Advertisement

Journal of Public Health

, Volume 18, Issue 4, pp 375–384 | Cite as

Colombia’s organ trade: Evidence from Bogotá and Medellín

  • Roger Lee Mendoza
Original Article

Abstract

Aim

This quantitative study seeks to determine why the underground organ commerce exists and thrives in Colombia, and how it responds to global donor shortages, public opposition and government initiatives to curtail it. Policy lessons and insights from the Colombian experience in organ donation and transplantation are identified in this study.

Subjects and Methods

Statistical random samples of 169 living and paid Colombian donors (or vendors) were apportioned between the key organ supplier cities of Bogotá and Medellín based on population. A pre-tested and interviewer-administered questionnaire was designed for organ vendors in these multi-stage samples. Qualitative analysis of pertinent Colombian laws and regulations forms the other half of this study.

Results

Survey results from Bogotá and Medellín tend to indicate shared demographic characteristics between Colombian vendors and their counterparts in developing countries that are major destinations for organ trafficking. The organ trade in Colombia is generally open, brokered and without price competition and provisions for vendors’ postoperative care, which help attract many foreign buyers. These factors also increase the vulnerability of vendors to unscrupulous third parties. The study finds that public indifference, state/institutional incapacity, corruption, and constantly changing trade environments, rules and operations subvert the legal and regulatory framework for organ donation and transplantation, which in Colombia is rather unique for its extent of coverage, complexity and detail.

Conclusion

The empirical evidence obtained from Bogotá and Medellín offers a challenge for governments to look beyond the availability of legal and regulatory restraints and remedies. Why and how these can be effectively undermined by organ trade participants without necessarily affecting or reversing their economic behavior are pressing issues that demand immediate attention.

Keywords

Broker Cadaveric Living donor Organ transplantation Organ vendor Underground trade 

Notes

Financial Disclosure

None

Conflict of Interest

The author confirm that there are no relevant associations that might pose a conflict of interest.

References

  1. Becker GS, Elias JJ (2007) Introducing incentives in the market for live and cadaveric organ donations. J Eco Pers 21:2–24Google Scholar
  2. Casas, J.G.L. (2008). Informe Colombia VII Reunión Red Consejo Iberoamericano de Donación y Trasplante. Mexico, November 16–18.Google Scholar
  3. Cherry M (2005) Kidney for Sale by Owner: Human Organs, Transplantation, and the Market. Georgetown University Press, GeorgetownGoogle Scholar
  4. Dailey, K. (2009). Body Parts à la Carte: What Living Organ Donors Can Spare. Newsweek. July 24.Google Scholar
  5. Danziger, R (2006). Human Trafficking. International Organization for Migration, Japan. Available at http://www.iomjapan.org/archives/IOM_RD_CTpresentation_25Feb2006.pdf (accessed December 9, 2009).
  6. Fabregas L. (2007). Transplant ‘tourism’ questioned at medical centers in Colombia. Pittsburgh Tribune Review. February 18.Google Scholar
  7. Friedman A (2002) Payment for living organ donation should be legalized. BMJ 333:746–748CrossRefGoogle Scholar
  8. Goodwin M (2006) Black Markets: The Supply and Demand of Body Parts. Cambridge University Press, CambridgeGoogle Scholar
  9. Goyal M et al (2002) Economic and health consequences of selling a kidney in India. JAMA 288:1589–1593CrossRefPubMedGoogle Scholar
  10. Hamer RA, El Nahas AM (2006) The burden of chronic kidney disease is rising rapidly worldwide. BMJ 332:563–564, March 11CrossRefPubMedGoogle Scholar
  11. Harris J (2002) An ethically defensible market in organs. BMJ 325:114–115CrossRefPubMedGoogle Scholar
  12. Hou S (2000) Expanding the kidney donor pool: Ethical and medical considerations. Kidney Int 58:1820–1836CrossRefPubMedGoogle Scholar
  13. Instituto Nacional de Salud. Donación y Trasplante de Órganos y Tejidos. Available at http://www.ins.gov.co/?idcategoria=1258 (accessed November 2, 2009).
  14. Interlandi, J. Health: Not Just Urban Legend. Newsweek, January 19, 2009.Google Scholar
  15. Laughlin B (1981) Black Markets around the World. Loompanics Unlimited, WashingtonGoogle Scholar
  16. Lim Y, Kim W (2008) The global impact of hepatic fibrosis and end-stage liver disease. Clin Liv Dis 12:733–746CrossRefGoogle Scholar
  17. Moazam F, Zaman R, Jafarey AM (2009) Conversations with kidney vendors in Pakistan: an ethnographic study. Hastings Cent Rep 39(3):29–44CrossRefPubMedGoogle Scholar
  18. Moreman CM (2008) Beyond the Threshold: Afterlife Beliefs and Experiences in World Religions. Rowman & Littlefield Publishers, Inc., Lanham, MDGoogle Scholar
  19. Naqvi SAA et al (2007) A socioeconomic survey of kidney vendors in Pakistan. Transp Int 20:934–939CrossRefGoogle Scholar
  20. Padilla BS (2009) Regulated compensation for kidney donors in the Philippines. Curr Op Org Transpl 14:120–123CrossRefGoogle Scholar
  21. Rensa, P. (2008). Human Tissue. Mi Cirugía en Colombia, November. Available at http://www.micirugiaencolombia.com/articulo.phphome=1&seccion_id=8&articulo_id=93&idioma_id=2 (accessed May 7, 2009).
  22. Reuters World Report (1996). Colombia Cracks Down on Trafficking in Human Organs. October 11.Google Scholar
  23. Roth, A. E., Sonmez, T., Unver, M. (2005). Efficient Kidney Exchange: Coincidence of Wants in a Structured Market. Microeconomics.Google Scholar
  24. Roth AE (2007) Repugnance as a constraint on markets. J Eco Pers 21:37–58CrossRefGoogle Scholar
  25. Satel S (ed) (2009) When Altruism Isn’t Enough: The Case for Compensating Kidney Donors. AEI Press, Washington D.CGoogle Scholar
  26. Scheper-Hughes N (2002) Should Markets Be Allowed to Solve the Shortage in Body Parts? In: Swartz TR, Bonello F (eds) Taking Sides: Clashing Views on Controversial Economic Issues. McGraw-Hill/Dushkin, CTGoogle Scholar
  27. Sharp LA (2000) The commodification of the body and its parts. Ann Rev Ant 29:287–328CrossRefGoogle Scholar
  28. Steering Committee of the Istanbul Summit (2008) Organ trafficking and transplant tourism and commercialism: The Declaration of Istanbul. Lancet 372:5CrossRefGoogle Scholar
  29. United Nations. Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime. 2000.Google Scholar
  30. United States House of Representatives. (2009). Organs for Sale: China's Growing Trade and Ultimate Violation of Prisoners’ Rights. Hearing before the Sub-Committee on International Operations and Human Rights, Serial No. 107-29, Washington D.C., June 27, 2001, Available at http://commdocs.house.gov/committees/intlrel/hfa73452.000/hfa73452_0f.htm (accessed July 8, 2009).
  31. Uy, J. Filipino kidneys cheapest in world black market, says NGO. Philippine Daily Inquirer, March 31, 2008.Google Scholar
  32. World Health Organization. (2004). In Focus: Organ Trafficking and Transplantation Pose New Challenges. Bulletin of the World Health Organization, 82 (September), 9.Google Scholar
  33. World Health Organization, FACTBOX: Five organ trafficking hotspots, Geneva, August 2005.Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Cherry HillUSA

Personalised recommendations