UPDATED at 3:25 p.m. EST on 2013-07-12
Allegations that the Chinese Red Cross has been involved in trading transplant organs for cash have highlighted a booming underground business in vital body parts, lawyers said this week.
State media reports recently alleged that hospitals in the two provinces of Jiangsu and Guangdong had been approached by local branches of the Red Cross Society of China for payments of 100,000 yuan (U.S. $16,300) for each successful organ donation.
The reports prompted the Shenzhen branch of the Red Cross to release a statement this week saying that it has worked on 25 cases with the General Hospital of Guangzhou Military Area Command and admitting that the hospital had contributed 150,000 yuan (U.S. $24,400) to promote organ donation.
But the branch denied the 25 cases were linked to organ procurement.
"The branch has provided detailed expense statements to the hospital," the statement said, adding: "There is no 100,000 yuan-per-organ arrangement, and donation usage is always disclosed to hospitals on a regular basis."
The reports aren't the first to cause a stir over organ trading.
Last month, a report on the popular social media site Tencent that an 18-year-old student from the western province of Gansu had sold a kidney to pay off a video-gaming debt sparked shock and concern among netizens, highlighting a growing trade in organs that is often brokered through specialist websites.
The student, identified only by his surname Zhang, was matched up with an organ dealer online, traveled to the central city of Shijiazhuang and signed a waiver agreement, and had one kidney removed in return for just U.S. $6,510, compared with a going rate of around U.S. $47,000, Tencent reported.
Typical sources
But such reports still only scratch the surface of the illicit trade, which takes place behind closed doors, and often attracts the poorest and most desperate people in China.
Beijing-based rights lawyer Liu Xiaoyuan said Chinese transplant organs are typically sourced either from relatives or from executed prisoners.
The ruling Chinese Communist Party admits the harvesting of organs from consenting, dead prisoners, and has vowed to diminish dependence on such organs in future.
Liu said the rise of lethal injections over firing squad executions would eventually make such organs scarce.
"I heard that a lot of organs from prisoners executed by lethal injection are unusable," he said. "So all of this is bound to have an impact on the rampant underground market in transplant organs."
Liu said clear and well-enforced legislation on organ transplants was the only way forward.
"The government lacks the manpower and the resources to make a serious strike at the underground organs trade," he said. "There are so many people waiting for kidneys, with a serious shortage available through normal channels."
"Of course the underground market is booming."
An open secret
Organ transplantation in China has long been criticized as opaque, profit-driven, and unethical. Critics argue death row inmates may feel pressured to become donors, violating personal, religious, or cultural beliefs.
China has also been extracting organs from living prisoners in addition to its much publicized and criticized practice of taking vital body parts from executed convicts, experts told a U.S. congressional hearing last year.
The illegal organ trade has become an open secret in today's China, with advertisements clearly visible on the Internet for people wishing to sell kidneys or livers.
"We see a lot of media reports saying that the fees for a kidney transplant are extremely high," Henan lawyer Niu Yuliang said in a recent interview. "But what fee is that, exactly? Is it the fee for surgery, or the fee paid to acquire the kidney?"
"If the organ is donated, then why do people need to buy them? Obviously, there are a lot of questions over this," Niu said. "It's unclear right now in this country what processes must be gone through to donate an organ, and who collects the donated funds for organs."
"People will only have peace of mind when this all becomes transparent and open."
Prisoners targeted
Rights groups have charged Beijing with a deliberate policy of linking the criminal justice system and local hospitals in an attempt to meet the growing demand for transplants after Chinese hospitals became proficient at performing them in the early 1990s.
They also accuse the authorities of skipping over the question of consent, either with coerced agreements before the prisoner is executed, or simply by cremating the bodies of those executed so no evidence remains.
Two-thirds of transplant organs in China come from prisoners, according to researcher Ethan Gutman, who has conducted interviews with Chinese medical professionals, law enforcement personnel, and over 50 former prisoners of China’s laogai labor-camp system since 2006.
Gutman said he believes that the practice of taking organs from Chinese prisoners began in the remote Xinjiang region—where ethnic Uyghurs say they are discriminated against by Han Chinese—in the 1990s and had expanded nationwide by 2001.
Though at first the victims of this practice were executed prisoners, he said, doctors began to take organs from living prisoners as well, he told the Oversight and Investigation and Human Rights Subcommittees of the House of Representatives Foreign Affairs Committee.
Beijing strongly denies that it deliberately kills prisoners to harvest organs, pointing to the Red Cross' fledgling Transplant Organ Response System set up in April 2011.
Reported by Shi Shan and Wen Jian for RFA's Mandarin service. Translated and written in English by Luisetta Mudie.