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Poor Romas Sell Human Organs on the Black Market: Trading Kidneys for Firewood

by Natasha Dokovska

“I have seven children, I don’t work, neither does my wife. For many years I thought about selling my kidney so I could give my children a better life, but just recently I found someone to buy it,” says 40 year old Ekrem. He explains that it was not a difficult choice because the 1,000 Euro ($1,465 USD) he got as compensation for the lost kidney will enable him to mend some holes in his home, pay electricity bills, and get enough firewood to last for the rest of the winter.

“Fortunately this was not a cold winter so we managed to keep warm with what we’ve got, otherwise we would have frozen to death,” says Ekrem.

Ekrem is one of the many Macedonian citizens who see selling their organs as a chance to save themselves from poverty. He does not consider the consequences. According to a Macedonian organization that works with people with kidney diseases, for Ekrem and about a hundred other Roma citizens in the country, it is the only way to offer a modest life for their children.

“I don’t care if it is legal or not, what matters is having food on the table,” says Ekrem. He says he is the tenth person in his family to sell a kidney. He does not reveal the “friends” who offered him this deal, because if he tells, Ekrem says he’ll “dry out” the source for the many families who are still waiting in line to sell a piece of their body.

Representatives from the non-governmental organization La Strada (or Open Gate) that works to protect victims of human trade were the first to react to the rising prevalence of human organ trade as a way of survival. This followed a report by the European Commission for Transplanting Organs which put Macedonia on the list of countries whose citizens illegally sell their organs. The same report implies that these “donors” are commonly poor and marginalized citizens, while the traders are usually criminals engaged in human trading, though corrupt policemen and doctors are also implicated.

“Roma are the most common victims, who pressured by poverty, agree on a certain [financial] compensation after an organ is removed, usually a kidney,” says Stanka Markoska, spokeswoman from La Strada. According to the organization there are serious indications that the human organ trade is spreading, especially in the Roma community.

Roma are the most common victims of human organ trading because they are in the worst social and economic state. Because of their poverty, for a certain price, they agree to have their organs removed, which are then sold with the help of mediators and usually to foreign countries. A kidney transplant can yield anywhere from 800 ($1,148 USD) to 1,200 ($1,738 USD) Euro, and has a “stable” value.

But although Macedonia is mentioned in the European report on organ transplants, no Macedonian doctor has officially identified any cases of illegal organ transplants among Macedonian citizens.

“There simply do not [exist the proper] conditions for illegal organ transplants in Macedonia because it demands a large team of professional doctors and medical staff,” says Dr. Ninoslav Ivanovski, president of the Macedonian Association for Organ Transplantation.

However, there are confirmed cases of organ transplants on Macedonians abroad: “We know there are Macedonian citizens that are traveling to buy a kidney in India and Pakistan and the situation in the past few years is a rising trend across Europe. In some ways, a legal sale of organs is established and our patients have been going there without our permission. We were not aware of it nor have we referred any of them to those far east countries to buy a kidney,” says Dr. Ivanoski, who confirms there have been offers in the past few years from an Israeli team of doctors to open a transplant clinic in Macedonia.

Israeli economic analyst Sam Vaknin, who from 2001-2002 worked in Macedonia, confirms that such an idea existed, but was never realized. “A group of businessmen and doctors came, most of them from Israel. They visited Macedonia to review the possibility of opening a clinic for organ transplants here, but they just came to visit and explore the options, they did nothing more,” says Vaknin.

While doctors argue whether human organ trade in Macedonia exists or not, the Ministry of Health formed a coordinating body to assess the information about it circulating in the media.

Daniela Aleksovska, spokesperson for the Ministry of Health, says the coordinating body will inquire into the allegations of illegal organ trade.

Aleksovska says the Ministry of Health has reached out to the US embassy to find out whether the American Medical Association has any reports on alleged organ trading in Macedonia.

So far, none of the allegations about the illegal human organ trade have been verified by any of the international organizations that address this problem. But Ekrem and others like him tell a different story: “Now my wife wants to sell her kidney so we can get some more money because the children are growing up, there will be weddings soon…We need to think about everything!”
About the Author
Natasha Dokovska has been a journalist for 23 years, covering social issues and human rights in Macedonia. She has been an editor for international policy, an advocate for human rights as an NGO activist and publisher, and has edited books related to peace journalism and other topics.

She is currently the editor for the first internet alternative radio in Macedonia and is also the Executive Director of JCWE, Journalists for Children and Women’s Rights and Protection of the Environment in Macedonia.

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