IamA Scott Carney, author of "The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers and Child Traffickers" Ask me anything.

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I've never come across Carter's work, but on first blush, I tend to agree. Sex trafficking exists for sure, but the organizations that exist to fight it don't really address the issues. Places like Polaris and International Justice Mission generally go after the semi-legal brothels that are trying to open up a regulated market. They certainly don't have the resources to go after the very small segments of gangster-run brothels.

What was the saddest individual fate that you witnessed? Which one made you angry the most?

There was this one case of a woman I met who sold her kidney in Chennai and then a few months later her son came down with kidney failure and she had to simply watch him die because she couldn't give him one of hers.

There's also the case of an Indian boy who was kidnapped out of a slum and sold to an adoption agency. I tracked him down in America ten years later and tried to reconnect him with his birth family. Eventually there was even a DNA match to prove the connection. Unfortunately the American family would have nothing to do with it, and never even called the parents in india. It was heartbreaking. Here is a link to the original story in Mother Jones. http://www.motherjones.com/politics/2009/03/meet-parents-dark-side-overseas-adoption

In regards to the kidney story, would you cite this as a reason not to donate a kidney? (even though the story is about the person selling the organ)

Whether or not you donate your kidney is a very personal decision, and once you've made it there is no turning back. In my case, I have chosen not to be an organ donor. This isn't because I don't want to help someone in a desperate situation, but because I feel the organ supply chains are hopelessly corrupted.

I donated my kidney last year through non-directed donation at the University of Maryland Medical Center. I have met with my recipient multiple times, keep in contact with him, and consider him and his entire family as my family. He now travels the US thanks to being dialysis-free.

I am not understanding what corruption you are citing, although I have not had a chance to read the rest of the comments or look into your research. Thanks for the reply!

I am really glad that this worked out for you so well. Usually medical programs keep donors and recipients away from one another. It's nice to see that it is changing somewhat. If you don't mind me asking, how did you meet the recipient?

UMMC by default leaves patients and recipients separate, but they act as the middle man and provide contact opportunities/information if both parties desire. I met my recipient during a check up when we were both at the hospital and had agreed to meet. :)

Right. If you both agree then doctors allow it. The thing is, that the default is secret. I think that is a major problem because if the source is a stolen organ then they will just say they are enforcing HIPPA.

Interesting point. However, I think then that the issue is with verifying reliable sources, rather than organ donation or HIPAA as a whole.

True. So the question is how do you best verify reliable sources when it's pretty obvious that the people you are supposed to trust sometimes lie.

Thank you for the link to your article! I'm honestly shocked and furious that the American family refused contact with the Indian parents even after DNA testing confirmed his identity. Do you know their reasoning behind refusing contact? If, as an adult, the boy ever finds out the truth on his own, I hope they're prepared for him to hate them.

I am also frustrated a how it worked out. I am still ready and willing to connect them if they ever choose to get in touch with me.

I seem to recall some years ago that the Chinese were accused of forcing convicts to donate organs. Is that true? Does it still happen?

A few years ago David Kilgore and David Mattas released a report called "Bloody Harvest" which alleged that Chinese prisoners--specifically Falun Gong practitioners--were being killed doe their organs. I found the report very convincing. I even spoke with a few former Chinese prisoners who told me that they were tissue typed while they were in prison. Here's the link to the report http://organharvestinvestigation.net/

As I lived five years in China, I can confirm this is true. It's everywhere on the streets if you speak Chinese and look Chinese and (seemingly) idolize Mao Zedong. Kind of like a public secret, where everyone knows what's going on but everyone chooses to turn a blind eye. Need to say also organ market is legal in China, no matter how you get those organs.

A lot of Indonesians go to China just to have kidney transplant, because that hospital (it's in Guangzhou but I cannot give the name) assures 100% availability of kidney stock, and also a warranty. If your newly transplanted kidney is rejected, you can have a new one within a week. It's ridiculous.

It's not from Falun Gong alone, by the way. Also coming from those corruptors, humanists, and basically everybody whom the government throws to prison with no chance of coming out again. It's also common secret in China that if you are a tourist, going home alone from a bar drunk, in the wrong taxi (the kind of taxi that looks legal but doesn't have meter, we call them 黑车 here, meaning black taxi) you risk missing your organs and your life.

One of our friends went missing that way. He was seen last in Tianjin, going home alone drunk (his habit) by a taxi. Some of his friends offered to take him home but this stupid guy vehemently refused. Well, it was the last time he was seen. It was 2009, end of the year, but forgot the exact month.

Anyway, great job, Scott. Sorry it's not a question. If you are going to write a book about the market in China, I'd like to read it. Wish you success from Indonesia here.

Thanks for sharing this. It's truly terrifying what happens in this world. I feel like I've only scratched the surface.

As a writer I find it fascinating that you're able to do what you do. I would love to, but investigative journalism...well, that's a demanding career. How did you discover this was a profession you wanted to pursue (rather than other forms of writing)?

At first I was a Ph.D. student in anthropology, but I dropped out right before the dissertation because I felt that I wanted my writing to be seen, rather than languish in the ivory tower somewhere. After that I just moved to India and started writing about what was around me. I sort of fell into investigative journalism.

That's pretty cool, best of luck on your future adventures!

Thanks man. I'm planning on doing another AMA when my book comes out. This was sort of unexpected.

Thank you for doing this AMA. I live just across the border from India - Pakistan. I am a Med student and have heard rumors that because of the families in rural areas of india have more mouths than they can feed legally, parents sometimes donate kidneys of their children for a low price, which makes its way up to Pakistani black markets, where it's sold for literally millions.

Do you think it's true? Also any cases in pakistan you've investigated like the one in India?

I can't speak to the specific villages that you are mentioning, however I can say that there are well-known hospitals in Pakistan that advertise that they can get you a matching kidney and donor very quickly. The evidence is very strong that they are simply going out into the slums and paying a meager sum of money for someone's body part and then selling it on the international market. It's that same sort of thing that I came across in India. It happens in Indonesia, the Phillipines, South Africa, Brazil. It's literally all over the world.

Nicholas Kristof recently got some heat for being duped numerous times by supposed victims of heinous societal misdeeds. How do you confirm your victims' stories? http://www.slate.com/articles/double_x/doublex/2014/06/nicholas_kristof_wants_to_save_the_world_with_his_new_york_times_columns.html

This is a great question. Kristof...where to begin? Our work is pretty different, and one of the reasons that I never worked on sex trafficking was because I was always suspicious of people like Somali Mom. Sex trafficking definitely occurs, but generally not the way that she claimed that it did.

There are a few cases where sources tried to dupe me, however, in the case of kidney selling, there are often clear paper trails. Not to mention scars. I tried my best to trace the entire supply chains.

Scott, would you say sex trafficking activist groups, in particular, are the ones most likely to repeat stories and figures from unreliable sources?

I answered this down below, but I'll repost here.

I don't want to comment on how other journalists may have been taken in, however I think that sex-trafficking stories have been the low-hanging fruit of the journalism world for a long time. It's very easy to locate brothels in certain foreign parts of the world, sex is an easy sell to an editor, and there are lots of organizations out there telling you that this is absolutely true. There a certain amount of inertia that needs to be overcome when you say something against anti-trafficking organizations. I mean, everyone is agains the idea that young girls are being kidnapped and raped in cages in BAngkok, you feel like a bad person to question that narrative. It just so happens, that sex sells for those non-profits, too. In this world it's a lot easier to try to "save the one" than it is to tackle the systemic issues of inequality around the world.

Scott, what can the average person do to help?

There are two things: First, write your congress person and ask them to seriously think about the issue. We need a totally transparent organ supply in order to combat the black market. Second, think about supporting the Coalition for Organ Failure Solutions http://www.cofs.org/ They are the only organization that I know of working on this issue.

How valuable are each of the harvested body parts approximately? Does it vary widely around the world or are different organs more valuable in different countries?

This is a tough question because body parts don't have a fixed value. Their price fluctuates like a used car. However, I did write a piece for Wired a few years ago where I tried to come up with general prices. Check it out here: https://drive.google.com/file/d/0B7i3t0BFtNaIQzF5UUFrZHVZVm8/edit?usp=sharing

edit: fixed link because the original on Wired's website is broken.

This link seems broken.

All the pictures are missing.

EDIT: Fixed version here https://drive.google.com/file/d/0B7i3t0BFtNaIQzF5UUFrZHVZVm8/edit?usp=sharing

Lame. I think I have a pdf somewhere. Here is part of it: http://www.scottcarney.com/2011/05/red-markets/

I just uploaded the original PDF to Google Drive. Download it here: https://drive.google.com/file/d/0B7i3t0BFtNaIQzF5UUFrZHVZVm8/edit?usp=sharing

edit your original response to have the link by pressing the red edit. This will get hidden as the conversation gets longer.

done.

Do you think an increase in voluntary organ donation would help reduce this market?

This is a fascinating question that has more than one answer. I tackle it in the last chapter of my book a little bit. In short, I have to say no. While voluntary donation will increase the overall supply of organs, it does nothing to stem the overall demand. Since 1984 when the National Organ Transplant Association started up the waiting list for a kidney was almost seven years long. Today, with vastly expanded voluntary supply (I think it is something like 50,000 transplants a year now), the list is still just as long. What is happening is that as the supply grows, doctors find more eligible recipients for organs. It's perverse, but the demand for organs is actually a reflection of the supply. Not the other way around.

Do the doctors who perform the operations ever get arrested for using black market organs? Seems like getting the surgeons out of the equation would be the fastest way to cut down on the trade, because organs are useless if nobody is there to install them.

Occasionally, however it is quite rare. In fact, it's usually the surgeons who are the criminals.

That's what I mean, arrest a bunch of them then see how many wealthy respected surgeons are interested in surgeries that come with long prison sentences. Make it so there is a lot for them to lose.

I'd support this. I think we should also think about hospital reform, too.

What sorts of hobbies do Blood Farmers tend to have?

Papu Yadhav was a dairy farmer before he started to kidnap people and then drain their blood. I guess there is some similarity in the business model.

Was he into sports, or more of an arts and crafts kind of guy?

Well, he lives in India. So I'm going to guess he's a cricket fan.

Say its Tendulkar's blood and sell it for a hundred times as much.

That's probably true.

How much of the illegal trade is actually non-consensual though? Do a lot of people sell their organs on the black market out of economic necessity or are they mostly forced into it by gangsters?

It's impossible to get accurate statistics of anything having to do with the illegal organ trade--but from what I witnessed it seems to me that the majority of the trafficking occurs because very rich companies and hospitals take advantage of desperately poor individuals. So, technically, most of it is consensual, it's also incredibly coercive. There's a reason that after every major tsunami and earthquake that the organ brokers come in right after the relief agencies.

So its less kidnapping people and leaving them in bathtubs full of ice and more pressuring incredibly poor people into selling their organs or face starving to death?

In a way that's much worse, rather than individual acts of violence it's an entrenched economic problem that is a lot harder to fix than simply arresting a few kidnapping gangs.

Yes. It's really rare to kidnap people--especially tourists. However, it DOES happen. In this article in FP (http://www.foreignpolicy.com/articles/2011/05/31/the_rise_of_the_red_market) I wrote about several cases where people are simply picked up off the streets and robbed of their organs. That said, it is generally a lot less risky for the brokers to simply convince people they've entered into a fair trade, rather than raise suspicion amongst law enforcement.

Jeez if anything was ever going to kick off an anti-capitalist revolution it would be rich people forcing the poor to sell their own organs "voluntarily".

preach it, brother.

Yes. It's really rare to kidnap people--especially tourists. However, it DOES happen. In this article in FP (http://www.foreignpolicy.com/articles/2011/05/31/the_rise_of_the_red_market[1] ) I wrote about several cases where people are simply picked up off the streets and robbed of their organs. That said, it is generally a lot less risky for the brokers to simply convince people they've entered into a fair trade, rather than raise suspicion amongst law enforcement.

Until they have you under. Once that have that, I would suspect they could scrap you for useful parts and leave you there. By the time you come to, they are long gone.

And that's if you come to.

True. In fact there are many many cases of people going in for surgery--something like an appendectomy--and having a kidney removed at the same time. The doctors would just say it was a complication and you would never know. This has been a problem in Egypt and India. Probably other places, too.

Don't know if you're still around but I thought I might as well bring up the fact that giving newer blood transfusions to older mice allows they to have the effects of aging reversed somewhat.

Given the blood farm in the story, that's somewhat of a horrifying thought.

Also, we are rapidly reaching the point where a company can use a 3-d printer to use stem cells to print working organs. Do you think this will put a damper on the trade or simply redirected it to harvesting adult stem cells?

Yes, I've read about that research. Crazy stuff. I am not sure that regenerative medicine is as promising as we want it to be. Or, rather, it is so promising that we sort of expect to have access to it at any moment. Unfortunately that hope seems to drive up the market for used human parts.

Random question then if you check into this thread again- some years ago (in 2006 I think) my family and I were visiting an orphanage in a small town in a poorer part of Transylvania in Romania where we heard them warning the kids to not trust strangers in the town because they might be kidnapped and their organs sold to wealthy Westerners. It sounded like a scare tactic to some degree, but I was wondering if that ever actually happens in poorer European regions at all. Thanks!

This sounds unlikely to me. Mostly because tourist kids dissappearing raises eyebrows. That said, in nearby Turkey a doctor named Yosuf Somnez performed hundreds of illegal kidney operations. http://www.newyorker.com/online/blogs/newsdesk/2013/04/an-organ-trafficking-conviction-in-kosovo.html

Just imagining that blood farm made me queasy. How do you deal with finding all these black market body parts or child kidnapper stories? Have you ever met any of the victims of these tragic events?

I've met many victims. In truth, they're really not that hard to find as long as you're willing to head out into the wild for a while. For a while I was traumatized by it, but over time I've come to accept that all I can do is witness these events and write about them. I can't stop them from happening.

I was wondering: what is the core difference you see between what causes these markets to spring up in less developed countries vs. in the west / more developed countries? What changes could be made to stop it in these LDC's? What changes would cause this stuff to happen in the MDC's?

I think it's important to realize that this is absolutely a global trade. While the organ selling happens in the third world, often times the buyers come from the first world. Money flows freely across borders and getting an organ is often as easy as getting a plane ticket. In my opinion the best way to cut down on the illegal organ trade is to make the legal markets for human body parts entirely transparent. You shouldn't be able to get a kidney in America without knowing the name of the person who donated it. Even if it is legal and ethical, the secrecy allows criminals to flourish since they can simply claim that they got their organs from an ethical source.

Thanks for the response. It sounds like the only difference is the first worlders would price their organs at too far above the going rate to make it worth selling, then? So well likely see selling organs here ( as well as buying ) if the costs of travel dramatically increase or if people get desperate enough? Interesting.

The problem is that organs aren't commodities. To treat them like they are just another thing to be bought and sold is neo-liberal folly.

I see what you are saying here. I guess with my first question I was expecting you to say that it boils down to cultural differences and a "sanctity of life" in the first world. Instead, I interpretted your answer as saying basically we are complicit already and it comes down to "outsourcing" for value. It's all very disturbing. I do want to go on the record as saying I think they should be commodities either. Either way you've done a lot of interesting work. I'll keep an eye out for future stuff you publish!

No worries. Thanks for the clarification

What is your biggest motivation to go out there and find these "men behind the curtain" who make all the trade possible? From what I understand is it can be incredibly dangerous. How do you keep from getting caught?

This is very difficult for me to answer, since it's hard for me to know exactly why I do what I do. I think part of it is that I want to live a meaningful life. And part of doing that is to attempt to explore the world as fully as possible. I was barely aware of the organ trade before I was living in India and 80 women in a tsunami refugee settlement all sold their kidneys. I was the only western journalist in the area and I just sort of got pulled into the topic. The more I poked around, the more I found.

How long have you lived in other countries? Do you mainly try to stick with something going on in your area or have you found yourself hearing rumors and chasing them?

Thank you for writing what you do, it helps.

I lived in India for about six years. These days I'm in Los Angeles and am planning to move to Boulder, CO in a few months. I spend some time chasing rumors, some time surfing Reddit, and some time writing.

Is there any widespread effort by investigative agencies to catch black market organ traders? Something akin to the DEA or perhaps an Interpol taskforce?

Not really. Most enforcement agencies don't want to go after organ traffickers because they also inevitably have to implicate the top hospitals in the world in the crimes. While they don't mind busting a rogue doctor or two, the real problem is systemic.

How big is this industry estimated to be? How many organ trades a year are we talking worldwide? Obviously with all things criminal we don't have exact stats but are we talking tens of thousands or millions or what?

It is easily worth billions of dollars, but there is no solid statistic that I can point to. It turns out that the criminals are terrible at filing quarterly reports. The best I can point to is a WHO report that says that 10% of organ transplants happen on the black market.

Do you think this will all go away when cloned organs come around? It has to happen someday. The tech can't be that hard to crack.

That's a big if. We have been promising new organs since the 1950s in one form or another. They've always been just ten years away. I think the hope for a synthetic future has made us more hungry for human body parts in the present because we feel like we deserve them.

Interesting. Prolly I agree with that. We are getting pretty used to medical magic.

What do you think of compulsory organ donation after death? As in, we make it the norm to chop bodies, not opt in?

That's one option. Another thing we need to consider is that we're not entitled to immortality. Death is natural, perhaps we need to face it sometimes rather than turning all of humanity into a potential source for spare parts.

Congratulations on double front page posts.

Can you remember any bad consequences of naive attempts to fix this problem?

Really? Double front page? It's not showing up that way on my computer. But I can dare to dream that this topic gets some real interest some time.

I think the original one got pulled down by the mods. I guess the title was inaccurate because it used the word "hostage"

What is the most inhumane operation you have ever seen or heard of?

The Blood Farm. Absolutely. I still am shocked by the horror of using humans simply for their vital fluids.

Did you find yourself scared for your life at any point in investigating this?

Occasionally. You never know what will happen when you start asking questions to the wrong people. That said, the only time that I was really scared for my life was on a story for Foreign Policy about a Maoist insurgency in central India. I got held up by child soldiers with AK-47's along with my reporting buddy. It was mad-max style scary. Here's a link to that piece. http://www.foreignpolicy.com/articles/2010/08/16/fire_in_the_hole

This will probably seem rude, but I'm sure a lot of people are curious...

So, how much could I get for my kidney? How about one testicle? Pint or two of blood?

Here's a rough guide. http://www.scottcarney.com/2011/05/red-markets/

Hey Scott,

You write about the stuff that makes up my worst nightmares. Does this stuff keep you up at night? How do you handle it?

Thanks a lot, big fan :)

Thanks Bararang! I really appreciate hearing from people who like my work. I think that for the first couple years that I started working on this topic I was really traumatized, I just didn't know it. Now I tell myself that it's for the greater good. I know that these things are horrible to contemplate, but if we can't read and write about them then how will we ever stop them. It's far to easy to simply ignore the horrors and pretend that they aren't there. I'm doing what little I can to help.

What do you think the best way is to prevent this sort of nonsense?

Are there aid groups?

What is most effective, economic growth, anti corruption, or education?

I've addressed this a little bit elsewhere in this thread, but my solution is to call for total transparency in the supply chain for human body parts. Right now HIPPA prevents you from knowing who donated the blood that saved your life after an accident, or from learning who donated a kidney to you. This is meant to protect the donors and the donor families. unfortunately, it also provides the prefect cover for criminals who want to hide the illegal sources of body parts.

Explain a time where your charector was questioned the most?

I used to play a lot of AD&D when I was a kid. People always wondered why I wanted to play a mage.

Would you support execution of organ traders then having all their organs donated to other people?

I don't believe in capital punishment.

Don't think of it as execution, think of it as non-consensual organ redistribution. Oh wait I suppose you're kinda against that...

yeah. kinda against it. But it was a good try.

You mentioned in your report meeting up with a professional blood donor who had HIV. What precautions do the Indian hospitals take in screening for blood borne pathogens during transfusion? Is a Ryan White like episode common in India?

It's scary, but sometimes the hospitals don't take any precautions at all.

I was just in the middle of reading the article when I had to leave to pick my son up from school. I'll definitely be looking up the book here in Canada though.

Hopefully it hasn't been asked yet, but one of the issues you mentioned that led to the blood farm was that "many local people here are superstitious and believe that losing bodily fluids will make them weak for the rest of their lives."

Is there a significant campaign to raise awareness that this isn't true?

Yes. There is a national campaign in India to increase the blood supply. I remember seeing some billboards that comment on this particular issue.

What's the most surprising body part you've seen for sale?

I still think the market for human hair is pretty strange. http://www.motherjones.com/politics/2010/02/remy-hair-extensions-india

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Greetings cousin!

Are there any other known places in the world where black market organ trading occurs? And how do they transport the organs?

It's a global problem. I think just about every country has some relation to it. Live organs aren't usually transported across international lines. In those cases the patients fly abroad for surgery.

You are extremely knowledgable in this topic. Where/how did you obtain your wealth of knowledge?

I spent six years researching it. Interviewing victims and criminals and whatever experts I could round up. There are only a few other people in the world who know as much about this topic as I do. (Lemme give a shout out to Nancy Scheper-Hughes while I'm at it: http://en.wikipedia.org/wiki/Nancy_Scheper-Hughes)

Hi Scott, thank you for your very important work. Do you think there are any fundamental differences between societies where these things happen, and those where they don't, other than poverty? Or are we all at risk, balancing on a knife edge of surface decency and circumstance? Is this a cultural illness or purely an economic illness? Are there economic prerequisites to meet before a society can develop a universal respect for human life?

It's not an issue of the first world being ethically pure and the third being backwards. The divide is between rich an poor. Poor people give up their bodies, rich ones benefit from them. While people aren't generally selling their organs in America, Americans are certainly flying abroad to buy them. Unfortunately, we're all implicated in this system.

Hi Scott, thank you for your response. I realized how naive my questions were immediately upon reading some of your other articles (I had only read the blood farm one). From some of your responses it seems like you may know of certain major institutions and hospitals in the west which are involved in the illicit organ trade. Is this true? If so, have you published their names? If not, what stops you?

I have published some names in my book where I had good solid proof. I'm not very shy about that stuff.

The big trafficking story of the last few months was Somaly Mam and her many many lies. Here's the link, though I'm sure you're aware of the details.

http://www.theguardian.com/world/2014/may/30/sex-trafficking-activist-somaly-mam-quits

Why did dozens of journalists fail to check the validity of the story and what steps have you taken to make sure the anecdotes and statistics you received are fact?

I don't want to comment on how other journalists may have been taken in, however I think that sex-trafficking stories have been the low-hanging fruit of the journalism world for a long time. It's very easy to locate brothels in certain foreign parts of the world, sex is an easy sell to an editor, and there are lots of organizations out there telling you that this is absolutely true. There a certain amount of inertia that needs to be overcome when you say something against anti-trafficking organizations. I mean, everyone is agains the idea that young girls are being kidnapped and raped in cages in BAngkok, you feel like a bad person to question that narrative. It just so happens, that sex sells for those non-profits, too. In this world it's a lot easier to try to "save the one" than it is to tackle the systemic issues of inequality around the world.

It doesn't look like there's much in the way of incidents like the Blood Farm being found (only thing in the news is the one India event).

Do you think that it's an abnormal event, or could it potentially be more widespread than we think?

It's absolutely abnormal. Rare, even. But it illustrates how once people start thinking that the body is a commodity just how far things can go.

Does what you learned from Wim Hof help you in surfing in cold water, or do you still need a wetsuit?

Great question. I am a terrible surfer though, so there is no helping me in the water on that front. Otherwise, though, yes. Wim Hof is amazing. I want to write a book about him.

Are there any other "hidden" markets or businesses that you haven't already researched but want to?

I wrote about 10 or 12 red markets in my book. There are definitely others, too

There was an X-Files episode once about a sort of organ lottery somewhere in Asia. The way it worked was you'd sign up to be in it, then one person would be randomly selected to donate an organ (kidney or whatever), and the proceeds would be split among the group.

Is that a real thing? I found it super eerie, but also kind of interesting. If it's real, I'm curious about what sort of people participate.

I don't think that's real.