Dollars from the Dead

More than 20,000 people, mostly minors, are trafficked out or through Kenya annually to places like Asia, Europe and other African countries according to the International Organization and Migration (IOM).  And although most reports says they are turned into forced labour and sex slaves chances are that some of them end up in the hands of illicit human organ trade cartels in the west.

According to a recent series of reports by the International Consortium of Investigative Journalists (ICIJ) conducted in eight months across 11 countries the business of harvesting bones, corneas, heart valves, skin and other body parts from cadavers to make medical products is thriving in the world.

The report vividly explains how “cadaver bone-harvested from the dead and replaced with PVC piping for burial-is sculpted like pieces of hardwood into screws and anchors for dozens of orthopedic and dental applications”.

In other instances the bone is ground and mixed with chemicals to produce strong surgical glues-used to attach organs and tissues after surgery- that is said to be better than artificial varieties while tendons are used to treat injured athletes. Other common uses of dead peoples’ body parts includes penis enlargement, breast reconstruction after cancer, smoothing wrinkled faces, cornea transplants, heart valve replacements, bladder slings for incontinence, bone grafts among others.

“In Kenya the most commonly harvested cadaver parts are corneas that are used in reconstructive eye surgery,” explains Dr. Eric Walong, a pathologist based at the University of Nairobi. “These donations happens with the dead person’s family consent and there is usually no monetary gains on either side of the deal”. 

Dr. Walong says that one of the biggest impediments towards the growth of organ industry in Kenya is the fact that there is no top of the range emergency services to preserve the bodies and organs in good shape awaiting surgical removal.

While families are mourning and rue the loss of loved ones, the ICIJ report claims, somebody somewhere might be celebrating all the way to the bank.

For instance ordinary “hustlers” wheeler-dealing with morgues in the United States can make up to $10,000 per corpse and RTI Biologics, a tissue and organ selling multinational grossly mentioned in the investigative report, is said to have raked in $169 million  in 2011. A fully processed disease-free body with all the organs recovered and applied to the various end uses can generate between $80,000 and $200,000 .

 A case in point on how global organ trade have become a “blood gold” mine in the last few years is Phillip Joe Guyett, arguably America’s largest freelance organ harvester ever nabbed. 

Bragging of how senior executives from multinational tissue companies treated him to $400 meals and five star hotel stays in order to clinch his services, Guyett writes in his peculiarly named memoirs Heads, Shoulder, Knees and Bones how he started seeing the dead “with dollar signs attached to their body parts”.

He was convicted of falsifying death records and sentenced to a prolonged jail term in 2006.

But while most European cadavers are from people who died in hospitals the report suggests that people trafficked from other part of the world like Africa might be killed to obtain vital organs and tissues since the demand is on the rise.

Weighing between three to four kilograms for an average adult human skin is one of the most sought after organ since it has a variety of uses.

“Human skin takes the colour of smoked salmon when it is professionally removed in rectangular shapes from a cadaver,” the ICIJ report says. “After being mashed up to remove moisture, some is destined to protect burn victims from life-threatening bacterial infections or, once refined, for breast reconstructions after cancer”.

Most of this multimillion dollar “blood gold” empire have been going on for years without the knowledge of the victims relatives, most of whom just pick the bodies of their loved one from the morgues straight to the cemetery without minding to check the cadaver’s conditions. 

“On the way to the cemetery. When we were in the hearse, one of his feet-we noticed that one of the shoes slipped off his foot, which seemed to be hanging loose,” Lubov Frolova, a Ukranian mother of one of the deceased whose organs and tissues were harvested told ICIJ. “When my daughter-in-law touched it  she said that his foot was empty”.

Police investigations revealed that two ribs, two Achilles tendons, two elbows, two eardrums and two teeth were among the organs that were missing in the body.

This was one of the incidences that led to the uncovering of a huge syndicate of illicit organ trade involving Ukrainian morgues and US human tissue multinationals was unearthed last months.

Besides violating the dead without the family consent the shadowy trade in human organs also exposes the recipients to the dangers of infections since most of the tissues are not subjected to proper medical test to establish the donor’s medical history.

While blood donations and intact organs like hearts and livers are bar-corded and strongly regulated it’s hard to verify the sterility of products made from skin and other tissues since there is no particular structures set in place to regulate the industry. Many countries leave the responsibility of identifying and confirming the identities of tissue donors to drug makers and tissue banks. 

However this might change soon since the World Health Organization (WHO) plans to track human tissue traded for transplants in order to ensure safety of donors and prevent illegal collections. ICIJ says that a work group to look at the issue has already been set up and it will have its first sitting in France at the end of August. 

“The working groups plans to introduce the system in five years, covering 193 countries,” the report claimed. “In addition to human tissue, the group intends to use codes for medical materials and other products derived from human tissues”.

Although the United States is the biggest trader of products from human tissue the authorities are unable to quantify the number of imported tissues, its country of origin or where the products subsequently goes. Many countries especially in the third world, including Kenya, don’t have don’t have regulations on the use of human tissues or if they are there they are week, ineffective or unimplemented. 

Supplying about two-thirds of the global human tissue product market, the United States through its Food and Drug Administration (FDA) which have the inspection records of only seven percent of the 340 tissue banks registered with it. 

“When the FDA registers you, all you have to do is fill out a form and wait for an inspection,” Dr. Duke Kasprisin, medical director for seven US tissue banks, told ICIJ. “For the first year or two you can function without having anyone look at you”.

With millions of hospitals in the world relying on FDA to ensure that they do not treat their patients with infected tissues, many practitioners have welcomed the WHO initiated.  

Also high in demand in the western human organ industry is the foreskin for the production of skin treatment medication and products.

And apparently this is not in short supply with WHO estimates claiming that 30 percent of world males are circumcisied with millions undergoing the process annually. 

Treated as a medical procedure in the west and a rite of passage in many third world countries the global demand for circumcision was triggered by a UNAIDS and Centre for Disease Control in 2007 indicating removing the foreskin reduces the risk of HIV/AIDS during penetrative sex.

The United States donated Sh960 million shillings towards the Ministry of Health’s five year nationwide free circumcision campaign aimed at curbing the spread of HIV/AIDS especially among communities that traditionally shunned the practice. 

But while a lot of attention is paid towards circumcision very little is discussed about what happens to the foreskins of the millions of males that are circumcised around the world every year. 

While in Africa the foreskin is either eaten by the initiate or circumciser, fed to animals or simply buried in the west, where practice is a hot debate with many arguing that its an unnecessary and painful process, the foreskin trade is a booming business. 

Besides being an important ingredient for numerous skincare products and interferon drugs the prepuce is chiefly used in the production of fibroblasts, skin cells used in the regeneration of new skin. Due to their biological properties fibroblasts are used in all kinds of medical procedures from eyelid replacement, growing skin for burn victims and those with diabetic ulcers to making anti-wrinkle creams and other products in the cosmetic industry.

According to scientific research one foreskin, which contains millions of fibroblast cells, treated through a process called culturing can be used for decades to produce miles of new skin for burn victims and those undergoing plastic surgery. 

A single foreskin contains enough genetic material to grow approximately 250,000 square feet of new smooth skin. With this lab-developed skin said to cost around $3,000 per square feet for burn patients one of this seemingly insignificant pieces of male genital flesh can generate thousands of dollars in revenues over a prolonged period of time. 

According to Caltech Undergraduate Research Journal, an award-winning undergraduate research journal of California Institute of Technology, infant foreskins are preferred because they have more potential for cell division and less incidence of tissue rejection since they have not fully developed their individual identifying proteins.

The inner lining of the foreskin is usually fused with the glans at birth making infant circumcision a precarious process. Although modernity has tried to alleviate the pain through contraptions like clamps, opponents of the practice among newborns argue that besides exposing the baby to unbearable pain and possible permanent tissue damage its also a violation of the young ones human rights.

Intercytex, a tissue generation company based in Cambridge United Kingdom, raised the foreskin utility business several notches higher by developing an injection-based drug called Valveta a few years ago. Dubbed a “fountain of youth in baby foreskins” Valveta is a foreskin-derived treatment product that rejuvenates and smoothens skin withered by age, wrinkles or damaged by scarring from acne, burns and surgical incisions. One vial of this medication, enough to treat an area of skin the size of a postage stamp, consists of about 20 million live fibroblasts, cells that produce the skin-firming protein called collagen which becomes increasingly scarce with age.

The number of Valveta vials that a patient needs is determined by the surface area of skin destroyed. However the drug, which goes for about $1000 (Sh82,000) per vial, is not approved for use outside the United Kingdom where it was introduced in 2007.

Despite spirited resistance from activists across the world infant circumcision remains popular in several parts of the world, which ensures that baby foreskin remains in constant supply. 

In Where is My Foreskin? The Case Against Circumcision Paul Fleiss, an American pediatrician and author known for his unconventional medical views, say “parents should be very wary of anyone who tries to cut their child’s foreskin since the marketing of purloined baby foreskins is a multimillion-dollar-a-year industry”.

And there might be a point to these allegations given that Dermagraft-TC, one of the many products grown from cells extracted from infant foreskins and used as a temporary wound covering for serious burn patients, sells for about $3,000 per square feet according to some American medical journals.