International news websites and social media networks have recently circulated the finding that Egypt is a “leading country” in the trade of human organ trafficking. Such accusations come at a time when Egypt is relentlessly combating the rings responsible for this deadly trade, the proof being the arrest by the Ministry of Interior of 12 people who had formed an organ trafficking gang in Giza in September. The case is now in court, where eyewitnesses and the Higher Committee for Organ Transplantation are giving testimony against them. To get to the bottom of the story, Al-Ahram Weekly has been investigating the allegations, notably by monitoring activities in the Cairo district of Sayeda Aisha and speaking with local people, including Ahmed (not his real name) who is in charge of local funerals. Ahmed introduced this reporter to a world of crime that few will be aware of. “If you think it is all about medical students coming to graveyards to buy organs or corpses [outlawed in Egyptian law], then think again. Your information is outdated,” Ahmed said. He added, over tea and a drag of smoke, that “there are gangs specialising in this kind of trade. For example, they could hit a victim on the street with a car, rush him to hospital, and take the organs they need. The victim might not discover what happened except after he had medical complications,” Ahmed said. “These gangs may kidnap children, drug them, and steal their organs. They prefer children because their organs sell for more. The streets of Egypt are full of poor children who may not be able to make it through the day with a decent meal. Many of these children don't mind selling their organs to human traffickers, unaware of the accompanying health hazards,” he added. Stealing the organs of the dead, Ahmed continued, is confined to “two categories: the corpses of criminals who have received death sentences and patients left to die that no one asks about. These represent a lucrative business for organ trafficking networks because they are easy targets. There are also street children, whether alive or dead…” Ahmed suddenly stopped talking, feeling that he had already said too much. The next stop was the Zeinhom Morgue, one of the oldest and biggest in Egypt, affiliated to the Ministry of Justice. It is there that the corpses of those who have died in accidents are taken for autopsy, before being cleaned, covered and buried after the authorities authorise burial. Workers at the morgue assured the Weekly that “there is no way that organs can be stolen from the morgue because security patrols work around the clock to keep the bodies safe.” One older worker at the morgue told the Weekly about one of the stranger incidents he had witnessed there when “years ago the morgue received a batch of dead bodies, all without any eyes. In that case, the prosecution-general was notified before the autopsy procedures.” He said that bodies remain secure in refrigerators until the families of the deceased take them for burial. In cases where a body cannot be identified, it cannot be buried until the prosecution authorises the burial in a public graveyard. If the body remains at the morgue for more than six months, or the morgue is overcrowded, the authorities authorise the burial after the body's details are recorded.
AMENDING THE LAW: Law 5/2010 which criminalises organ trafficking had some loopholes, however. In July, eight articles of the law were amended and the penalty for organ traffickers increased from a life sentence to death. The problem, however, is not with the law, but with its application, points out Shawki Al-Sayed, a legal expert. “The security bodies should concentrate on criminals and quick trials should be held. Organ trafficking has been on the rise in Egypt. Some physicians act as brokers who facilitate surgery or forge documents and IDs to strike organ trafficking or transplantation deals. Human traffickers also abuse the poor who are willing to sell their organs for money,” he said. “The government bodies should coordinate better to end organ trafficking, especially the Doctors Syndicate and forensics authorities affiliated to the Ministry of Justice.” The Higher Committee for Organ Transplantation was formed in 2010 after a decree regulating organ transplantation was issued, said Ali Mahrous, head of the Central Administration for Non-Governmental Medical Institutions and Licences. The committee supervises and grants licences for cases that require organ transplantation according to a set of regulations. “There are 41 medical facilities in Egypt that do organ transplantation operations. The Ministry of Health has approved transplantations for more than 15,000 patients since 2010,” he said. But it was vital, Mahrous stressed, to raise awareness of the health hazards associated with organ trafficking among the poor who may be tempted to trade their flesh for money. It is also important that organ transplantation operations take place at hospitals properly supervised by the Ministry of Health. “Thousands of patients are waiting for donors from relatives to no avail. Donating organs from the recently dead is the hope these patients have been waiting for and could end organ trafficking. The donation process, however, depends on the family of the deceased's approval to execute their will and the readiness of a specialised medical team to extract and transport the organ from the deceased,” Mahrous said. “Approximately 60,000 patients suffer from kidney failure in Egypt, and the numbers are increasing by 10,000 every year,” said Rashad Barsoum, a pioneering surgeon in kidney transplantation and a member of the Higher Committee for Organ Transplantation. “These patients are a burden to their families and the government which pays for their medicine and dialysis. Most of these patients can't find donors among their living relatives. Thus, it has become vital to spread the culture of donation among the recently deceased who may have left a will to this effect,” he said. That is where the job of the committee comes in. “The committee is racing against time to finalise procedures to facilitate taking organs from the recently deceased and obtaining their families' approval. It is also listing hospitals where organ transplants can take place, be they affiliated to the government, a university, the Ministry of Health or the Armed Forces. A number of sub-committees will be created, such as moral, educational, technical and financial sub-committees. Judges will supervise the prioritising of the donations, which will be listed on a computerised system,” Barsoum said. A number of criteria decide the priority of patients receiving organs, such as the patient's age, his health condition, the deceased's age, and how far their tissues match. “The committee has suggested ways by which anyone can approve the donation of their organs after death, such as registering this on their driving licence, in which case the state will offer the family of the deceased financial compensation.” The committee's work also includes obtaining the donor's approval and medical reports confirming the death of the donor along with x-rays, MRIs, reports confirming that the organs are disease-free, and the location of donors and recipients before adding them to the waiting list, Barsoum explained. “The committee's financial requirements are still being studied. Its decisions, however, will make sure that the receiving patient will not be burdened financially. A hotline will be announced to facilitate communication between the committee and the public and to receive donation applications, complaints and suggestions,” he added. Head of the Surgery Department at Zagazig University Khaled Safwat told the Weekly that a new unit for transplants and implants was being set up. “The unit will be the first in Egypt and the Middle East and is a ray of hope for the 20 to 25 per cent of patients who suffer from intolerable pain in their abdomens and are in need of surgery and the removal of a part of their intestines,” he said. Assistant professor of surgery at Zagazig University Ahmed Abdel-Ghani said that this “intestinal transplantation is a huge medical leap and a new lease of life for patients suffering from chronic intestinal failure who cannot be sustained on intravenous feeding because of possible complications. Isolated intestinal transplants have a very high success rate, while multiple intestinal transplantations have a 72 per cent success rate,” he said. He added that it was imperative to spread the culture of organ donation in Egypt from the recently dead to revive the hopes of the sick. The Doctors Syndicate takes harsh punitive measures against physicians found guilty of facilitating organ trafficking, commented Rashwan Shaaban, assistant secretary-general of the syndicate.
LACKING DATA: Sources at the World Health Organisation (WHO) told the Weekly that it was difficult to obtain accurate data regarding organ trafficking, whether in a certain region or on a global level. The closest estimates the WHO has obtained have been through non-governmental organisations, the media and United Nations offices, it said. “Despite the fact that Egyptian laws contain all the articles included in the United Nations protocol to combat human trafficking, the rights of illegal immigrants in the protocol for the ending of illegal immigration by sea, land or air are ignored,” said Hafez Abu Seada, head of the Egyptian Organisation for Human Rights (EOHR), a rights group. “In 2010, the EOHR issued a report on the trafficking of African immigrants in Sinai. The report documented cases in which illegal immigrants were subjected to organ trafficking. Their organs were sold to recipients from different countries, increasing the dangers of the spread of diseases the recipient might not be aware of,” Abu Seada continued. The cases mentioned in the report are a continuation of the “Trafficking in Persons” report issued by the United Nations Office on Drugs and Crime in 2006, Abu Seada said. “This report says that human trafficking is on the rise and that each gang comprises different nationalities. Trafficking is not confined to Egypt: it is a global crime,” he said.
