Israel doth protest too much
By Paul Woodward, War in Context, August 25, 2009

Organ trafficking accounts for around 10 per cent of the nearly 70,000 kidney transplants performed worldwide annually, although as many as 15,000 kidneys could be trafficked each year…

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. — Jane’s Intelligence Weekly, March, 2008

The publication of an article, “Our Sons Plundered Their Organs,” written by Donald Boström and published in the Swedish newspaper Aftonbladet on August 17, has provoked on outcry in Israel. Allegations in the article that Israel soldiers stole organs from the bodies of dead Palestinians have been described by Israeli government officials as a “blood libel” and the Swedish government has been called on to condemn the publication.

The Swedish Prime Minister Fredrik Reinfeldt rejected these demands on Monday:

Reinfeldt said it was not for the government to comment on the content of every newspaper, stressing that a free press is an integral part of Swedish democracy.

“It’s important for me to say that you cannot turn to the Swedish government and ask it to violate the Swedish constitution,” he was quoted as saying by the TT news agency.

Reinfeldt also rejected the suggestion that the row could undermine his country’s work in the Middle East peace process as the current holders of the EU presidency.

The allegations about organ theft are old but what prompted them being raised anew was the recent and widely reported New Jersey corruption scandal in which organ trafficking played a central role.

The Associated Press reported on July 25:

Levy Izhak Rosenbaum of Brooklyn called himself a “matchmaker,” but his business wasn’t romance.

Instead, authorities say, he brokered the sale of black-market kidneys, buying organs from vulnerable people from Israel for $10,000 and selling them to desperate patients in the U.S. for as much as $160,000.

The alleged decade-long scheme, exposed this week by an FBI sting, rocked the nation’s transplant industry. If true, it would be the first documented case of organ trafficking in the U.S., transplant experts said Friday.

“There’s certainly cross-national activity, but it hasn’t touched the United States or we haven’t known about it until now,” said University of Pennsylvania medical ethicist Arthur Caplan, who is co-directing a U.N. task force on international organ trafficking.

The claim that this is the first documented case of organ trafficking in the United States does not appear to be true. Moreover, the attention now being drawn to Israel’s role in the global organ trafficking market may explain why there has been such an outcry in Israel about the Boström article. Whether or not the Swedish journalist’s allegations have any basis, the Israeli effort to focus international attention on Sweden may well to some extent be driven by the desire to turn attention away from a wider issue: Israel’s role in the trade in human organs.

To learn about this issue, it isn’t necessary to scour the Internet for English translations of Swedish newspaper articles. One of the most authoritative sources is a renowned American professor whose work recently featured in JWeekly.com, a Jewish publication in the San Francisco Bay Area. An article published on July 30 began:

Nancy Scheper-Hughes insists she is “no Dick Tracy.” But she played an important whistle-blowing role in the caper involving corrupt rabbis, money laundering and human organ traffic in Israel.

The U.C. Berkeley anthropology professor is a leading expert in the study of human organ trafficking. She has spoken to countless international government and health officials decrying the practice. Her research has led her around the world, from the slums of Brazil and peasant villages in Romania to the streets of Tel Aviv.

She also started the Organ Watch Project as a kind of watchdog organization tracking the brokers, surgeons and thugs who profit from the trade.

One of her more startling realizations: Officials in many countries knew all about illegal transplants, yet didn’t care. “It was a public secret,” she said from her Berkeley home. “It was normalized in Israel.”

Professor Scheper-Hughes’ findings featured in testimony she gave at Congressional hearings on human organ trafficking held on June 27, 2001. There she described not only the global issue but also Israel’s role. She also repeated allegations that there have been cases of organ theft committed by Israelis on dead Palestinians.

Here are extracts from Professor Scheper-Hughes’ Congressional testimony:

In July of 2000, Avraham Ronan, a retired lawyer in Jerusalem, explained why he went through considerable expense and considerable risk to travel to Eastern Europe to purchase a kidney from a displaced rural worker, rather than wait in line for a cadaver organ in Israel:

Why should I have to wait years for a kidney from someone who was in a car accident, pinned under the car for many hours, then in miserable condition in the I.C.U. [intensive care unit] for days and only then, after all that trauma, have that same organ put inside me? That organ is not going to be any good! Or, even worse, I could get the organ of an elderly person, or an alcoholic, or a person who died of a stroke. That kidney is all used up! It’s far better to get a kidney from a healthy man who can also benefit from the money I can afford to pay. Where I went the people were so poor they did not even have bread to eat. Do you have any idea of what one thousand, let alone five thousand dollars, means to a peasant? The money I paid was a gift equal to the gift that I received.

The magical transformation of a person into a “life” that must be prolonged, saved, at any cost, has made life into the ultimate fetish as recognized many years ago by Ivan Illich. The idea of “life” itself as an object of manipulation, a relatively new idea in the history of modernity. The fetishization of life — a life preserved, prolonged, enhanced at almost any cost — erases any possibility of a social ethic.

—

… in Israel today there is an amazing tolerance at official levels toward outlawed “transplant tourism,” which is organized through a local business corporation in conjunction with a leading transplant surgeon, operating out of a major medical center not far from Tel Aviv. Mr. D., the head of “the company” (as transplant patients call it), has developed links with transplant surgeons in Turkey, Russia, Moldavia, Estonia, Georgia, Romania, and (most recently) New York City. The cost of the “package” increased from $120,000 in 1998 to $200,000 in 2001 and, with the pressure from transplant candidates to develop links in more developed countries, the cost is still rising. The transplant “package” covers: the rental of a private plane (to accommodate a group of six patients, each accompanied by a family member, the Israeli doctors, and the business coordinator; the “double operation” (kidney “extraction” and kidney transplant); the kidney and the “donor” fee (the donor is usually paid no more than $5,000); the “fees” paid to bribe airport and customs officials; the rental of private operating and recovery rooms and OR staff; and hotel accommodations for accompanying family members. The covert operation (in both senses of the term) is accomplished in five days. Day 1: on site pre-operative rests and dialysis; days 2 and 3: the operations (two or three patients per night, depending on the size of the group); days 4 and 5: on site recovery and the flight home.

The specific country, city, and hospital sites of the illicit surgeries are kept secret from transplant patients until the day of travel. Meanwhile, the sites are continually rotated to maintain a low profile. The surgeries are performed between midnight and the early morning hours. In the most common scenario, Israeli patients and doctors (a surgeon and a nephrologist) fly to a small town in Turkey on the Iraqi border, where the kidney sellers are often young Iraqi soldiers or guest workers. In another scenario, the Israeli and Turkish doctors travel to a third site in Eastern Europe, where the organ sellers are unemployed locals or guest workers from elsewhere.

The passivity of the Ministry of Health in refusing to intervene and crack down on this multi-million dollar business, which is making Israel something of a pariah in the international transplant world, requires some explanation. First, in the absence of a strong culture of organ donation and under the pressure of angry transplant candidates, each person transplanted abroad is one less client with which to contend. A more troubling phenomenon is the support and direct involvement of the Israeli Ministry of Defense in the illicit national “program” of transplant tourism. Some patients who traveled with the outlaw Israeli transplant surgeon to other countries noted that in each of the organized transplant groups were members of the Ministry of Defense or those closely related to them.

We in the United States cannot claim any high moral ground given the number of transplant centers that court and cater to paying foreigners, thereby subverting the idea of donated organs as a national and community resource. Dr. Michael Friedlander, chief nephrologist at Hadassah Hospital in Jerusalem, counts among his recovering international transplant patients, several Israelis who have recently returned this year and last (2000–2001) from Europe and the United States with kidneys that were purchased from living donors. The doctors in charge of the identified kidney units where these transplants have taken place claim ignorance, on their part, saying they believed that the donors and recipients were either biologically or emotionally related. Among a great many kidney experts the understanding is that commerce in kidneys between strangers is everywhere protected by a policy of “Ask — but please don’t tell me anything I don’t want to hear.”

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In March 2001 I spent the day with Abraham Sibony, a recent immigrant to Israel from Morocco, who had embarked on a career as a petty thief. Sibony was in and out of jail for several years when he was contacted in a prison workshop by a warden attached to a local organs broker. “Do you want to find a quick way out of your troubles,” Sibony was asked. Surprised to learn that he could make $30,000 by selling one of his kidneys, and even more surprised to be told by an outlaw transplant doctor that “people were healthier and lived longer with only one kidney”, Sibony was in and out of surgery in a few days during a brief furlough from prison. Though Sibony has not, unlike many other unlucky kidney sellers, suffered from any significant medical complications, he was ill-prepared for a long period of recovery in prison, and angry that he was paid only $6,000 and had no legal recourse against the lawyer-transplant recipient and his broker who had deceived him, a story that is very common among the world’s kidney sellers.
[…]
That there are no fixed political, ideological, or religious boundaries with respect to illicit transplant practices is clear in the case of the Middle East. Residents of the Gulf States (Kuwait, Saudi Arabia, Oman) have for many years traveled to India and to countries in Eastern Europe to purchase kidneys made scarce locally due to local fundamentalist Islamic teachings that allow organ transplantation (to save a life), but prohibit organ harvesting from brain-dead bodies. Meanwhile, hundreds of kidney patients from Israel, which has its own well-developed, but under-used transplantation centers (due to lingering orthodox Jewish reservations about brain death) travel in privately brokered “transplant tourist” junkets to Turkey, Moldova, Romania where desperate kidney sellers can be found, to Russia where an excess of lucrative cadaveric organs result from lax standards for designating brain death, and to South Africa where the amenities in transplantation clinics in private hospitals can resemble four star hotels.

The infamous Zaki Shapira, head of kidney transplant services at Bellinson Medical Center, near Tel Aviv (and, ironically, former member of the Bellagio Task Force on global transplant ethics) has been operating as a transplant outlaw since the early 1990s when he used local Arab brokers to locate willing kidney sellers among strapped Palestinian workers in the Gaza and the West Bank. When Shapira’s hand was slapped by an ethics review board (the Cotev Commission) in the mid 1990s, Shapira simply moved his illicit practice overseas — to Turkey and to countries in Eastern Europe where the considerable economic chaos of the past decade has created parallel markets in bodies for sex and for kidneys.

But affluent Palestinians from the West Bank also travel in search of transplants with purchased kidneys to Baghdad, Iraq, where several medical centers cater to transplant tourists from elsewhere in the Arab world. The kidney sellers, I was told by one Palestinian transplant patient whom I interviewed in March 2001, are mostly young men, foreign workers from Jordan, and poor Iraqis who are housed in a special wing of each hospital in dorms that could be called “kidney motels”, while they wait for the blood and cross-matching tests that will turn them into the day’s “winner” of the kidney lottery. In Iraq the transplant package, complete with pre- and post-operative care and with fully equipped modern apartments provided in the hospital complex for accompanying relatives, is only $20,000, up, we were told, from only $10,000 several years ago. In fact, it was the appearance of these successful transplanted Palestinians in the after care clinic of Hadassah hospital (See Friedlander 2000) that prompted Jewish patients to pursue alternative transplant options for themselves.

While in Israel for Organs Watch in the summer of 2000 and, again in March 20001, when I accompanied Mike Finical, of The New York Times (see Finical 2001), I interviewed more than 50 transplants professionals, transplant patients, and organs buyers and sellers involved in commercialized transplants. Most surgeons, while worried about the risk to their patients and the potential for exploitation of both organs sellers and buyers on the part of unscrupulous doctors and their commercial brokers and intermediaries, none were willing to condemn a practice which they saw as “saving lives”.

Since the summer of 2000 an undisclosed number of Israeli kidney patients have traveled to major medical centers in the United States, sometimes accompanied by their Israeli surgeon or nephrologist, for illegal transplants with paid living donors. In some cases the kidney seller travel from abroad with the transplant candidates, in other cases the sellers are located in the United States by local intermediaries and brokers. I interviewed two men, one a young student, the other a retired Israeli civil servant, both of whom had recently returned from the U.S. with a brand new, purchased kidney. Itay, the student, preferred not to think about his donor, and was told by his doctor to think of his trip to the United States as an extended vacation holiday. The older transplant patient also tried to cast his payment to the stranger who gave him her kidney as a bonus — “vacation money” for her to recuperate while she had a good time far away from home.
[…]
… transplant doctors in Sao Paulo and Rio de Janeiro told me that during the military period (1964–1984) they had being given “quotas” of organs to be delivered to military hospitals, organs got by any means possible, including (I was told by one guilt-ridden practitioner) chemically inducing the signs of brain death. The execution of street children in Brazil (seen as enemies of decent people) that reached a peak in the 1990s (well after democratization) involved not only death squad killings but mutilations in the public morgues, a secret dimension of what was essentially a form of class warfare and ethnic cleansing.

And in South Africa toward the end of apartheid when a super-abundance of Black bodies produced in the violence and chaos of the anti-apartheid struggle piled up in police mortuaries, the harvesting (and sometimes the selling) of desired body parts both for muti (magical medicine) and for transplant was a hidden feature of that struggle. In these sad contexts, traditional sangomas and surgeons could both be described as witch doctors. Meanwhile, human rights groups in the West Bank complained to me of tissue and organs stealing of slain Palestinains by Israeli pathologists at the national Israeli legal medical institute in Tel Aviv.

A March 8, 2008 report for Jane’s Intelligence Weekly said:

As global demand for live transplants keeps growing, the shadowy organ trading business is rapidly expanding, dominated by unscrupulous brokers and facilitated by inadequate national legislations, widespread corrupt practices and a general lack of public awareness on the extent of the trade.

The illegal trade in body parts is largely dominated by kidneys because they are in greatest demand and they are the only major organs that can be wholly transplanted with relatively few risks for the living donor.

Organ trafficking accounts for around 10 per cent of the nearly 70,000 kidney transplants performed worldwide annually, although as many as 15,000 kidneys could be trafficked each year.

China, India, Pakistan, Egypt, Brazil, the Philippines, Moldova, and Romania are among the world’s leading providers of trafficked organs. If China is known for harvesting and selling organs from executed prisoners, the other countries have been dealing essentially with living donors, becoming stakeholders in the fast-growing human trafficking web.

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.

On December 18, 2007, Haaretz reported on the first conviction brought after Israel made human organ trafficking illegal:

In a precedent-setting ruling yesterday the Haifa District Court yesterday sentenced two Haifa men to jail for trafficking in humans for the purpose of harvesting their organs.

John Allan (formerly Mohammad Gheit), 59, was sentenced to four years in jail with a three-year suspended sentence. Allan was also ordered to pay each of his six victims NIS 15,000. Hassan Zakhalka, 32, was sentenced to 20 months in prison and 12 months suspended sentence for aiding and abetting human trafficking for the harvest of organs.

This is the first time an Israeli court has issued a conviction for this offense, based on a law passed at the end of last year.

The pair confessed to the charges against them in a plea bargain with the prosecution.

Allan and Zakhalka admitted that at the end of 2006, they persuaded Arabs from the Galilee and central Israel who were developmentally challenged or mentally ill to agree to have a kidney removed for payment. They located their victims by placing ads in the newspaper offering money for organ donation. According to the indictment, the pair gave false information to the donors, and also pressured and threatened them to give up their kidney. After the surgery, Allan and Zakhalka did not pay the donors as promised.

One of the victims was an illiterate 32-year-old single mother from an Arab village in central Israel. The pair told her she would undergo a simple operation, and she would be back on her feet in two days. At one point, the woman changed her mind, and in response Allan and Zakhalka threatened to report her to the police, telling her it was a crime to agree to donate a kidney. Like the other victims, the woman was flown to Ukraine where she underwent the surgery. When she returned home, the victims refused to pay her the $7,000 they had promised her.

Allan and Zakhalka were part of a criminal ring that included an Israeli surgeon, Dr. Michael Zis, who also worked at Assaf Harofeh Medical Center. According to the indictment, Zis sold the kidneys he harvested for between $125,000 and $135,000, of which Allan received $10,000 dollars. The State Prosecutor’s Office is preparing an extradition order against Zis, who is being held in prison in Ukraine.

The conviction of Allan and Zakhalka was made possible by an amendment to the criminal code that was passed in October 2006, which added a number of clauses prohibiting trafficking in humans for the purpose of harvesting organs. Judges Josef Elron, Ron Sokol and Menahem Raniel decided to accept the plea bargain because they said clear legal interpretation had not yet been formulated with regard to the crime of human trafficking for the purpose of harvesting organs, Lacking such clear interpretation of the clause, they said, “the parties might be dragged into presenting much complex evidence.”