COVID-19 a ‘perfect storm’ for organ trafficking victims

一种s global job losses mount due to the COVID-19 pandemic, desperate people are seeking new ways to make money via social media, and evidence points to a resulting deadly surge in illicit organ trafficking.

今年4月,Shivkumar(名字改变了to protect his identity) took out a loan for a power loom, confident in joining the local saree production industry.

一种nd then the pandemic hit.

“I have no choice but to commit suicide if I do not [sell] my kidney to pay the debts,” says the 32-year-old from the Southern Indian state of Andhra Pradesh.

Shivkumar六个月没有工作，他的1,600,000卢比（21,700美元）的贷款截止日期已经过去。他还紧急需要资金来支持他的妻子和三岁儿子。

“那群已经没有受过教育，没有保险，失业的人现在更加迫切希望接受他们不应该接受的报价。”

一种imée Comrie, project coordinator, GLO.ACT at United Nations Office on Drugs and Crime

Like millions of other workers this year, Shivkumar has been left without a steady income because of the pandemic. But his case is also emblematic of something more sinister, as restrictions to halt the spread of the virus destroy people’s livelihoods and organs become a prized currency on the ‘red market’.

GLO.Act Act.Act Ant-Acting Anti-Andipinator在联合国毒品和犯罪办公室的反贩运计划的项目协调员AiméeComrie说：“贩运的条件变得越来越成熟。”

在过去的六个月中，随着医院关闭或转移资源为Covid-19，在全球范围内进行的移植量较少，从而在等待名单上创造了大量的患者积压。

暴跌供应仅增加了对器官的全球需求。世界卫生组织（WHO）发言人告诉大流行之前，每年不到10％的全球器官捐赠需求。scidev.net。

同时，财富的不平等现象急剧增加，使穷人在经济上更加脆弱。

“That group of people who were already uneducated, uninsured, unemployed are now even more desperate to take up offers which they shouldn’t take,” says Comrie. “It just created a perfect storm.”

近年来，器官的“经纪人”已经使用Facebook页面作为所谓的红色市场的招聘媒体。但是，由于大流行而造成的运动的财务困难和限制使涡轮增压了该平台的非法用途，作为卖方做广告的场所。

Delhi-based Nandram (whose name has also been changed to protect his identity) lost his job as a youth hostel worker in April and is living with his parents again, which he calls “torture” as they vehemently disapprove of his homosexuality.

The 26-year-old posted his wish to sell a kidney on numerous Facebook pages, and says he has seen an uptick in similar posts since the pandemic struck.

The Facebook page which Nandram posted in, entitledSelling of Kidney，已经活跃了一年多。自从锁定开始以来的六个月至9月，卖方的评论与前八个月相比，卖方的评论翻了一番。

南德拉姆说，他已经与三个声称在过去三个月中通过这些网络出售肾脏的人进行了交谈。

该页面是二十多个scidev.netidentified, most with names as obvious askidney buyer要么捐赠肾脏以现金。自大流行以来，用户的评论跨越了这一页面，编号超过900。

International trade

The red market has both national and international forms.

差异通常是经纪人的组织程度，中间人，他们在进行移植，接收者和卖方的医疗专业人员之间占用了狮子的份额和协调。

一种t the more sophisticated, international end, this is “very big business”, says Comrie.

埃及以其高度局部的器官贸易和国际网络的杰出枢纽而闻名。

Recipients in the international networks have historically travelled to the country from wealthier Gulf states and surrounding African countries, often paying hundreds of thousands of dollars in a practice sometimesknown as transplant tourism。

同志谨慎地认为，由于今年施加的旅行限制，这种做法已暂时消退。总部位于开罗的慈善埃及个人权利倡议（EIPR）的研究员Ayman Sabae也表示，自从他收到有关器官贩运的报告以来已经有一段时间了。

但是他坚持认为，总体而言，由于规则的执法和经济上的稳定状况，贸易一直保持不变。

埃及的难民拥有有限的工作和社会福利权利 - 主要是苏丹，厄立特里亚人和一些叙利亚人 - 最容易受到贸易的影响。萨巴（Sabae）说，冠状病毒已加剧了已经严重的财务脆弱性。

SeánColumb是一名器官贩运专家，也是利物浦大学法学讲师。他还强调，难民可能承担埃及大流行的最大成本。

他说：“我认为（经纪人）尤其是针对移民的原因是他们找不到工作。”

Refugees already often find themselves barred from the job market, and Columb argues that rising unemployment and even less support from an Egyptian state crippled by the pandemic may force refugees to consider drastic options.

但是危机还将影响计划通过今年通过地中海逃到欧洲的难民。

自3月25日埃及的锁定活动限制活动以来，直到6月下旬重新开放，记录的海上十字路口降至8,045according to UN figures, compared to 16,198 last year — and the lowest for this period in five years. April saw the lowest monthly crossings on record, at 1,187.

But fewer crossings may only have made refugees more vulnerable to the organ trade, according to Columb.

他说，一方面，走私者的价格由于更大的边境控制而上涨。另一方面，由于旅行限制，到达利比亚无法前往欧洲的难民的积累现在可能意味着“二到三个月”等待可用的船。

“And that ship may never come, then you’re in debt,” says Columb.

他补充说：“如果您已经提前向走私者支付了这笔钱，那么您将永远不会因为非法而收回。”“由于涉及更多的债务，因此他们被推向[这些]进一步的极端。”

India was once one of the world’s hotspots for the international trade, before laws were tightened in 1994. But close family and spouses are allowed to donate organs, a legal loophole which has proven open to exploitation, as brokers forge documents feigning these relationships between sellers and recipients.

Partly because family ties are harder to prove for foreign recipients, central commands for international networks have moved more to neighbouring countries like Sri Lanka and Bangladesh.

In Kerala, South India, local sales are still “very, very common” says Davis Chiramel, a priest in the Southern Indian district of Thrissur and founder of the Kidney Federation of India, which works to encourage kidney donation after death.

他接到希望出售肾脏的人的电话，这些肾脏误解了慈善机构的目标，并说自从大流行以来，他已经看到了激增。

In the past six months, he has received two to three calls a day, or several hundred since India’s lockdown, which he claims is twice as many as during the same period in 2019. The vast majority, he says, are driven by financial difficulties.

The pandemic has also added to the growing demand. Sanjay Agarwal, head of nephrology at the All India Institute of Medical Science and convener of India’s National Transplant Registry, says the diversion of resources to treating COVID-19 means his public hospital still has not performed a transplant since March at the time of writing.

Yet at any one time, he says, India needs around 300,000 renal transplants — a number climbing year-on-year because of rising hypertension and diabetes. Only 8,000 transplants were performed in the country last year, and supply is not increasing, meaning a huge unmet demand.

Liver, corneas and skin

肾脏是迄今为止最多的器官，尽管肝脏销售也在增加。有时，未经证实的报告还提到角膜，血浆和皮肤移植。

尽管非法器官销售仍然是全球的一个问题，但提供国家和国际红色市场的卖方来自全球南部国家的国家。

“It’s still a big problem in India, Nepal, Bangladesh, Pakistan, Egypt — maybe Syria,” says Debra Budiani-Saberi, founder of Coalition for Organ-Failure Solutions (COFS), which promotes advocacy, prevention of organ trafficking and support to victims globally.

除了海湾外，外国接收者从美国和欧洲等地方旅行进行移植。有时，他们飞往卖方也被运输到的第三个国家，这些网络从中运行。

“Israel’s been renowned for its sophisticated international rings, in coordinating transplants in South Africa, with Brazilians, and in Turkey,” says Budiani-Saberi.

在世界各地成为头条新闻的一个案例中，发现总部位于科索沃的医疗诊所的医生至少进行了24次手术in 2008。接收者主要来自以色列，并为该行动付出了100,000美元，而大多数低收入卖家来自东欧，中亚和俄罗斯，有时仅收到8,500美元。其他报告展示受害者的费用低至2500美元。

一种2013年OSCE报告争论器官贩运“在过去的十到15年中一直在增长”，联合国的同志表示同意scidev.net: “In my view, it’s getting worse.”

从理论上讲，器官销售可以是同意的，但Comrie承认她尚未看到没有“欺骗或欺诈”的案件，而她看到了一些“大量”案件，这些案件被骗子被骗了并且根本没有收到任何钱。

她说，典型的受害者是男性，受过良好教育，边缘化和来自农村地区，并且面临财务困难。她说，经纪人经常会撒谎，并告诉潜在的卖家，例如“您的风琴会像树上的水果一样恢复生长”。

随着冠状病毒突出这些漏洞，一位发言人告诉scidev.net: “We need to remain vigilant and protect affected populations.”

根据WHO estimates从2007年开始，最近的可用5％至10％每年全球肾脏移植是商业化的 - 这意味着almost 10,000 last year。

The practice is legal only in Iran, where it applies just to nationals and the Iranian diaspora.

Budiani-Saberi说，COFS在过去五年中每年协助了大约250名器官贩运的受害者。尽管它每年都会确定数百名受害者，但它没有更多的资源来支持。

She says that although the “clandestine nature” of this abuse prevents her from having accurate data on organs trafficked per year, she estimates it at least in “in the hundreds” and possibly in the thousands.

联合国的最新全球的Report on Trafficking in Persons从2014 - 17年开始记录大约100例器官贩运案件。

But Comrie calls this a “vast underrepresentation”, as figures are self-reported by member states when local authorities catch people involved in the illicit trade. She argues that the shame accompanying organ removal and criminalisation of victims prevents those affected from speaking out.

“No country wants it to be known that its citizens are selling their body parts to survive,” she explains, arguing NGOs are sometimes even disbanded for exposing these issues as national problems.

“Wilful blindness” by authorities who have other priorities also plays a part, while amateur trade in makeshift venues remains too underground to monitor.

加州大学伯克利分校的高级医学人类学家劳伦斯·科恩（Lawrence Cohen）补充说：“大多数[数据]收集是偶然的研究人员，他一次在一个地方学习。”

Ultimately, he says, it is “data no one wants”.

漏洞

Experts say addressing illegal trafficking will not be easy.

Legislation and law enforcement is one problem. In India, the legal loophole persists while authorisation committees, in charge of monitoring live donations and clearing certain transplants, do not have the authority to check bank accounts for payments.

In Egypt, new legislation from 2010 banned commercial organ sales and imposed penalties for all involved, which were increased further by a 2018 law. But as EIPR’s Sabae argues, “it’s not a law that would be enforced on its own”, but “requires institutions, it requires resources, it requires work … it would require campaigns for public awareness”.

Comrie认为，执法不习惯机器人贩运案件，并且经常努力调查这些复杂的犯罪。她领导着联合国毒品和犯罪办公室（毒品犯罪现象）虚拟模拟工具的开发，明年将培训警察在现场发现关键证据。

另一种选择是增加已故捐助者的供应，例如，在印度，目前仅占器官移植的5％至10％。非营利组织Mohan Foundation的Sumana Navin旨在鼓励在印度进行此类捐款，他说，今年死者的捐款尤为重要，因为传播Covid-19的风险使医院进行活着的捐助者移植变得更加困难。

“医院正在继续捐款，因为如果您不继续前进，您将失去挽救这么多生命的机会。这是一个永远不会回来的机会。”

然而，污名有时仍然存在于已故的捐赠中。

作为解决方案，医学专家引用了西班牙的选择退出，而不是选择使用模型，用于使用已死的人的器官，英国也搬到了今年。但是在埃及等国家，尽管宗教领袖现在正式认可了这种做法，但公民仍然不愿签署。

Tackling the vulnerabilities of victims could also help eliminate organ trafficking, argues Columb, especially when it comes to refugees who sell their organs as a last resort.

他说：“应该有重新安置，这不仅是一个国家要做，还必须有真正的国际团结。”他坚持认为国家向联合国难民机构的重新安置计划的搬迁承诺需要增加。

最后，用于招聘的平台上几乎没有控件。

Out of the Facebook pages thatscidev.net发现有些人活跃了一年多，并积累了一千多个关注者。评论来自世界各地的用户 - 跨越印度，尼日利亚，巴基斯坦，南非和菲律宾。

联合国的同志说：“社交媒体有责任，如果他们真的致力于解决这个问题，那就不应该那么难。”

scidev.netrequested a comment from Facebook on the problem, but Facebook did not reply by the time of publication.

很明显,pandemic has not just brought devastation through the millions infected, it has also created the deadly side effect of an ever more thriving organ trafficking industry.