Honourable senators, I rise today to speak to Bill S-204, which aims to create new offences with regard to organ harvesting and organ trafficking abroad. This bill has been introduced in the Canadian Parliament multiple times over the last decade. In fact, this is the third time that I am tabling this bill, which was almost passed in the last Parliament.
As much as I would like to pride myself for slowly and steadily making this bill a reality, I fear we are behind. While medical and technological advances in recent decades have improved our lives in ways previously unimaginable, they sadly have also created new means of exploiting the world’s most vulnerable.
One of the most awful new forms of such exploitation is the use of social media to illegally harvest and traffic human organs. A journalist with The Independent U.K. reported being offered a kidney by a man from India within two days of joining an organ Facebook group. The international character of this problem, which often sees vulnerable people exploited to meet the demand for organ transplantation in places like Canada, requires us to take action.
Before the year 2000, trafficking in human organs was primarily limited to the Indian subcontinent and Southeast Asia, and the recipients of organs were typically from the Gulf states, Japan and other Asian countries, with the European Union and the United States issuing sporadic reports of patients travelling abroad to obtain organs, primarily kidneys.
However, since then, organ trafficking has spread throughout the globe, with organ recipients exploring opportunities for transplantation in Eastern European countries as well as Russia. Today, partly as a result of tougher law enforcement against trafficking in Eastern Europe, the Philippines and on the Indian subcontinent, trafficking in human organs is shifting to Latin America, North Africa and other regions where the economic crisis, along with social and political instability, create opportunities for traffickers.
As with most covert affairs that prey on the vulnerable, statistics represent only a fraction of the reality. However, the information that is available is enough to paint a horrifying picture. Trafficking in persons for the removal of their organs is prohibited by international law as part of a general prohibition on human trafficking, defined to include exploitation for the removal of organs. Together with drugs, humans, arms, diamonds, gold and oil, organs have become the subject of an illegal billion-dollar industry, estimated to generate profits between $600 million to $1.2 billion a year. To exploit the gap between the supply and demand of organs even more, criminal organizations that traffic in human beings have expanded their practices to include organ trafficking.
Consequently, over 100 countries have passed legislation banning the trade of organs. Additionally, several countries with significant problems of organ trafficking have responded with legislation strengthening existing laws that ban organ trafficking and organ sales. Further, there are a number of governmental and professional bodies with initiatives to regulate domestic and international organ transplantation and tackle organ trafficking, including, for example, the Council of Europe Convention against Trafficking in Human Organs.
The crime of trafficking in human beings was first defined in the UN Palermo Protocol, adopted in 2000, which has become universally accepted as the international legal framework against human trafficking.
The Declaration of Istanbul in 2008, widely recognized as the most important guide for professional and governmental bodies in the field of organ transplantation, defines organ trafficking and further states that all commodification of organs is ethically wrong and must be criminalized.
Honourable senators, human organs have become a valuable and profitable black market commodity, involving transnational crime syndicates operating through vast international networks. Cases of organ trafficking continue to be reported from around the globe despite the fact that almost all countries in the world prohibit compensated organ donation, a practice widely viewed as targeting impoverished and otherwise vulnerable donors and as a violation of the principles of equity, justice and respect for human dignity.
According to the UN Office on Drugs and Crime, trafficking for the removal of organs was detected in at least 10 countries between 2012 and 2014, mainly in central and southeastern Europe, Eastern Europe, central Asia, North Africa and the Middle East. In terms of demand, the practice of travelling abroad to receive an organ transplant for consideration, almost exclusively monetary consideration, has been reported the most among nationals of the United Kingdom, Saudi Arabia, Taiwan, Australia, the United States and Canada, among others.
In 2012, the World Health Organization claimed an illegal organ was sold every hour. Overall, the number of illegal transplants worldwide is believed to be about 10,000 a year. This would mean that in the 10 years we have dedicated to putting an end to organ harvesting and trafficking, over 100,000 illegal transplants have occurred.
Sadly, my entire allotted speaking time could be spent recounting story after story of victim organ donors, such as the missing six-year-old boy who was found alone in a field crying, with both of his eyes removed, presumably for their corneas; the young girl who was kidnapped and taken to another country for the sole purpose of harvesting her organs; and a terrified group of women and men who were found locked inside an apartment, being held through deception and threats, waiting to be taken to a clinic to unwillingly have a kidney removed.
Vulnerable groups who find themselves desperate enough to sell a part of their own body are not in a position to negotiate. A Sudanese man working as an organ broker in Cairo describes the organ trade as a family business and an economic lifeline. He explained that the price of a kidney varies according to the seller’s ability to negotiate, meaning that a seller unaware of the price of a kidney would receive a much lower sum. However, the broker said that, unlike many of his colleagues, he always paid the seller. When asked how many organ transactions the man would broker, he answered that he would deal with an average of 20 to 30 organ sellers each week.
This appalling number is largely due to the number of migrants in North Africa, which has become an important hub for organ harvesters. Smugglers are selling migrants unable to afford the fare to make the journey across the Mediterranean to organ harvesters. A former trafficker told investigators that people who couldn’t pay were given to traffickers who would kill them to harvest their organs, and then sell them for $15,000.
I am aware that fellow Canadians also live in desperation as the number of organ donors still does not match the number of Canadians requiring an organ. According to the Canadian Medical Association, over 4,500 Canadians remain on organ transplant wait lists, some of whom will die before receiving a transplant.
It is estimated that the current number of legal transplants performed covers only the needs of 15% of all patients on waiting lists worldwide. This shortage of available organs has prompted countries to develop procedures and systems to increase supply, mainly through the promotion of deceased donation programs. This alone, however, has not been enough to fill the gaps between the demand and supply of organs.
It is projected that the demand for organ transplants will increase 150% over the next two decades. For some, this is a logical explanation for the continued harvesting of organs worldwide, as there is an increasing demand for organs, but a lack of availability.
Sadly, an illegal transplant is not a lifeline for Canadians needing a vital organ. Instead, the recipient can often suffer from surgical complications, infections and poorer outcomes overall. These patients experience loss of the organ and death at higher rates than domestic organ transplant recipients. In spite of the growing body of information on the ramifications of transplant tourism, Canadians continue to travel abroad for commercial organ transplants. Doctors have reported that three to five people a year still arrive at St. Michael’s Hospital, having obtained a kidney in countries such as China, Pakistan or India. St. Paul’s Hospital in Vancouver reports also seeing three to five returning organ tourists a year.
A study on the clinical outcomes of patients treated at an Ontario transplant centre after receiving organs through commercial transactions abroad found that most of the patients needed follow-up care on an urgent basis, and some required lengthy hospital stays. This not only puts Canadian citizens at risk, but also contributes to burdening our already struggling health care system.
Although transplant tourism has slowed as a result of COVID-19 travel regulations and lockdowns, marginalized people are at twice as high a risk of being exploited in the shadows.
Indeed, there is an important connection between disease outbreaks and human trafficking, as outbreaks are associated with multiple risk factors, such as a breakdown of the rule of law, an increase in criminal activity, competition for resources and a disruption of family ties. For example, research shows that the Ebola outbreak in West Africa in 2014 left thousands of orphans at increased risk of exploitation.
History shows us that countries having recently experienced a disease outbreak are more likely to have trafficking outflows. As COVID-19 is an international pandemic, it can only be assumed that an increase in human and organ trafficking will also have global repercussions.
Medical anthropologists are still working to understand the reality of life for organ sellers, and some attention has recently been paid to the lived experiences of people who sold their bodily organs. As explained by a 25-year-old kidney seller from Bangladesh, while weeping uncontrollably, “We are living cadavers. By selling our kidneys, our bodies are lighter but our chests are heavier than ever.”
Organ sellers do not escape poverty by selling their organs. Unsurprisingly, after selling their organs, individuals face deteriorating health and are subject to social isolation, marital conflict and public shame due to the high stigma placed on selling body parts. Sellers also face worsening economic conditions as their damaged bodies impede their ability to return to their physically demanding jobs. This leads many sellers falling back into debt again after selling their organs.
Organ tourism creates a context where everyone loses, except for the organ traffickers.
Honourable senators, it is our duty to make sure that our citizens’ desperation does not grant them permission to export human suffering. Canadian legislation should not give human organ traffickers the upper hand.
In 2013, seven people in Kosovo, suspected of running an international organ trafficking ring taking kidneys from poor donors lured by financial promises, stood trial. At least 24 kidney transplants, involving 48 victim-donors and recipients, were carried out between 2008 and 2009.
After the trial, a Canadian prosecutor working for the European Union Rule of Law Mission in Kosovo said that the Canadian government must pass legislation barring Canadians from buying human organs in foreign countries.
A Canadian man who admitted to purchasing a black-market kidney, but never faced criminal charges, was among the more than 100 witnesses who testified at the trial. Most of the names of the victim-donors and recipients were traced through documents seized during a police raid into a medical facility in Kosovo in 2008.
The court heard that the victim-donors were promised $10,000 to $12,000 in return for their kidneys, but many said they were never paid. “At least two were cheated out of the entire amount and went home with no money and only one kidney,” the court heard.
It was reported that the kidney recipients, who were mostly wealthy patients from Canada, Israel, Poland, the U.S. and Germany, paid up to $170,000 for the procedure, and the defendants are believed to have profited by $1 million from the illegal transplants.
Unfortunately, honourable senators, there is a widespread view internationally that the trafficking of human organs is not a pressing concern for wealthier demand countries, including Canada. The responsibility of ending this practice should be placed on the victims of the crimes. Unless this issue is addressed by demand countries, the burden of combating these crimes will remain entirely on the countries from which victim-donors tend to originate, as well as on countries where illegal organ transplants are conducted, which in both cases, are typically less wealthy countries.
Honourable senators, Bill S-204 amends the Criminal Code to create new offences in relation to trafficking in human organs and tissue. It also amends the Immigration and Refugee Protection Act to provide that a permanent resident or foreign national is inadmissible to Canada if the Minister of Citizenship and Immigration is of the opinion that they have engaged in any activities relating to trafficking in human organs or tissue.
I would like to specify that my bill does not prevent Canadians from travelling abroad to receive an organ transplant through legitimate and legal means. However, it is imperative that the highest demand countries such as Canada participate in the detection, investigation and prosecution of those who illegally obtain organs.
Honourable senators, as many of you know, this bill was initially tabled in the Forty-second Parliament as Bill S-240. It was studied and debated both in the Senate and the other place where it passed with all-party support on April 30, 2018. Unfortunately, Bill S-240 did not come to a final vote in the Senate, and consequently died on the Order Paper.
Honourable senators, I ask that you support the timely passage of this important bill. As the prosecutor in the Kosovo case said, organ trafficking is the:
. . . exploitation of the poor . . . the vulnerable and the marginalized in our society.
The recipients are wealthy, influential citizens from foreign countries, largely Western countries . . . .
They should be held criminally responsible. Trafficking in human organs is indeed a cruel harvest of the poor. Thank you.