|Many of the black market organ donors in China are migrant workers who are unemployed or need to pay off debts [GALLO/GETTY]
In China, where a growing demand for organ transplants coupled with a dramatic shortage of donors has fuelled a rampant black market trade, selling your organs for cash is a mouse click away.
An internet search reveals a website offering kidneys for sale and the contact information of those able to procure them. A young woman, posing as a migrant worker from Hebei province, calls a man who has advertised on the website, identified as Mr He.
"I need money," she says over the phone. "Do you want a woman's kidney?"
Mr He asks her age. Twenty-five, she replies.
"Of course we want your kidney."
Mr He tells the woman to travel to Xuzhou city, Jiangsu province, where somebody will be waiting when her train pulls into the station. She'll be given a physical examination and, if she's found to be in good health, Mr He will find a suitable transplant candidate. He says he'll pay RMB 320,000 (50,000 dollars) - a dubious offer, since most kidneys in China sell for around RMB 100,000 (15,000 dollars) - and promises to transfer the money before surgery.
In China, around 1.5 million people require organ transplants, but just 10,000 receive them each year. The vast majority of organs in China still come from condemned prisoners, but new government regulations have reduced the number of organs available for transplant. Meanwhile, few Chinese agree to donate their organs upon death, widening the gap between supply and demand.
No way to back out
Illegal organ traffickers have stepped in to fill that gap. Last month, Southern Weekend, a newspaper in Guangzhou, broke the story of Hu Jie, a migrant worker from Hunan province who decided to sell his kidney in Linfen, Shanxi province, in order to pay off debts.
Hu changed his mind before surgery but found that his mobile phone, identification and belongings had been taken. He was told by traffickers that he wouldn't be allowed to leave the city until the surgery was completed.
The story exposed the workings of an illegal trafficking network.
"The illegal organ trade is widespread in China," said Zheng Xiaojun, a lawyer at Tian Run Hua Bang law firm, under the Sichuan Provincial Department of Justice. "There's booming demand… so there's a large underground market in organ trafficking in China, acting as an intermediary between organ seekers and organ donors."
For decades, China, which executes more prisoners annually than any other country, has relied on organs removed from the condemned, a practise that has drawn international criticism. But in 2007, the government mandated all death penalty sentences to be reviewed by the Supreme Court, curtailing executions.
In 2007, the country banned organ transplants from living donors, except from spouses, blood relatives and step or adopted family members. With fewer organs available for transplant, and a growing list of patients in need, the black market trade flourished even further.
Lax punishment and many loopholes
Organ trafficking is made easier by a lack of proper regulations and hospital loopholes, according to an article by the Procuratorial Daily this April.
The Regulation on Human Organ Transplantation, which came into effect in May 2007, requires administrative punishment for employees of medical institutes, but punishment for selling or purchasing remains lax, the article said. Many organ donors pose as spouses and relatives of organ seekers by using fake IDs.
The Ministry of Health recently announced it would crack down on medical facilities found conducting organ transplants without proper qualifications, levying large fines and ordering the hospitals to conduct institutional overhauls or risk closure. Staff found breaking laws will be stripped of licenses, and officials in charge will be removed and held legally responsible.
The government is also trying to alleviate the organ shortage. In 2008, a liver transplant registry was established in Shanghai. In 2009, the country launched a nationwide system to coordinate donation after death, beginning with a pilot project in ten provinces and cities that encouraged post-death donations as well as starting a fund to provide financial aid for those in need and to donors' families.
Despite these efforts, China Daily reported in 2009 that 65 percent of all transplants still came from executed prisoners.
By the end of this year, Chinese will be given the option of registering as organ donors when they apply for drivers' licenses. The government is also considering offering financial incentives to encourage voluntary donation.
"The move is to streamline the donor registration system so as to expand the pool of organs available for transplant surgeries," vice health minister Huang Jiefu was quoted in the state media as saying. "Other financial compensation could also be considered, such as tax rebates, medical insurance or tuition wavers for donors' family members."
Critics have expressed doubt the drivers' license scheme will have the desired effects.
"Most Chinese would think it was a curse for them to fill out such a form while applying for a driving license," Yang Junyi, a Shanghai Red Cross spokesman, told state media.
A version of this article first appeared on Inter Press Services news agency.