Saturday, June 11, 2011

Blood, Bones and Organs: The Gruesome 'Red Market'

Locals say this building in Kolkata, India, was once the center of the Indian black market bone trade. They say workers once dried human bones on the roof and cleaned corpses inside.
Scott Carney

Locals say this building in Kolkata, India, was once the center of the Indian black market bone trade. They say workers once dried human bones on the roof and cleaned corpses inside.

Journalist Scott Carney figures he's worth about $250,000, but that number isn't based on his savings or his assets; it's what Carney thinks his body would fetch if it were broken down into individual parts and sold on what he calls the "red market."

In his new book, also called The Red Market, Carney explores the shadowy but lucrative global marketplace for blood, bones and organs. He tells NPR's Melissa Block that despite being underground, there's no question the red market is thriving.

In one Indian refugee camp, so many women have sold their kidneys that the camp has earned the nickname Kidneyville.
Enlarge Scott Carney

In one Indian refugee camp, so many women have sold their kidneys that the camp has earned the nickname Kidneyville.

Scott Carney

In one Indian refugee camp, so many women have sold their kidneys that the camp has earned the nickname Kidneyville.

"It's really hard to get accurate figures on what the illegal market is on body parts, but I'm figuring it's definitely in the billions of dollars," Carney says.

'When You're At Your Most Desperate Place ... The Brokers Come In'

As part of his research, Carney visited an Indian refugee camp for survivors of 2004's massive tsunami. Today, the camp is known by the nickname Kidneyvakkam, or Kidneyville, because of how common it is for the women who live there to sell their kidneys.

"The women are just lined up," Carney says. "They have their exposed midriffs and there are all these kidney extraction scars because when the tsunami happened, all these organ brokers came in and realized there were a lot of people in very desperate situations and they could turn a lot of quick cash by just convincing people to sell their kidneys."

The buying and selling of organs is against the law in almost every country, but Carney says the market has managed to grow thanks to the dire situations many of its donors find themselves in.

"When you're at your most desperate place is when the brokers come in," Carney says. "One of these women, her name was Rani, gave up a kidney because her daughter had actually tried to commit suicide because she was in a very difficult marriage ... In order to treat her, the hospital needed a certain amount of cash ? I think it was about $1,000 ? and [Rani] didn't have any money so she did the only thing she could, which was to sell her kidney because an organ broker just sort of approached her very quickly. And that's a pretty common situation. "

The Red Market
By Scott Carney
Hardcover, 272 pages
William Morrow
List Price: $25.99

Read An Excerpt

The Black Gold Market

In his book, Carney also delves into the marketplace for human hair, known as "black gold."

"It is amazingly valuable," he says. "The market is about $900 million around the world, and about 40 percent of [that] hair is sold for human extensions."

Many of those transactions take place at the Sri Tirumala Temple in southern India, where people give their hair to the god Vishnu as an act of humility.

"I went there about two years ago and had my head shaved with probably about 1,000 other people," Carney says. "These women came, swept up the hair and threw it into these giant steel vats. [The hair] eventually gets combed and sorted and sold at an auction, and shipped out to the international market."

Hair collected in a single cut from a person's head, known as "remy," is used all over the world for hair extensions. But the shorter hair, often shorn from men, serves a very different purpose.

"Most of the hair that gets shorn is from men," Carney says. "That gets sold to chemical companies and gets reduced to an amino acid called L-cystine, which is used as a leavening agent in baking goods."

The Body As Commodity

In his book, Carney argues that part of what makes red market transactions ethically troubling is the role different social classes play in the whole operation.

Scott Carney is an investigative journalist with more than a decade of experience living and doing research in India.
Enlarge Scott Carney

Scott Carney is an investigative journalist with more than a decade of experience living and doing research in India.

Scott Carney

Scott Carney is an investigative journalist with more than a decade of experience living and doing research in India.

"One of the very foundational concepts of the book is when people, say, give an organ ... it's always going to a richer person and, oftentimes, it's going to a person in another country," Carney says. "It's reduced to commerce so quickly."

He says if he had his way, every bag of blood, organ transplant and egg donation would be tagged with the donor's name.

"We have to look at the beginning of the supply chain," Carney says. "We have to be sure we're getting these things ethically and not just assume that we're being ethical."

And while revoking donors' right to anonymity could mean they don't donate at all, Carney says we also need to consider the alternative.

"You will see donations plummet," he says. "But on the other hand, if you were allowing crimes on the magnitude of literally whole villages selling their kidneys, who are we protecting?"

The Red Market
By Scott Carney
Hardcover, 272 pages
William Morrow
List Price: $25.99

I weigh just a little under two hundred pounds, have brown hair, blue eyes, and a full set of teeth. As far as I know, my thyroid gland pumps the right hormones into the twelve pints of blood that circulate in my arteries and veins. At six feet two inches, I have long femurs and tibias with solid connective tissue. Both of my kidneys function properly, and my heart runs at a steady clip of eighty-seven beats per minute. All in, I figure I'm worth about $250,000.

My blood separates neatly into plasma, red blood cells, platelets, and clotting factor and would save the life of someone on an operating table or stem the uncontrolled spilling of a hemophiliac's blood. The ligaments that keep me together can be scraped from my bones and implanted in the wounded knee of an Olympian athlete. The hair on my head could be made into a wig, or reduced to amino acids and sold as a leavening agent for baked goods. My skeleton would make a striking addition to any biology classroom. My major organs ? heart, liver, and kidneys ? could go on to prolong the lives of people whose organs have failed, and my corneas could be sliced off to restore sight to the blind. Even after death a determined pathologist could harvest my sperm and use it to help a woman conceive. The woman's baby would have a value of its own.

Since I'm an American, my flesh sells at a premium; if I had been born in China, I would be worth much, much less. The doctors and brokers, no matter the country, who would move the pieces of my body through the markets stand to make a considerable sum ? much more than I could as a seller ? for their services. It turns out that the global laws of supply and demand are as fixed in organ markets as they are for shoes and electronics.

In the same way that a mechanic can swap out worn car parts for new ones and oil creaky joints to get an engine running again, a surgeon can prolong someone's life by trading broken pieces for newer ones. Every year the technology barriers get lower and the process cheaper. But there's no scrap heap for quality used human parts. Attempts to create artificial hearts, kidneys, and blood pale in comparison to the real thing. The human body is just too complex. At the moment the body can't be replicated in a factory or lab. Which means the only way we can meet the demand for body parts is to find sources of raw materials in the population of living and recently deceased people.

We need great volumes of human material to supply medical schools with cadavers so that future doctors have a solid understanding of human anatomy. Adoption agencies send thousands of children from the third world to the first to fill the gaps in the American family unit. Pharmaceutical companies need live people to test the next generation of superdrugs, and the beauty industry processes millions of pounds of human hair every year to quench a ceaseless demand for new hairstyles. Forget the days of grass-skirt-wearing cannibals on tropical islands, our appetite for human flesh is higher now than at any other time in history.

There is a strange alchemy that happens when we decide that a human body can be swapped on the open market. Most people instinctively know that what makes humans special is more than just our physical presence ? from the electrons and quarks that give us mass to the complex biological structures that sustain our every breath; there is also a sense of presence, which only accompanies life. For the purpose of this book and to make sense of it as I write, I give the human body the benefit of a soul. Losing that soul transforms a body into a jumble of matter.

Though we like to think that our bodies are sacred and above the hardscrabble logic of the market, the sale of human parts is booming. Several billion dollars' worth of humanity changes hands every year. With almost six billion people in the world the supply is significant. There are just slightly fewer than six billion spare kidneys (or twelve billion if you are absolutely merciless) and almost sixty billion liters of blood in the global supply. There are enough corneas to fill a soccer stadium. The only thing stopping businesses from grabbing the potential profits are the rights to mine the resources.

Take, for instance, the market for adopted children. At the moment a family decides they want to bring in a needy child from a foreign country, they only have an abstract idea about that child's identity. In their search for the perfect baby they refine their expectations based on the available baby market. They troll through online menus issued by international adoption agencies, read newspaper articles about desperate children in orphanages, and make difficult decisions about what particular set of characteristics will trigger the adoption.

Sure, at some point the child will be a member of the family, but to actually obtain one they have to engage with an often shady supply chain of middlemen and corruptible government officials, many of whom see children as little more than bodies. It is only after they have brought the child into their home that the child transforms from an abstraction into someone real.

It doesn't matter what our moral position is on the subject, bodies are unquestionably commodities. And yet they are uncomfortable ones. As a product, bodies aren't assembled new in factories filled with sterile suited workers; rather they are harvested like used cars at scrap markets. Before you can write a check and pick up human tissue, someone needs to transform it from a tiny piece of humanity into something with a market value. Unlike scrap, the price of a human body isn't measured only in dollars. It is measured in blood, and in the ineffable value of lives both saved and lost. When we buy a body part, we take on the liabilities for where it came from both ethically and in terms of the previous owner's biological and genetic history. It's a transaction that never really ends.

Excerpted from The Red Market by Scott Carney. Copyright 2011 by Scott Carney. Excerpted by permission of William Morrow.

Source: http://www.npr.org/2011/06/10/136931615/blood-bones-and-organs-the-gruesome-red-market?ft=1&f=1032

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