The market in Jordan’s spare body parts [Archives:2007/1060/Health]

June 18 2007
Abd A-Salam Nabulsi, a leading neurologist and member of the Jordan Society for Organ Donations. (TML photo)
Abd A-Salam Nabulsi, a leading neurologist and member of the Jordan Society for Organ Donations. (TML photo)
Mohammad Ben Hussein
The Media Line Ltd.

Organ trade is banned in Jordan and anyone caught selling or buying organs faces serious trouble with the law. However, knowledgeable officials and volunteers say the number of backdoor sales could easily surpass 300 a year. Who are the main players in the business? What is the procedure? And who would be ready to give up a vital organ for cash?

Ziad, 20, desperately needed to come up with $1,500 to propose to the girl he loved before her parents could talk her into marrying a school teacher.

Unemployed, with a criminal record and no skills to offer the job market, Ziad could not have been more desperate.

He knocked on the doors of friends and relatives to borrow the dowry, but the economic recession hitting the country made it impossible for others to assist him.

Selling a kidney would be the perfect solution to his distress, he thought to himself.

“That was the magical solution to my problems and on top of that I could start a small business,” says Ziad, who was offered $4,000 for a kidney.

Within a week of making his decision, Ziad received a down payment and had all the necessary medical tests to have his kidney transplanted. The deal was done in secret as organ trade is banned in Jordan and anyone caught selling or buying organs faces trouble with the law.

“I was told to keep my mouth shut until after the operation,” recalls Ziad.

In any case, in a tribal-dominated nation where social relations are very strong, Ziad would have committed social suicide if he disclosed to relatives or friends that he was selling a kidney.

Illicit organ selling is a lucrative business thriving in the shadows of society.

Brokers like Khalid (not his real name), who arranged Ziad's organ sale, earn five times as much as professionals. Such brokers have developed contacts with the wealthy as well as with the impoverished. The poor are the organ suppliers while the rich get restored quality of life for their money. Khalid, a school dropout, became involved in the kidney business five years ago when he sold a kidney in Iraq for $2,000.

“I am neither stealing nor forcing people to do wrong. What I do is to help patients get what they want by finding them donors,” says Khalid.

In the past, Khalid used to send his clients, the donor and the recipient, to Baghdad. But since the war broke out, neighboring countries like Syria, Lebanon and Egypt have provided the perfect venues for transplanting organs.

It is simple: the deal is done in Jordan but the surgery takes place outside the country, thus allowing the brokers to escape the wrath of law.

In some rare cases recipients can have the operation in Jordan, but it is more risky and much more costly.

In Ziad's case the choice was made for the recipient, Um Jihad, to have it done in Egypt. The woman was confined to a wheelchair, her pale face swollen and constantly suffering from acute abdominal pain and occasional seizures. Her family needed to find her a kidney fast because her health was deteriorating at an alarming rate.

Um Jihad used to go with her son, 'Salih, for dialysis sessions at King Hussein Medical Center three times a week, each session lasting three hours. Um Jihad has been on dialysis for seven years and doctors told 'Salih his mother might not survive for more than a year.

'Salih and his brothers were ecstatic when they heard from Khalid about the donor. They agreed to pay a staggering $15,000 for the transplant.

“None of my brothers or sisters had a blood type compatible with my mother's,” says 'Salih, a popular hairdresser in the up-market area of Shmeisani.

The mother had her name on the national waiting list for two years, but it would have been too late by the time her turn came around.

When the transplant date approached Ziad was sent to Cairo, where he was given papers to sign.

Ziad waited a few days in an apartment before being called for the operation, during which time he ventured into the bustling markets of Cairo and indulged himself in lustful nights.

“Everything was at my disposal – women, drugs and alcohol. The host used to give me everything I wanted,” says Ziad. The operation, which lasted nearly four hours, was declared a success.

'Salih paid the money and headed home with his mother, who started looking at life through different eyes thanks to Ziad's kidney.

In the meantime, Ziad moved back to the apartment to recuperate. The excitement of having a new life and marrying the girl he loved overrode the pain of his surgery. Next day, the host, an Egyptian, arrived to conclude the deal. But first Ziad had to pay some bills.

“They made me pay for every glass of juice I drank or joint I smoked and all the women they brought me,” says Ziad, who ended up wasting the price of his kidney on drugs and women.

He was left with $200.

“I had no choice but to take the money and return home. I know I had been conned, but there was nothing I could have done about it,” says Ziad.

His dreams of marrying his beloved evaporated in the blink of an eye. Now he is hooked on drugs and minus one kidney.

It is very hard to tell how many people sell kidneys in Jordan, because such operations are done secretly, but knowledgeable officials and volunteers say the number could easily surpass 300 a year.

Jordan's health minister went on record last month as saying the organ trade was thriving in the country. He warned that certain groups tended to target individuals from poor backgrounds to persuade them to sell their organs.

'Abd A-Salam Nabulsi, a leading neurologist and member of the Jordan Society for Organ Donations, says everyone must shoulder his responsibility to stop this problem from spreading further.

Although Nabulsi admits to the existence of the problem, he insists Jordan is among the countries in the region to suffer least.

“We have to develop a strategy that includes civil society groups and other organizations to encourage people to donate their organs after their death. If we implement such a system, then no one would have to sell his kidney,” he says.

Kidneys can fetch the equivalent of $20,000 to $50,000, depending on the buyer. The transplant is done in Lebanon, Syria or Egypt, “because they are less strict there,” says Nabulsi, who insists Jordan is free of illegal transplants.

Despite Nabulsi's assertions, clandestine transplant operations have been increasing in Jordan, where private apartments have been turned into makeshift clinics. Organ brokers recruit Iraqi doctors to do the surgery.

Officials from the Jordan Medical Association (JMA) admit there are hundreds of Iraqi doctors working illegally, with some practicing prohibited operations such as abortions and organ transplants.

“We are worried about the practices of Iraqi doctors. The government must step in and close down illegal clinics,” says Bassim Kisswani, secretary general of the JMA. Talib Assaf, a lawyer and human rights activist who has done extensive research on the organ trade, says the absence of legislation encourages the grey market to flourish.

“This is the perfect crime; the financial arrangements take place in one country and the transplant in another.”

The cure is to legalize the organ trade, according to 'Abd A-Rahim Malhas, a former minister of health.

“Let's legalize kidney sales and control it. Tax and price it,” he says. “We are acting like ostriches by burying our heads in the sand. We know the sales are happening. Even relatives take money from each other for donation, so why don't we step in and do something about it,” Malhas told The Media Line. But Nabulsi thinks such a move could be disastrous.

“Imagine Jordan turning into a kidney sale tourism destination. We should not encourage poor people to do wrong things.”

Nabulsi is also worried about the health complications that illegal transplants could cause. A few months ago, a 44-year-old Jordanian man slipped into coma because of a bacterial infection he picked up while being operated on in Cairo. He died in Amman after he was discharged from the clinic.