Susanne Lundin: Kidneys for sale - and there are plenty of takers

The website Philippines is an online portal that allows service providers and consumers to find and interact with each other. Naoval, an Indonesian man with "AB blood type, no drugs and no alcohol", wants to sell his kidney. Another man says: "I am a Filipino. I am willing to sell my kidney for my wife. She has breast cancer and I can't afford her medications." Then there is Enrique, 21, who is "willing to donate my kidney for an exchange".

Other offers of this type could, just a few years ago, be found at, which promised kidneys for the equivalent of 50,000-70,000. The cost of the operation, including the fees of the surgeons - licensed in the United States, Great Britain, or the Philippines - would be included in the price.

All of this internet activity is but the tip of the iceberg of a new and growing global human-tissue economy. Indeed, the World Health Organisation has estimated that about 10 per cent of organ transplants around the world stem from purely commercial transactions.

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Trade in organs follows a clear pattern: people from rich countries buy the organs, and people in poor countries sell them. In my research on organ trafficking, I have entered some of these shadow markets, where body parts from the poor, war victims and prisoners are bought or stolen for transplant into affluent ill people.

One woman, originally from Lebanon, told me a wealthy businessman from Spain paid a huge sum for her kidney. But in the end she received no monetary payment and today, her life is much worse than before, because medical complications make it difficult for her to work. Similar stories are told by organ vendors I have met from the former Soviet states, the Middle East and Asia.

Organ trafficking depends on several factors. One is people in distress. They are economically or socially disadvantaged, or live in war-torn societies with prevalent crime and a thriving black market. On the demand side are people who could die if they don't receive an organ transplant. Then there are organ brokers, who arrange the deals between sellers and buyers.

Well-equipped clinics and medical staff are also needed. Such clinics can be found in many countries, including Iran, Pakistan, Ukraine, South Africa, and the Philippines.

The Philippines is known as a centre of the illegal organ trade and a "hot spot" for transplant tourism. From the 1990s until 2008, when a new policy was adopted, the number of transplants involving organ sales by Filipinos to foreign recipients increased steadily.

Hector is one of the several hundred cases of kidney vendors documented by social workers in three impoverished towns in Quezon province. His brother was trapped in Malaysia with high debts to criminal gangs, so Hector sold his kidney in order to buy his freedom.Another vendor, Michel, became a broker himself: after selling one of his kidneys to pay for his father's medicines, the surgeon forced him to deliver more organs. The organs were transplanted into recipients mainly from the Philippines, Israel, Japan, South Korea and Saudi Arabia.

Trade in humans and their bodies is not new, but today's businesses are historically unique, because they require advanced biomedicine, as well as ideas and values that enhance the trade in organs. Western medicine starts from the view that human illness and death are failures to be combated. It is within this conceptual climate - the dream of the regenerative body - that transplant technology develops and demand for biological replacement parts grows.

One of the more obvious manifestations of treating the human body as a resource to be mined is the hospital waiting list, used in many countries. A man I interviewed recently for a study of Swedes who had been on the waiting list, but who decided to buy kidneys abroad, described to me his trip to Pakistan for the transplant: "I'm not the kind of man who uses other people, but I had to. I had to choose between dying and getting back my life."

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There is no way around this dilemma. The biological imperatives that guide the priority system of waiting lists are easily transformed into economic values. As always where demand exceeds supply, people may not accept waiting their turn - and other countries and other peoples' bodies give them the alternative they seek.

• Susanne Lundin is professor of ethnology at Lund University, Sweden.