Interview 04 Sep 13

A Global Trade in Hope and Desperation

The director of a new film that explores international organ-trafficking says that prosecutions like the recent kidney-trading trial in Kosovo will not stop the black market in body parts.

Edona Peci
 The Medicus clinic in Kosovo, where kidneys were sold

Ric Esther Bienstock was at Prizren’s DokuFest festival recently for the screening of her film ‘Tales From the Organ Trade’, but Kosovo, the scene of a recent high-profile kidney-trafficking trial, is not unknown territory for the Canadian director.

While filming, Bienstock visited Kosovo several times, and the case of illicit kidney-trading from the Medicus clinic near Pristina, which saw five local Albanians jailed earlier this year, became an important part of her investigative documentary.

“What I tried to do is to really tell the human stories behind the headlines we see in Kosovo and all around the world about the organ trade,” the Toronto-based director, who interviewed donors, patients and doctors in an attempt to understand the illicit business, told BIRN.

The idea for the project developed out of ‘Sex Slaves’, Bienstock’s investigation into the trafficking of women from former Soviet countries into the global sex industry which won an Emmy award for outstanding investigative journalism in 2007.

“I filmed actually in Moldova and Ukraine and there was talk about people having sold their kidney to the black market trade. I was looking into the body part business but the truth is that the black market is dominated by kidneys, because we have two kidneys and you can give one, or in the case of the black market, sell one,” she explained.

A still from the film 'Tales From the Organ Trade'

Opening with Janis Joplin’s song ‘Piece of My Heart’ and footage of people who sold one of their kidneys, the 82-minute documentary takes viewers to Manila, Istanbul, Colorado, Toronto, Tel Aviv – and to Pristina.

“There is a real shortage of kidneys around the world and it’s what’s driving desperate people to go to the black market. I thought it was very interesting [to analyse] the idea of people who generally are law-obeying citizens, who don’t break the law, who aren’t criminals,” Bienstock said.

“The other side of the equation is people who live in abject poverty, who are so desperate that they think the only thing they can do is sell a body part. And then the people who do these operations are often medical professionals – they are surgeons, they are nephrologists, doctors, anesthesiologists,” she continued.

The Kosovo connection

During investigations she launched in America, Bienstock met a Canadian man who sold his kidney and ended up in a clinic in Kosovo. It was then, she said, that she became interested in the Medicus case.

“One of the characteristics of the Medicus case is that almost everybody – apart from some local doctors – were brought in from foreign countries. So both the recipients and the donors were not from Kosovo, they were from Turkey, Moldova and Belorussia [Belarus], and the doctor was Turkish,” she explained.

She said that in many organ-trade hot-spots, such as the Philippines, both donors and doctors are usually locals.

“The person who is getting the kidney might be a foreigner but everybody else involved is local. This was not the case at Medicus,” she said.

Another difference between Kosovo and the Philippines lay in the procedures employed for the buying and selling of kidneys.

In Manila, Bienstock explained, poor people often approached brokers, but in the case of Medicus, “it was much more international”, with one main broker, alleged to be Israeli citizen Moshe Harel, suspected of running the entire process.

“He didn’t go from country to country to find the donors. The donors were found by other brokers. So, it’s a little bit of an organised chain of people,” she said.

Harel is still wanted by the Kosovo authorities but in April, a court in Pristina convicted the Medicus clinic’s owner and four other locals of participating in the illegal organ-trading ring.

The indictment said that around 30 illegal kidney transplants took place at Medicus in 2008.

Police initially raided the clinic that after a Turkish man whose kidney had been removed was found seriously ill at Pristina airport.

Investigators then established that poor donors from Turkey, Russia, Moldova and Kazakhstan were lured with promises that they would receive up to 15,000 euro for their kidneys, which were then sold to rich transplant patients, mainly Israelis, who paid more than 70,000 euro.

After the verdict was handed down in April, the EU rule-of-law mission prosecutor in Kosovo said that eight more people were also being investigated, although no further details have yet been made public.

A moral dilemma

Bienstock said that although organ-trafficking is illegal, “the moral story is a completely different story”.

The Canadian director interviewed one Israeli patient, Raul Fein, who bought a kidney and underwent the transplant operation at the Medicus clinic, and also tracked down the donor, a Moldovan woman called Ana Rusalenko.

“I don’t regret I sold my kidney,” Rusalenko told Bienstock in the interview, explaining that she had not suffered any health problems as a result of the operation in Kosovo and didn’t feel short-changed by the financial transaction.

The documentary ends with an on-screen message: “While you watched this movie, 118 people died of kidney disease.”

Bienstock believes that despite efforts to crack down on the trade, and prosecutions like the ones in Kosovo, the demand for transplants is increasing and there are plenty of people who are so poor they are willing to sell.

“No matter what you do to crack down, desperate people do desperate things, and there’s nothing more desperate than someone who wants to live,” she said.

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