfa in the Maarat al-Numan region, south of Idlib.

The official Syrian News Agency (SANA) stated at the time that “a doctor turned a house in the village of al-Ghadfa, east of Maarat al-Numan, into a primitive medical laboratory, where the army found a large number of transparent packages containing human organs, including a head, eyes, hearts, lungs, livers, kidneys and other viscera preserved in the chloroform liquid.

In a 2016 interview with the Russian agency Sputnik, the Director General of the Forensic Medicine Authority in Syria, Hussein Nofal, stated that the black market for the sale of Syrian organs across the world has reached 15,000 Syrians during the last six years.

Nofal spoke at the time about documents confirming that more than 25,000 organ removal operations had been carried out since the beginning of 2011.

But he further specified that these operations are taking place, especially in border areas far from state control, in addition to the operations that were conducted in refugee camps in neighboring countries.

The concealment of organ trade led to the deletion of an investigative report published in the state-run al-Baath newspaper (the mouthpiece of the ruling party) on the issue in October 2020. The deleted investigation documented how the process of obtaining Syrian organs has become easier and cheaper, with the bad economic conditions and the high unemployment rate, bearing the responsibility for selling organs to what it called “mafias” and medical and non-medical organizations.

This secrecy and censorship are evaded by statements that indirectly confirm the widespread of the phenomenon.

Hussein Nofal, in 2020, who became at the time the honorary chief of forensic medicine, called for the establishment of a free bank for human organs in Syria for all people without prejudice, including liver, kidney, pancreas, stem cells, and bones such as the blood bank, in order to combat organ trade similar to the EU states.

He explained that the poor living conditions could push some to sell their organs for money, calling for the Public Prosecution to be informed as soon as advertisements were published about this in order to take the necessary measures against the traffickers.

Nofal justified the absence of accurate statistics on the phenomenon for being an illegal crime, which is basically not declared, but the Anti-Trafficking in Persons Department can monitor Facebook pages and prosecute organ traffickers.

According to the “Huna Sotak” website, the Public Prosecutor in Damascus Countryside, Ahmed al-Sayed, said that the rate of complaints may also give an indication of the extent of the spread.

More than 20 complaints related to human organ trade reached the court in Damascus between March 2011 and September 2015, and such complaints did not reach the court before the start of the Syrian conflict.

These complaints included the names of criminals, as well as the names of several doctors and hospitals, made mainly by relatives of those who died in the trade.

Al-Sayed said it is very difficult, or even impossible, for these people to be referred to the courts, given the difficulty of tracing them amid the chaos in the country.

Cross-border networks

Organ trafficking networks spread in poor countries and areas of chaos and conflict, taking advantage of people’s poverty and destitution, the absence of oversight, and the inadequacy of laws.

Organ brokers use many methods to obtain organs and sell them on the black market, including kidnapping, murder, fraud, the temptation with money, and advertisements on social media.

Enab Baladi monitored several pages on Facebook where organ trade is active, such as the page “Donating kidneys and livers in exchange for money,” the page “Donating kidneys for a fee,” the page “buying and selling human organs,” and the page “buying and selling a kidney from all over the world.”

Enab Baladi monitored dozens of comments on social media, including requests for human organs or offers to sell them. It also followed up on a group of brokers who camouflaged behind fake pages, interfering in the comments and requesting communication “in private.” The comments also included inquiries about the prices of human organs and the mechanisms for selling them.

On a Facebook page, Naji (pseudonym), 25, posted a comment offering his kidney for sale and told Enab Baladi, “A mediator from the Maghreb contacted me and asked me to travel to Turkey to perform the operation. I refused his offer and stipulated that the operation be performed in my place of residence in Amman, and I have a hospital and a doctor of my choice, but the mediator apologized, and the sale was not completed.”

Naji justifies his will to sell his kidney by saying, “We lost what we had in Syria, and we were displaced from our areas because of the regime,” adding, “We were a financially comfortable family. We now live in Jordan, and I am the only one who works at home and spends money on my family of five people. Living expenses in Amman are high, and the salaries are low, there is no future.”

Naji works as a waiter in a luxury restaurant in Amman, but his modest salary is not enough to support his family and transportation expenses, he said.

Naji builds high hopes on selling his kidney, as he indicated his intention not to sell it for less than 50 thousand dollars so that he can emigrate, buy a small house, help his brother complete his studies, and open a small business.

When Naji was asked by Enab Baladi about the legality of selling his kidney in Jordan and the extent of his knowledge of the procedures, he replied that he did not know any information about that.

By reviewing the laws, it became clear that Jordanian law does not allow a living donor who wants to donate a kidney or a liver lobe to donate to a recipient outside the family.

Transplant Tourism

In many cases, patients travel to countries such as India and Egypt for organ transplantation due to the availability of many options at cheap prices and the presence of networks and brokers that facilitate the process. For years, Syria has become a destination for patients for the same previous reasons.

The 50-year-old Umm Ayman (pseudonym) has been suffering from kidney failure for years, which called for a replacement kidney transplant; however, she could not find a donor from her family.

Umm Ayman, based in Saudi Arabia, told Enab Baladi that her health has deteriorated in recent years and that she tried to undergo a kidney transplant in the Kingdom but was unable to do so because of the complicated procedures and the high cost.

I searched with my family for solutions, and after the question and inquiry, we were advised to go to Damascus because the financial costs there are less due to a large number of offers and the ease of communication with people who arrange everything, from finding a donor in return for money to arranging the operation in hospitals in a short time. Umm Ayman tells her story of going to Damascus to plant a kidney.

Umm Ayman headed to Damascus at the beginning of 2022, where she met doctors and brokers who promised her a kidney transplant soon, after finding a suitable donor, in exchange for money, and she is still waiting in Saudi Arabia in hope.

With regard to trade and transplant tourism, the Istanbul Declaration 2008 on organ trafficking stated that the important and positive development of organ transplantation was marred by some abuses and the receipt of some reports about organ trade, the exploitation of donor persons, and the practice of organ transplant tourism, which relies on the travel of well-off patients to purchase organs from poor donors.

The World Health Organization (WHO) called in 2004 for the need to take the necessary measures to protect poor and vulnerable people from organ transplant tourism and selling it, including paying attention to this phenomenon globally and stopping the practice of trading human organs and tissues.

Syria is “cheaper”

The Honorary President of Forensic Medicine in Syria, Hussein Nofal, estimated the selling price of a single kidney in EU countries at between 50,000 and 70,000 US dollars, and the higher the supply, the lower the price, considering that prices drop in countries such as Syria.

He also explained that many Lebanese prefer to perform a regular kidney transplant in Syrian government hospitals, as the cost is five to ten times cheaper, while in Lebanese hospitals, it ranges between 10,000 and 15,000 US dollars, and at the American University, it may reach 50,000 US dollars without the price of the kidney.

Why do people sell their organs?

The deteriorating economic situation in Syria, and extreme poverty, push people to sell parts of their bodies, such as the kidneys, the testicles, and part of the liver, Dr. Daawa al-Ahdab, a social psychologist, told Enab Baladi.

Donating an organ to one of the family members strengthens social relations within the family and is considered a noble moral and a kind of loyalty and righteousness. However, selling an organ in the body for a financial need reflects the extent of the economic deterioration that Syria is experiencing, al-Ahdab added.

The donor feels proud of his/her body part because it is out of giving and generosity, but in the case of selling in order to meet the requirements of the family and children, the donor will wait for the favor to be returned.

But if the donor does not find the appreciation he/she expects, they enter into a state of depression, and some become anxious because they think they will have to sell another part of their body later.

There are other cases of depression and psychological disturbances in the event that the donors fail to achieve the goal for which they sold their organs and believe that they have made a foolish decision. They also may not find sympathy or understanding from society, which may see that there is nothing worthy of a person selling a part of his/her body, and thus expose them to blame and lack of support, according to al-Ahdab.

Organ trafficking in law

Syrian law allows organ donation on the condition that there is no sale and material and moral gain, and allows organ transplants to be performed, provided that the doctor has a license to practice the profession and that his/her work meets the principles of professional medicine, lawyer Mahmoud Hamam told Enab Baladi.

The purpose of the operation should be treatment, and the consent of the patient or his/her legal representative, unless in necessary cases, is required, Hamam added.

According to Legislative Decree No. 3 of 2010, human trafficking involves several crimes, starting with luring, transporting, kidnapping, deporting, harboring, or receiving people, to use them for illegal business or ends, in exchange for material or moral gain or on a promise or by granting advantages or seeking to achieve any of that, or otherwise, in addition to the elements of the crime and the place of protection in these crimes.

The lawyer pointed out that Law No. 3 included all cases related to human trafficking and that the criminal description in it does not change according to different methods, whether it is by threat, the use of force, persuasion, or the exploitation of ignorance, weakness, fraud, or exploitation of the position or collusion and mention all the means of committing this act.

The law considers human trafficking a crime, even if it is carried out with the victim’s consent, and the law punishes it with temporary imprisonment for a period of no less than seven years and a fine of up to one million SYP.

Hamam also clarified that the origin of surgical operations is treatment, and the law criminalizes the removal of a healthy organ from the body in exchange for money or gain and considers it human trafficking, and the perpetrators are punished even if there is consent from the victim, with the exception of organ donation if it is with the consent of the donor, with the intention of charitable work.  

The lawyer emphasized that the law in Syria is applied only in rare and exceptional cases because the decree was taken under international pressure.

Online promotion

Syrians’ publications related to the sale of human organs on social media platforms indicate the extent of the loss of hope and despair over the improvement of their living conditions in Syria or the neighboring countries.

The advertisements for organ demand scattered on the streets, and organ transplant operations in government and private hospitals, coupled with a nominal waiver of the donated organ, confirm the fragility of the Syrian law and its oversight.

Some find in this a reference to organized gangs, which are overlooked by the competent authorities, which raises many questions and doubts about the role of the Syrian government in this trade.

Regarding the use of social media to promote organ trafficking, lawyer Hamam pointed out that it is considered one of the means of committing the crime of human trafficking and is punishable by law.

The World Health Council Resolution 44025 directed all countries to avoid the purchase and sale of human organs, as well as prohibiting promotional advertisements for them.

The resolution considered that practices that rely on soliciting vulnerable persons or groups, such as illiterates, the poor, illegal immigrants, prisoners, and political and economic refugees, on becoming organ donors are unacceptable and incompatible with the goal of combating the organ trade.

That taking effective measures to prevent and combat trafficking in persons requires a comprehensive international approach in countries of origin, transit, and destination and includes measures to prevent such trafficking, punish traffickers and protect victims of such trafficking, including by protecting their internationally recognized human rights, in accordance with the “Protocol to Prevent, Suppress and Punish Trafficking in Persons,” supplement to the Convention against Organized Crime.

Article 5 of the UN protocol provides for the criminalization of trafficking in persons for the purposes of, inter alia, removing their organs, or attempting and participating in its commission, and organizing or directing other persons to commit it.

Article 3 indicates that the consent of the victim of trafficking in persons is not considered in the cases described in Paragraph “A,” in which human trafficking is mentioned for the purpose of removing organs, as it was considered that brokers take advantage of vulnerable population groups, so often these donors agree to remove their organs for money.