(Minghui.org) In 2006, The Epoch Times newspaper broke a stunning story about what is undoubtedly one of the most horrible atrocities to be committed by any government, not only in modern times, but in all of recorded history. As documented in the investigative report, "Bloody Harvest," by noted human rights lawyer David Matas and former Canadian Secretary of State for the Asia-Pacific region David Kilgour, there is overwhelming evidence of the Chinese Communist regime's chilling role in systematically murdering Falun Gong practitioners, harvesting their organs while they are alive, and making huge profits from doing so. In response to the international outcry, the Chinese regime has attempted to explain away one of the main pieces of circumstantial evidence--the meteoric rise in the number of organ transplantations in recent years and the extremely short wait times in a culture notoriously averse to organ donation--by stating that it has harvested organs from executed criminals after their deaths. Faced with undeniable evidence, it has attempted to escape culpability for a monstrous atrocity by admitting to a lesser crime. In this report, we will show evidence that directly contradicts this claim and lends further credence to the serious charges leveled against the Chinese regime.
Table of Contents
Preface
Chapter I. How many organs can be accounted for by death row inmates?
1. Reference to historical data
2. Numbers based on an "estimation formula"
Chapter II. Organ matching issues
1. Tissue matching
2. Probability of Human Leukocyte Antigen (HLA) matching
3. Probability of blood type matching
4. Match requirements for liver transplants
Chapter III. Number of death row executions
1. Number of annual executions of death row inmates in China
2. No large-scale Strike-Hard campaigns from 2003 to the present
Chapter IV. Estimating the upper limit on suitable organs that can be derived from death row "donors"
1. Tissue matching - a bottleneck with death row "donors"
2. Critical time window dictated by cold ischemia
3. Death row inmates' organs, a one-time resource
4. Factors limiting death row inmate organs
5. Harvesting of death row inmate organs follows the "court-driven model"
6. Legal requirements for an "uncollected bodies" classification
Chapter V. China's organ transplant market skyrocketed in 2003
Chapter VI. Unprecedented market conditions for organ transplants between 2003 and 2006
1. Extraordinarily short waiting periods previously unseen
2. Expensive fees make organ transplants tremendously profitable
3. China turns into a center for global organ transplant tourism
4. A niche market within China's limited organ market takes off
5. High quality organs used for overseas recipients
6. Sudden disappearance of the abundant donor resources after 2006
Chapter VII. Sources of extra organs
1. Features that likely characterize the new source of organs
2. Illegally detained Falun Gong practitioners - a new source of organs
3. Uncertain whereabouts of many Falun Gong practitioners
4. Blood testing of detained Falun Gong practitioners
5. Detained Falun Gong practitioners - a reservoir for large-scale matching and live organ harvesting
6. Bypassing "the courts" in handling of Falun Gong practitioners to facilitate organ harvesting
7. Live organ harvesting of Falun Gong practitioners follows the "military driven model"
8. Additional open questions
Chapter VIII. Evolution of live organ harvesting
1. Isolated cases
2. Large-scale live organ harvesting
3. A small step from "using death row organs" to "live organ harvesting from Falun Gong practitioners"
Chapter IX. Broadened definition of death row inmates
1. Vulnerable groups broadening the definition of death row inmates
2. Contrasting the tragedy of live organ harvesting contrasts with a "joyful moment" on the White House lawn
3. Revelation of Gresham's Law - demonizing propaganda drives indifference to life
Chapter X. The killing of a beggar and a homeless person reveals lack of bottom line in Chinese doctors' ethics
1. Organ deal behind the death of a beggar
2. Homeless person killed for his organs
Chapter XI. Additional evidence
1. Whistleblowers expose live organ harvesting
2. Recordings from telephone investigations
3. Testimony from intermediaries
4. Testimony from Falun Gong practitioners and other inmates
5. Investigative report by David Matas and David Kilgour
Chapter XII. The Chinese Communist government's reactions to allegations of organ harvesting from living Falun Gong practitioners
1. Sujiatun cover-up
2. Third party investigators denied visas
3. Denying the validity of the evidence so far collected
4. Suddenly expediting the overhaul of the organ market
5. Use of death row organs: from outright denial to a high profile admission
6. Another peak in organ transplants?
Chapter XIII. What can you do?
1. An excerpt from Karski: How One Man Tried to Stop the Holocaust
2. Even a single case of live organ harvesting amounts to a monumental crime
3. So-called "economic miracles" are no excuse for persecution
4. What can you do?
Appendices
1. Technical difficulties in organ transplants
2. Liver transplant charts from two hospitals with close ties to the Chinese military
3. Published organ transplant statistics by Chinese experts
4. Organ transplants in underground hospitals
5. Organ transplant statistics provided by Huang Jiefu and Shi Bingyi
6. Organ transplants in other countries
7. Average waiting period for organs in Chinese hospitals
8. Cost of organ transplants
9. Guarantee of donor quality
10. Disappearance of Organ Transplant Chapter from the China Medical Association website
11. "Organ deal behind the death of a beggar" - South Wind Window magazine
12. "Where did the organs come from?" - cover story from Caijing magazine revealing a case of killing for organs
Preface
Between 1999 and 2007, China's organ transplant market experienced rapid growth. In 2003, the number of organ transplants in China mushroomed. From 2003 to 2006, a record number of overseas "organ transplant tourists" rushed to China, attracted by the incredibly short average waiting periods of only one to two weeks, compared to waiting periods ranging from two to three years in other countries. This begs the question: Where did all these transplant-ready organs come from?
The Chinese Communist regime used to deny harvesting organs from executed death row inmates. Now they say that most of these organs came from death row inmates.
The question is, was the number of death row prisoners alone able to sustain the drastically growing demand in China's organ market between 2003 and 2006?
In March 2006, when a whistleblower alerted the world to the possibility of live organ harvesting from Falun Gong practitioners in China, a potentially new source of organs emerged.
"The explanation that most of these organs come from death row inmates is inconclusive. If so, the number of executed felons must then be much higher as so far assumed," said Manfred Nowak, the United Nations Special Rapporteur on Torture, in an interview with the Epoch Times. [1]
In a report published in November 2008, the United Nations Committee Against Torture stated that it "takes cognizance of the allegations presented to the Special Rapporteur on Torture who has noted that an increase in organ transplant operations coincides with the beginning of the persecution of [Falun Gong practitioners]." [2]
The Congressional-Executive Commission on China stated in its 2009 annual report that "In the past year, allegations of organ harvesting from non-consenting Falun Gong prisoners have emerged again, further raising concerns about possible abuses in China's organ transplant industry." [3]
The official Chinese response was to deny these allegations, as they had consistently done previously when allegations of the use of death row organs had arisen in the past. Moreover, the Chinese government rejected numerous requests for third party independent investigations. Meanwhile, China's organ transplant market peaked between 2003 and 2006, the period during which the alleged live organ harvesting from imprisoned Falun Gong practitioners occurred.
Starting in 2007, the Chinese government began to reorganize its unregulated organ transplant market and introduced several acts to regulate transplants. During that time, the number of organ transplant hospitals was reduced from over 600 to 160. The international organ transplant community welcomed these changes. As the world focused on the allegations of live organ harvesting from Falun Gong practitioners, the Chinese government for the first time in history openly stated that most of the organs came from death row inmates. One has to question the motivation behind this high profile admission and whether the Chinese government was attempting to cover up an unimaginable evil by confessing to a lesser crime.
In November 2009, Seraphim Editions, a Canadian book publisher, published Bloody Harvest, The Killing of Falun Gong forTheir Organs. Its coauthors, David Matas, a human rights lawyer who received the Order of Canada for his human rights work, and David Kilgour, a former crown prosecutor and former Member of Parliament, produced a damning body of evidence and used deductive reasoning to conclude that the allegations were indeed true.
This report focuses on the Chinese Communist government's attempt to cover up the allegations of the harvesting of organs from living Falun Gong practitioners, taking into consideration that Chinese officials consistently denied the use of death-row organs in the past but later admitted to this practice. Using publicly available data and materials, we are providing a gross estimate of the annual number of death row executions and eligible death row "donors" to calculate the total quantity of organs available if death row inmates were the only source. Our estimates closely parallel historical data and indicate that the increase in death row organs has kept pace with the increase in death row executions at a relatively steady rate. We further conclude that, based on the massive increase in the number of organ transplants between 2003 and 2006, death row organs alone could not possibly have met market demands. In China, voluntary organ donations have traditionally been rare. This raises concerns about the source of the additional organs, and allegations of organ harvesting from living Falun Gong practitioners suggests a plausible explanation.
This report also looks at the limited number of death row donors, provides circumstantial evidence of live organ harvesting from Falun Gong practitioners, and delves into the reasons behind the shift from using death row donors to live Falun Gong practitioners. In particular, the report points out several extraordinary occurrences in China's organ market during its peak activity between 2003 and 2006
It is our hope that this report will cause other whistleblowers to come forward with information. We urge those who have participated in live organ harvesting not to keep silent and to follow their conscience wisely to reveal the truth so they can atone for the crimes they may have committed, knowingly or unknowingly. We hope that the international community will put pressure on the Chinese government to stop its persecution of Falun Gong, and allow third party independent investigations into the allegations of live organ harvesting from Falun Gong practitioners.
Authors' note: The reason this report focuses on the period between 2003 and 2006 is because data published by the Chinese government showed a sudden, massive growth in the number of organ transplants during that time. It by no means suggests that live organ harvesting from Falun Gong practitioners did not exist at other times since the start of the persecution of Falun Gong in 1999. As long as the persecution continues, we have no reason to believe that this atrocity has stopped.
Chapter I. How many organs can be accounted for by death row inmates?
1. Reference to historical data
It is probably not possible to get an accurate count of organ transplants performed with organs derived from death row inmates between 2000 and 2008. However, historical data may serve as a reference. For this discussion, we have divided the period from 2000 to 2008 into three phases: prior to 2003, between 2003 and 2006, and after 2006. We suspect that between 2003 and 2006 a large number of Falun Gong practitioners were victimized as live sources of organs. But let us first take a look at the time periods before 2003 and after 2006 to analyze the number of organs from executed death row inmates. Assuming that the number of organs prior to 2003 and after 2006 from death row inmates was stable, this should allow us to extrapolate the numbers accounted for by death row inmates between 2003 and 2006. Any significant increase in organ harvesting between 2003 and 2006 will then raise questions about the sources of those organs for that time period.
According to official reports, from 2000 to 2008, the percentage of organs donated for transplant purposes by family members of the patient increased each year. At the same time, the percentage of organs accounted for by death row inmates was decreasing. The number derived from unrelated donors post-mortem remained insignificant throughout. In 1999, family donors accounted for 2% total organ transplants. In 2004, the number was at 4%. [4] In 2006, it had risen to 6%. According to authoritative sources quoted by China Daily, by 2008 and 2009, related donors accounted for 40% all organ transplants, and nearly 60ame from death row inmates, while organs taken from unrelated donors post-mortem accounted for only 130 cases. [5] China's Caijing magazine (No. 24, 2005) reported that "950rgans were from cadavers, almost all of which were executed death row inmates." [6] Life Week magazine reported in 2006, "Control of 98% the sources of organs for transplantation in China resides outside the system of the Ministry of Health." [7] The China Liver Transplant Registration website listed incomplete statistics on liver transplants from 1999 to 2006. Although the total numbers listed were far below the actual number of transplants performed across China, it is useful in showing the percentage of live organs among all organs transplanted, which confirmed that live organs accounted for a very small percentage prior to 2006. [8]
Sources of organs for organ transplantation provided by Chinese officials are shown in the following chart:
Number of organs derived from death row inmates prior to 2003 and after 2006
The data mentioned above indicate that over 95% the organs came from death row inmates between 2000 and 2002. By 2008, this number had dropped to around 60%. If we only consider kidney and liver transplants as an example, according to data provided by Huang Jiefu, deputy minister of China's Health Ministry, there were 6,000 to 6,500 organ transplant surgeries between 2000 and 2003. [9] Shi Bingyi, director of the Organ Transplant Center of the People's Liberation Army (PLA), provided 2008 data when he was a guest at Xinhuanet.com in September 2009. He said that there were "between 3,000 and 4,000 liver transplants and over 6,000 kidney transplants" in 2008. [10] In other words, the combined count of liver and kidney transplants ranged from 9,000 to 10,000. Based on an official claim published by China Daily, that 650rgans came from death row inmates, the number of organs derived from executed prisoners would be 65% 9,000 to 10,000, that is, between 5,850 to 6,500.
However, the years between 2003 and 2006 were significantly higher in terms of total transplants performed. There were 12,000 to 20,000 cases annually during that period (see details in Chapter V of this report). This cannot be explained if executed death row prisoners were the only source.
Economist Thomas Rawski from the University of Pittsburgh conducted a study in 2000 on China's GDP statistics. Based on public data released by the Chinese Communist Party (CCP), China's accumulated GDP growth was 24.7 0uring the three years between 1998 and 2000. However, energy consumption decreased by 12.8 0uring the same period. Rawski thought this was impossible. He concluded that the CCP falsified the GDP numbers. Despite the controversy over this study, one thing is clear: The CCP has not been able to produce falsified numbers without introducing inconsistency. If we study the official data, it is possible to reveal the CCP's contradictions.
2. Numbers based on an "estimation formula"
The actual number of organs taken from executed death row inmates can be estimated using various other sources. Historical data has provided the approximate number of organs from death row inmates annually, which is around 6,000. We used a formula to estimate how many organs death row inmates could account for.
The estimation formula is as follows:
Total number of organs (kidney and liver) from death row inmates =
Annual number of death row inmates executed X
Percentage of death row inmates executed with suitable organs X
Number of organs an executed death row inmate can provide X
Percentage of organs suitable for transplantation in an individual
We based our estimate on kidney and liver transplants because China's transplant experts often only consider these two organs when providing data. In fact, transplants of other organs are relatively rare. Therefore, the kidney and the liver are the most useful indicators for our purposes. The variables in our estimation formula are based on an assortment of publicly available data. At the outset we made assumptions about the total number of annual executions of death row inmates. We assumed that the total number of annual executions is 10,000. If the percentage of death row inmates executed whose organs can be used is 30%, the maximum number of organs an executed death row inmate can provide is three (two kidneys and one liver), and the percentage of an individual's usable organs is 75%. We set these variables near the upper limit of their ranges, which may slightly overestimate the number of organs available from death row inmates each year. The result of our calculation is as follows:
Estimate of maximum number of organs (kidney and liver) supplied annually by death row inmates in China
Annual number of death row inmates executed | Percentage of death row inmates executed whose organs can be used | Number of organs an executed death row inmate can provide | Ratio of an individual's usable organs | Number of organs (kidney and liver) supplied annually by death row inmates | |
Estimate | 10,000 | 30% | 3 | 75% | 6,750 |
The result indicates that the maximum number of organs (kidney and liver) derived from executed death row inmates annually is approximately 6,750. This correlates well with historical data. As mentioned earlier, between 2000 and 2002, and again in 2008, this number ranged between 6,000 to 6,500. Since our estimate used the upper limits of the variables, our result is quite reasonable.
Explanation of variables in the estimation formula
1) "Percentage of organs suitable for transplant in an individual"
An executed death row inmate can supply two kidneys and one liver (with other organs out of consideration in our current calculation). However, not all three organs always turn out to be useable. As a special source of organ supplies, death row inmates are executed in different locations or at different times. Without an organ sharing network, even if an inmate has multiple organs for supply, not all of the organs may be used. The newspaper China Medicine stated in the article "Establish an organ transplant registration network" that without such a network, sometimes only kidneys were taken from a supplier while other organs were wasted. [11]
Despite this constraint, we use the 75% value in the above formula to make our subsequent analysis more convincing.
2) "Number of death row inmates executed annually" and "percentage of death row inmates executed whose organs can be used"
One may wonder why we set the annual number of death row inmates executed at 10,000 instead of 20,000, and why we set the percentage of death row inmates executed whose organs can be used at 30 0nstead of 500r 80%. This will be analyzed in more detail later. At this point we will look at the issue of organ matching because it is an important factor in one of the variables of the formula.
Chapter II. Organ matching issues
A major issue with organ transplantation is transplant rejection by the recipient. The human body's immune system protects the body and prevents unknown objects from entering. If the object appears to be an "uninvited guest" or "enemy," the immune system will try its best to force the object out. For example, a newly transplanted kidney can help the patient excrete waste products, but the immune system will forever recognize the transplanted kidney as foreign.
1. Tissue matching
The purpose of tissue matching is to reduce transplant rejection. The following are some primary concerns in measuring tissue compatibility:
ABO blood group type - having the same blood type is ideal. The two blood types need to at least tolerate each other and meet the requirements for a blood transfusion.
Cross-match test - a test of the recipient's serum and donor's red cells (main test) and a test of the recipient's red cells and donor's serum (secondary test). Even when the blood types are the same, a cross-match test is mandatory prior to a kidney transplant. A negative test result indicates that the transplant will not be rejected.
Stem cell toxicity test - for a transplant to be successful, the result of this test has to be negative. This test shows how the recipient's serum will work with the donor's stem cells. If the rate at which the cells are killed is below 10 percent, the result is negative; if the rate is between 10 and 15 percent, the result is a weak positive; and if the rate is over 15 percent, the result is positive.
Panel Reactive Antibody (PRA) test - a method of measuring anti-human antibodies in the blood. A person's PRA indicates the percentage of donors whose tissue can be bonded with the antibodies in the recipient's blood.
Human Leukocyte Antigen (HLA) matching - this identifies the types of antigens found in white blood cells and other tissues in the body. HLA antigens are the "personal identification card" of human biology. Two haplotypes, consisting of a set of three antigens each (six antigens total), make up each person's HLA. One haplotype comes from the father and one from the mother. Therefore, the probability of two siblings having identical HLA (the same two haplotypes) is one in four. The probability of unrelated people having identical HLA is almost zero. An HLA test is used to provide evidence of tissue compatibility and performed for potential kidney, bone marrow, liver, pancreas, and heart transplants. The probability that a transplant will be successful increases with the number of identical HLA antigens.
2. Probability of Human Leukocyte Antigen (HLA) matching
There are common, rare, and extremely rare types of HLA antigens. For a common HLA type, a match can be found within 300 to 500 people. The probability of finding a rare type match is one in ten thousand, and the probability of finding an extremely rare type match is one in several tens or hundreds of thousands. [12]
From a medical point of view, the probability of having two unrelated people matched to the final stage of transplantation is one in several million.
According to the National Marrow Donor Program's website, http://www.marrow.org/, out of 4,000 volunteers, roughly 200, or 5 percent, can be potential donors, and out of 4.5 of these potential donors, only one can qualify. In other words, only 1.1 percent of the total volunteers can eventually be matched with a given recipient. The invention and widespread use of immunosuppressive drugs have, to a certain degree, alleviated the graft rejection caused by inadequate HLA matching. Kidney transplants require matching six HLA antigens. At present, the common practice in mainland China is to match four HLA antigens. The number of matching antigens determines the probability of graft rejection and the need for medication during the late stages of transplantation. The optimum result is to have all six HLA antigens matched. According to media reports, the probability of unrelated people having four matching HLA antigens is between 20 and 30 percent. [13] The deputy director of Urology and Transplantation at the Shanghai No. 1 Hospital quoted a similar ratio during an interview with Morning News reporter Fan Yi. [14]
3. Probability of blood type matching
In China, the distribution of human ABO blood types differs among regions. The following table shows the distribution of ABO blood types in Guangdong and Beijing. [15]
Region | O | A | B | AB |
Guangdong | 46 | 25 | 23 | 6 |
Beijing | 29 | 27 | 32 | 13 |
From this data, we can calculate the probability of identical blood type matching. For the Guangdong region, it is 33 percent, and for the Beijing region, it is 28 percent. That means that the probability of identical blood type matching among the Chinese population overall is around 30 percent.
4. Match requirements for liver transplants
From an immunological perspective, the liver is considered an "immune privileged organ," and, therefore, unlike other organs, matching requirements between liver donor and recipient are not as strict. Ideally the donor and the recipient should have matching blood types, or at least meet the requirements for a blood transfusion, but there are no strict requirements regarding the lymphocytotoxicity test. Although HLA matching is still performed, neither the lymphocytotoxicity test nor HLA matching has any real clinical significance for liver transplants. However, there are other requirements for a potential liver donor: 1) Age - under 50. 2) Healthy liver - no liver disease; HBsAg negative; no active hepatitis; no high blood pressure, arteriosclerosis, or other diseases that might impact the quality of the liver. 3) No tuberculosis. 4) No cancer. 5) No severe infection. 6) Death did not occur long after the donor was in a coma, i.e., the donor had sufficient blood circulation in the liver prior to death. 7) Size of the liver close to, or a bit smaller than, that of the recipient.
China has a large population of hepatitis carriers. In his interview with Yangzi Evening News, Zhao Wei, vice president of the Nanjing No. 2 Hospital and a Hepatitis B expert, told the reporter that the Hepatitis B virus has a high infection rate: approximately 57.6 percent of the Chinese population has been infected at some point, and there are roughly 120 million current Hepatitis B carriers.[16] Article 31 of the "Interim Provisions of the Administration of the Clinical Applications of Human Organ Transplant Technologies" also stipulates that hepatitis carriers and other patients with infected blood cannot qualify as organ donors.
This means that, although there is no strict HLA matching requirements for liver transplants, there is still an acute shortage of liver donors due to the requirements mentioned above.
Chapter III. Number of death row executions
Through our estimates, we have set the number of annual death row executions at 10,000. In this section, we will explain how we reached this number.
Some may wonder whether the massively growing organ market was the result of a sudden increase in China's death row executions. According to the article, "The number of death row executions has decreased significantly," posted on Chinanews.com on September 6, 2007, "For more than a decade, the People's Court has continuously been strict and prudent in the use of the death sentence, resulting in the steady reduction of death row executions." [17] Although there is little credibility in the Chinese Communist government's propaganda, it is a fact that there was no sudden, massive increase of death row executions during the peak of China's organ market between 2003 and 2006.
Let us take a look at how organizations outside of China, as well as experts in mainland China, have estimated the number of death row executions in China.
1. Number of annual executions of death row inmates in China
First of all, we need to distinguish the number of death row executions from the number of death sentences. A significant portion of those sentenced to death in China receive a stay of execution. In most cases these sentences are often commuted to time in prison. The aforementioned article on Chinanews.com also quoted Jiang Xingchang, vice president of the Supreme People's Court, who said, "In recent years, in many places in China the percentage of death sentences with a two-year reprieve has come close to, or even surpassed, the percentage of death sentences with immediate execution."
Outside estimates of the number of annual executions of death row inmates in China vary from 1,000 to 10,000. In the article "Facts and Figures on the Death Penalty" published on January 1, 2007, Amnesty International stated, "At least 1,010 people were executed in China during the year, although these figures are only the tip of the iceberg. Credible sources suggest that between 7,500 to 8,000 people were executed in 2006." [18] In its 2007 report, Hands Off Cain, an Italian-based organization against the death penalty worldwide, stated, "In 2006, there were at least 5,628 executions worldwide," and "at least 5,000 executions took place in China." [19] In an interview with the media, Liu Renwen, professor at the Institute of Law, Chinese Academy of Social Sciences, stated that academic circles estimated that roughly 8,000 people were executed annually. In his article "The Puzzle of the Number of Death Row Executions in China," Wang Guangze, a mainland scholar, revealed that according to a veteran criminal defense lawyer in Henan Province, the number of annual executions in Henan Province is over 500 in a non-strike-hard year, and can reach as high as 800 in a strike-hard year. Wang thus deduced that with 30 provinces, an annual number of 10,000 death row executions in China is highly possible. [20] In March 2004, China Youth Daily reported that while urging the Supreme Court to reconsider all death sentences, the National People's Congress claimed that the country executed approximately 10,000 people every year.
As most of the outside estimates come from organizations that are against the death penalty, it is possible that their estimates are high. In other words, the actual number may turn out to be less than 10,000. Thus, in our calculation, it is safe to use 10,000 as the upper limit.
Some may ask whether there were nationwide strike-hard campaigns that would have increased the number of executions.
2. No large-scale Strike-Hard campaigns from 2003 to the present
Between 1983 and 2002, there were three large-scale nationwide Strike-Hard campaigns: from 1983-1987, from 1996-1997, and from 2001-2002. While it may not be clear to the outside world how many people were executed during these three campaigns, the first campaign between 1983 and 1987 could be referred to as "random killing." The campaign slogans at that time were: "Arrest borderline cases without hesitation;" "Sentence borderline cases without hesitation;" "Execute borderline cases without hesitation." This campaign resulted in grave consequences, so the latter two campaigns changed policy from "taking strict, prompt action" to "combining punishment with leniency," and to "reducing and avoiding the death penalty" and "executing doubtless cases and holding the ones with doubts." There has not been a large-scale Strike-Hard campaign from 2003 to the present. In other words, Strike-Hard campaigns have not played a key role in the massive growth of the organ market.
Chapter IV. Estimating the upper limit on suitable organs that can be derived from death row "donors"
In this section, we will explain why we are assuming that the number of death row inmates with organs suitable for transplantation is 30% the total.
1. Tissue matching - a bottleneck with death row "donors"
In Chapter II and Appendix 1, we have shown that HLA matching is extremely complex. There are seven groups of HLA, with a total of 148 antigens. The possible permutations number well over 2,000,000. Except for twins from the same egg, it is practically impossible to locate a supplier and a recipient with identical HLA. As a result, rejection reaction always follows a homograft. It has to be treated with intense immune suppression. The probability of unrelated people meeting minimum matching HLA requirements (for immunosuppressant drugs to be effective after transplantation) is between 20-30%. Thus, the percentage of death row inmates with matching organs cannot exceed 30% with any significant sample size.
2. Critical time window dictated by cold ischemia
When an organ leaves the human body, the tissue will break down. When a person's heart stops beating, his or her organs will be useful for a 15-minute window, and must be procured promptly and preserved by a special medium at very low temperatures. Even under optimal conditions, the organ must be transplanted within a critical time window because of cold ischemia (cooling of an organ with a cold perfusion solution after organ procurement surgery). With current technology, the critical time window is 24 hours for a kidney, 15 hours for a liver, and 6 hours for a heart. Therefore, in addition to tissue matching, cold ischemia is a second critical restraint. It is simply not yet possible to preserve organs suitably for future needs.
In addition to these technical limitations, there are other important considerations when using organs from death row inmates that will be explained below.
3. Death row inmates' organs, a one-time resource
Organs from death row inmates are a one-time resource. Unlike organs hosted by a pool of living people, organs from death row inmates cannot be reserved for future use. Of course, there are reports that some courts have stayed executions until the hospital found a matching recipient. However, in most cases, executions of death row inmates are a political act for the Chinese Communist regime to maintain its power, and therefore, not every execution can be put on hold for medical reasons. For example, due to perceived political needs, the Chinese Communist regime makes a habit of executing death row inmates on national holidays, such as New Year's Day, May Day, or National Day, to get the most exposure from the event. Quite often, the dictated times of such executions mean that the inmates' organs are not used. Wang Guoqi, formerly a burn specialist at the Paramilitary Tianjin General Hospital in Tianjin, testified before the Subcommittee on International Operations and Human Rights of the United States House of Representatives. In a written statement he stated, "I have removed skin from the corpses of executed prisoners," and further described how he went to the places of execution to remove the organs. Among four inmates executed, only one was a match for organs. Dr. Wang was told to take the corpse to an ambulance within 15 seconds of the gunshot. He and another doctor then took 13 seconds to remove the skin. [21]
4. Factors limiting death row inmate organs
Execution of death row inmates happens in different locations and at various times. Since China does not have an organ sharing network, such as the United Network for Organ Sharing in the United States, the tissue matching of organs from the executed inmates can only take place in or near the area of execution. Therefore, death row inmates are considered a rare resource. Some scholars have pointed out that local courthouses often team up with the local hospitals to protect local interests. This phenomenon makes it much harder for hospitals outside the area to get access to organs. It was not until August 2009 that China announced an experimental organ donation system in ten selected provinces and cities.
The following chart illustrates how death row inmates can be divided into four different groups based on their location and times of execution. In principle, in any given location at any given time, the organs from the executed death row inmates can only be matched with the patients in that specific location at that specific time. Thus, the number of wasted organs is likely to be very high.
For this reason, we fear that detained Falun Gong practitioners have become a reservoir for large scale matching and live organ harvesting, which we will discuss in later sections.
5. Harvesting of death row inmate organs follows the "court-driven model"
On October 9, 1984, China's Supreme People's Court, Supreme People's Procuratorate, Ministry of Public Security, Ministry of Justice, Ministry of Public Health, and Ministry of Civil Affairs promulgated and implemented the "Interim Provisions on Using Cadavers or Organs from the Cadavers of Death Row Inmates," providing legal authority for using organs from executed death row inmates.
While the court, the procuratorate, the detention center, and the hospital are integral parts of the process to harvest the death row inmates' organs, the key party is the court, since it hands down the death sentences and carries out the executions. Prior to execution, the death row inmate is required to undergo blood tests with approval from the detention center. Then the court carries out the execution under the procuratorate's supervision. Both the court and the procuratorate restrict access to the execution site and assist the doctors in harvesting organs from the executed inmates. The Chinese Communist government adopted this process when China's organ transplant market was in its earliest stage and introduced the aforementioned 1984 Interim Provisions to give the process legal authority. It has been following this process since. Phoenix Weekly (number 21, 2005) quoted a source as saying, "Without the Justice Department's approval, it would be impossible for hospitals to harvest organs from executed death row inmates." [22]
The courts play a key role in procuring organs from executed death row inmates
The court-driven model renders the process of using organs from executed death row inmates a rather public, programmed, and sometimes even bureaucratic one, in which the court, the procuratorate, the detention center, and the hospital play integral roles with their own interests in mind. This process is known to human rights watchers, despite the Chinese Communist government's consistent denials until recent years (see Preface). It should be made clear that doctors cannot simply go to the detention center and ask the prison guards for executed death row inmates to harvest the organs. The more parties and steps involved, the less efficient the process of organ harvesting.
6. Legal requirements for an "unclaimed bodies" classification
The 1984 Interim Provisions provided the following guidelines for accepting organs from unclaimed cadavers or those from executed inmates; the guidelines stipulate that cadavers are acceptable if:
They are unclaimed or refused by the family of the executed;
They are voluntarily donated by the death row inmates;
Family of the executed gives consent.
Inevitably, driven by potentially huge financial benefits, some people have found ways to exploit loopholes in these guidelines. For example, in some cases, families were not notified of the time of execution and the bodies remained unclaimed as a consequence. Nevertheless, these guidelines do impose legal restrictions on the use of death row inmate's organs.
Reactions from families of the executed to the embezzlement of death row inmate organs
Since 2000, families of executed inmates have openly complained about the removal of organs without consent. Some have even filed lawsuits. This has increased the uncertainty surrounding the use of death row inmates' organs.
In September 2000, Yu Yonggang from Taiyuan City, Shanxi Province was sentenced to death for robbery and murder. Yu's mother repeatedly stated that the hospital and the court had taken away her son's organs without her consent. She wrote a letter entitled "A Citizen's Tearful Complaint" to bring the matter out into the open, pointing fingers at the relevant government bodies.
In May 2000, Fu Xingrong, a farmer from Jiangxi Province, was executed for murder. The local court sold his kidneys to one of the major hospitals in Jiangxi Province without Fu's family's consent. Out of grief and indignation, Fu's father committed suicide. Fu's sister hired an attorney and filed a lawsuit against the local court.
On September 23, 2003, Lanzhou Morning News reported a case in which a detention center in Gansu Province had "donated" organs from an executed death row inmate without his consent. The local court later ruled that the detention center must pay the family 2,000 yuan as compensation. The director of the detention center admitted to the media that organ donation must have written consent from the death row inmate, and that the detention center did not have any written document from the inmate in this case. [23]
The reactions of families such as these have created hesitation about the use of death row prisoners' organs, at least to a certain degree, and at this time, death-row-derived organs can no longer be considered a broad and readily-available resource.
Other considerations include age (ideally, the 'donor' should be between 20 and 30) and health status. Many inmates are addicted to cigarettes, alcohol, and drugs, which makes them less than ideal donors.
All of this explains the relatively low percentage of potentially useful organs that can be derived from death row "donors." We have discussed how a poorly matched organ directly impacts the quality of the transplant surgery. If a high number of patients were to die on the operating table or have a short survival time after the surgery, it directly impacts the surgeon's reputation and career. It stands to reason, then, that the transplant surgeon prefers not to use a randomly sourced organ in surgery. In summary, we consider a figure of 20-30% suitable organs derived from death row inmates a reasonable, if not optimistic, estimate, and in our calculations, we have settled on the 30% figure as the upper limit.
Due to these limitations on the use of death row prisoners' organs, the annual number of organs from executed inmates is probably around 6,000. Yet, between 2003 and 2006, there was a massive growth in China's organ transplant market. Clearly death row prisoners' organs alone did not meet this skyrocketing demand.
Chapter V. China's organ transplant market skyrocketed in 2003
According to Huang Jiefu, deputy Minister of Public Health, "The number of organ transplants in China has grown rapidly in the past ten years between 1997 and 2007." [24] In a story published by Nanfang Zhoumo, "China stops organ transplant tourism," Huang criticized the explosive growth of organ transplants in hospitals: "There are more than 600 hospitals and over 1,700 doctors engaged in organ transplant surgeries. This is way too many!" [25] By comparison, there are approximately 100 hospitals in the United States specialized in liver transplant surgery and less than 200 specialized in kidney transplant surgery. In Hong Kong, there are only three hospitals, and each is specialized in liver, kidney, and heart transplant surgery respectively. The statistics published by the Tianjin Oriental Organ Transplant Center and the No. 2 Hospital of the Second Military Medical University (also known as Shanghai Changzheng Hospital), two hospitals that have close ties to the Chinese military, provide a glimpse into the rapid growth of China's organ transplant market. (Appendix 2)
Chinese experts' figures on organ transplants, although they vary, clearly indicate the massive growth in China's organ market in the past ten years. (Refer to Appendix 3 for exact data.) Between 2003 and 2006, underground hospitals emerged as well (Appendix 4). The organ transplants from these underground hospitals are very likely not included in the public statistics. Therefore, the number of actual organ transplants during this period should be higher than the public data.
Using the data provided by Huang Jiefu, and Shi Bingyi, director of the Organ Transplant Center of the People's Liberation Army, as well as reports by the Chinese media, we have created the following table to show the trend in China's organ transplant market. (See Appendices 3 and 5 for detailed background information.) In it, we have divided the period from 2000 to 2008 into three phases: prior to 2003, between 2003 and 2006, and after 2006.
2000 - 2008: Three phases in China's Organ Transplant Market
Timeframe | Annual No. of Organ Transplants | Main source of donors | |
Phase I | Prior to 2003 | Averaged around 6,000 since 2000 (with even lower numbers prior to 2000) | Death row inmates |
Phase II | Between 2003 and 2006 | 12,000 in 2004; other estimates placed the 2005 number at 15,000, and 2006 numbers at 20,000; no conclusive national data available for 2003, however, in a leading military organ transplant hospital, there was an increase of nearly 60% from 2002 to 2003 (with 801 cases), which then almost doubled to 1,601 cases in 2004 (claimed by the hospital website to be the highest number of organ transplant operations in the world in 2004) | Death row inmates and other unknown sources |
Phase III | 2007 and later | Dropped approximately 40% by 2008 (no conclusive national data available for 2007) | Death row inmates and living donors among relatives |
Although the number has dropped significantly since 2007, it is still higher than the period prior to 2003. According to the Chinese government, the higher number is due to the increase of living donors among relatives as a result of vigorous promotions. At present, 40% of organs come from living donors among relatives. [26]
But this doesn't address the sudden, large increase in transplants from 2003 to 2006.
The question is, who was the source of organs that caused China's organ transplant market to skyrocket?
The number of organ transplants during the ten-year period between 1997 and 2007 was relatively stable in other countries around the world. In Canada, the number of organ transplants rose from 1,500 in 1997 to 2,200 in 2007, while in the United States the number rose from 20,000 in 1998 to 27,000 in 2008 (Appendix 6). Yet in China, after a relatively stable period between 1997 and 2002, there was a sudden, rapid growth of transplants. After the allegations of live organ harvesting of Falun Gong practitioners emerged in 2006, the number of transplants dropped drastically. China does not fit the worldwide pattern.
Chapter VI. Unprecedented market conditions for organ transplants between 2003 and 2006
By now, the readers may ask: Where did all the extra organs come from? Let us take a look at some unique features of the organ transplant market in China between 2003 and 2006.
1. Extraordinarily short waiting periods previously unseen
According to data published by the United States Department of Health and Human Services, the average waiting period for organs in the U.S. is two years for a liver and three years for a kidney. [27] In China, the waiting period for these organs at some hospitals is calculated in weeks.
The following table shows the average waiting period for organs published by three major organ transplant centers in China during the period of 2003 and 2006 versus that in the U.S. Such an extraordinarily short waiting period points to an extraordinary source of organs.
Average Waiting Period for Organs in China and the U.S.
Oriental Organ Transplant Center (Tianjin No. 1 Central Hospital) | Organ Transplant Institute of the People's Liberation Army (Shanghai Changzheng Hospital) | CITNAC, China International Transplantation Network Assistance Center (The First Hospital of China Medical University in Shenyang) | U.S. data from www.organdonor.gov | |
Average Waiting Period | 2 weeks | 1 week for a liver transplant | 1-2 months for a liver. 1 week to 1 month for a kidney. If 1st surgery fails, 2nd surgery within 1 week. | (Liver 2 yrs; Kidney 3 yrs) 230 days for a heart 501 days for a pancreas 796 days for a liver 1,068 days for a lung 1,121 days for a kidney |
(Source: See Appendix 7)
2. Expensive fees make organ transplants tremendously profitable
While fees for organ transplants vary between different hospitals, they are high across the board. Here is an example of fees for different organ transplants published by CITNAC.
Fees for Organ Transplants (U.S. Dollars)
Kidney transplant | $62,000 |
Liver transplant | $98,000 - $130,000 |
Liver and kidney transplant | $160,000 - $180,000 |
Kidney and pancreas transplant | $150,000 |
Lung transplant | $150,000 - $170,000 |
Heart transplant | $130,000 - $160,000 |
(Source: See Appendix 8)
According to a Phoenix Weekly report in 2006, as more and more overseas patients came to China for organ transplants, the fees gradually increased as well. In 2004, the fee for a liver transplant at the Oriental Organ Transplant Center was USD 32,000 (approximately 250,000 yuan). In 2005, it was over USD 40,000 (approximately 330,000 yuan). Some intermediary agencies charged a brokering fee as high as USD 13,000. In addition, overseas patients had to pay monthly fees to interpreters. Staying in the hospital also cost extra. [28] These extra fees explain the higher numbers listed in the table above.
Expensive fees, along with the cheap supply of organs, made organ transplants tremendously profitable. The Organ Transplant Center of the 309th Hospital of the People's Liberation Army stated, "The Organ Transplant Center is one of the most profitable departments. Gross income was 16,070,000 yuan for 2003 and 13,570,000 yuan for January through June in 2004. It is expected that the gross income will exceed 30,000,000 yuan in 2005." [29]
Southern Weekend [Nanfang Zhoumo] reported, "The Oriental Organ Transplant Center's rapid growth has brought about huge revenue and profits. According to previous media reports, liver transplants alone bring the Center an annual income of 100 million yuan (with the exchange rate at 8.11 yuan per US dollar)." [30] In September 2006, the Center put to use a new building with a price tag of 130 million yuan. The new building has 500 beds with a more than 10,000 overall annual turnover rate. The surgery center in the new building can support the operation of nine liver transplants and eight kidney transplants simultaneously. It is the largest, vertically integrated organ transplant center in Asia."
Such profit from organ transplants bore a grave consequence. On the one hand, people with financial means are willing to buy organs at a high cost. On the other hand, the huge profit pushes the hospitals to pursue new sources of organs by all means. Given China's political and legal environment, certain groups of people become especially susceptible targets.
3. China turns into a center for global organ transplant tourism
Given the fees involved, the majority of organ transplant patients in China are made up of:
Overseas patients (global organ transplant tourists)
Rich business owners, celebrities, and Communist government officials in mainland China
A small group of desperate, ordinary patients who exhaust all their financial resources for an organ transplant
According to a Lifeweek magazine report in 2004, most of the domestic patients are those who "have their own businesses or enterprises," or those who "have positions in the government." The report also stated that within a few years, thousands of overseas patients had gone to China for organ transplants, turning China into "a center for global organ transplant tourism." "Besides Korean patients, there are patients from more than 20 countries and regions in Asia such as Japan, Malaysia, Egypt, Pakistan, India, Saudi Arabia, Oman, Hong Kong, Macau, and Taiwan who have come to the Tianjin No. 1 Central Hospital (also known as the Oriental Organ Transplant Center) for organ transplants... The ward café looks like an international conference center where patients of different colors and ethnic backgrounds gather to share their medical experiences." [31] (In July 2007, the Ministry of Public Health in China put a stop on Chinese hospitals performing organ transplant surgeries on foreign patients.)
4. A niche market within China's limited organ market takes off
Exorbitant fees did not make the organ transplant market inaccessible. On the contrary, there was an unexpected, rapid growth in China's organ transplant market starting in 2003, with an annual growth of 5,000 to 10,000 or even more cases of organ transplants.
Every year, approximately 1.5 million people in China need organ transplants due to late-stage organ failures. The scarcity of organs was worse than that in the United States and other countries that have advanced organ transplant procedures. However, starting in 2003, China turned into a center for global organ transplant tourism due to its abundant source of organs. In a 2004 interview with Lifeweek magazine, Zheng Hong, deputy director of the Oriental Organ Transplant Center, proudly stated, "The availability of organs in China is in fact much better than that in other countries." [32]
So what was happening here?
In China's unregulated, overall limited organ market (small market), there is a niche market with abundant availability of organs for special patients (big market). We have to understand this "big market within the small market" phenomenon before we can fully understand the true situation of China's organ market.
In its denial of the allegations of live organ harvesting, the Chinese Communist regime claimed that there were more than 1 million patients in China waiting for organs. It used this as an argument that it was not possible to get matching organs within a short period of time. However, this denial was contradicted by claims at various organ transplant hospitals.
5. High quality organs used for overseas recipients
There were many abnormal phenomena in China's organ market during the 2003-2006 period. Besides the features discussed above, there is another one worth mentioning. The quality of the organs was not compromised as the quantity of organs increased. On the contrary, the quality of the organs supplied between 2003 and 2006 was superb. During the peak of China's global organ transplant tourism, the majority of China's organ transplant recipients were overseas patients. Similar to exported products, the organs used for these patients had much higher requirements.
In the Q&A section on its website, CITNAC provided this answer to the question on organ quality: "The live donor kidney transplant provided in China is completely different from the cadaver donor kidney transplant provided by hospitals and dialysis centers in Japan." "The key to kidney transplants is tissue matching. Before the live donor kidney transplant surgery, we test the functions of the donor kidney as well as the donor's white blood cells to ensure the safety of the donor kidney. It is safe to say that compared to a cadaver donor kidney transplant in Japan, kidney transplants are much safer and more reliable here." (See Appendix 9 for reference.) The 'live donor' characteristic is the selling point to attract overseas patients.
Some independent overseas investigators have phoned organ transplant hospitals in mainland China, posing as patients or patient family members, to inquire about organ transplant information. The answers given were similar: "Donors are all healthy," "Donors are around 30 years old," "Quality is guaranteed to be the best." [33]
6. Sudden disappearance of the abundant donor resources after 2006
Under normal conditions, the availability of organs is rather steady, which, as we discussed earlier, is the case for Canada and the United States, where there has been no major increase or sudden decrease in the past decade. A drastic increase of organs was seen between 2003 and 2006 in China. But after the allegations of live organ harvesting of Falun Gong practitioners surfaced and attracted international attention in March 2006, there was a sudden drop in organ transplants in 2007 in China.
While denying the allegations of live organ harvesting of Falun Gong practitioners, the Chinese Communist regime accelerated the reorganization of its organ transplant market. It introduced several acts to regulate organ transplants and restricted the number of organ transplant hospitals to be by "permission only." Out of more than 600 previously existing organ transplant hospitals, only 160 received permission to continue operations.
Is the reduction in the number of organ transplant hospitals the reason for the reduction in organ transplants? It is certainly not. At least, this is not the root cause. The reduction in the number of permitted hospitals should lessen the competition for organs. If there is no major change to the source of organs, there should now be more organs available to those major hospitals. Yet, the number of organ transplants at these major hospitals has decreased drastically. Therefore, the issue lies in the disappearance of donor resources, rather than the number of organ transplant hospitals.
In an interview with Science Times in May 2007, Shi Bingyi, director of the Organ Transplant Center of the People's Liberation Army and member of the standing committee of the Chinese Medical Association Organ Transplant Society, said, "The number of organ transplants in China reached a historic peak in 2006, in which nearly 20,000 cases of organ transplants were performed. For the first five months in 2007, the number of organ transplants has decreased compared to that of the same period in 2006, largely due to the shortage in organ donors." [34]
An article published in Nanfang Zhoumo in July 2007 describes the issue further: "Organ transplant surgeons complained about the shortage of organ donors." "Zhu Zhijun is the deputy director of the Orient Organ Transplant Center. In his office on the second floor of the Center, Zhu appeared to be worried. He told the reporter that since the Chinese New Year, the Center, which is the biggest organ transplant facility in Asia, has performed only 15 liver transplants in nearly six months, while in 2006, the Center had set a record of more than 600 liver transplants in one year." [35]
Relatively Stable Supply of Death Row Organs
Earlier we assumed that the number of organs from death row inmates is relatively stable. Prior to 2003 and after 2006, the number was around 6,000. Several factors contributed to this stability:
1) Organ transplant technology and the use of immune depressants matured in the late 1990s. There was no sudden increase in the number of organ transplants as a result of breakthroughs in technology.
2) Matching requirements for organ transplants remain high; technology has not lessened these requirements, making the same organ resource relatively stable.
3) Lack of an organ sharing network in China, which means most of the matches take place between a local hospital and local death row inmates. This and local protectionism have limited the scope of matching.
4) Death row sentencing is in lock-step with political direction. With no recent Strike-Hard campaigns, the number of death row executions is relatively stable.
5) The legitimacy of using death row organs, as well as the moral acceptance among Chinese due to years of indoctrination that organ donation is the least contribution death row inmates could make to society, have allowed the organ transplant hospitals in China to care less about pressures from the international community.
Based on the above reasons, it can be concluded that organs from executed death row inmates are a relatively stable source of organs, and not responsible for the spike in 2003-2006, or for the subsequent sharp decline.
Impact of the Supreme People's Court's Ruling on Death Row Organs
On January 1, 2007, the Supreme People's Court reclaimed the right to review death row sentences from the provincial supreme courts, resulting in the reduction of death row sentences. Was this the cause for the severe shortage of organ donors in 2007? It had an impact but was not the root cause. According to a Xinhua News Agency report on March 10, 2008, after the Supreme People's Court's reclamation of reviewing death sentences, 15% of death row sentences were overturned in 2007. [36] This percentage (likely to be overestimated) indicates that the recovery did not have a large impact on organs available from the executed death row inmates. This can be supported by the actual number of organ transplants performed. In the section, "Reference to Historic data" in Chapter I, we quoted China Daily that 65% of organs came from death row inmates in 2008 and 2009, in which close to 10,000 cases of organ transplants were performed each year. That means that approximately 6,000 organs came from death row inmates, which is close to the level between 2000 and 2002.
Therefore, the sudden decrease in organs in 2007 has to be due to the sudden disappearance of other organ resources (although it is still uncertain whether they have completely disappeared).
In conclusion, the rapid growth between 2003 and 2006 and the ensuing quick disappearance of organ resources in China are unprecedented in history and bear unique features that are not supported by the theory that death row inmates were the main source of organs during the years in question.
Since 2007, due to the shortage of organ donors, live related donors have become a new source of organs. Chinese media have also carried out extensive campaigns on this subject in an effort to raise awareness. According to a People's Net report, the Oriental Organ Transplant Center in Tianjin performed 84 cases of live donor liver transplants in 2007 (with a relative donating a partial liver). [37] However, since live donors did not become a major organ resource until after 2006, this does not help explain the period between 2003 and 2006, when China's organ market skyrocketed.
Chapter VII. Sources of extra organs
If the annual number of organs from death row inmates is around 6,000, and with the number of relatives willing to be donors very limited between 2003 and 2006, where did all the extra organs come from to supply the more than 12,000--and as many as 20,000--organ transplants per year?
1. Features that likely characterize the new source of organs
The number of people that make up the donor supply base is larger than the number of current death row inmates.
Because this is an illegal undertaking, the donors need to be readily accessible and just as readily hidden once outsiders discover the new source of organs.
Despite the illegalities involved, the participants bear no legal consequences. In other words, current government policies tolerate the exploitation of this source of organs. Harvesting organs from this source would be "turning waste into a useful thing."
These individuals need to be held in large numbers in given locations to increase the probability of organ matching.
Last but not least, doctors bear no legal responsibility or moral obligation for killing these people for their organs.
2. Illegally detained Falun Gong practitioners - a new source of organs
Using death row organs requires legal authorization. Hospitals cannot casually go to a prison and harvest organs from death row inmates. But what about a group that is outside the justice system and is being suppressed and defamed by the government? And what if there is an illegally detained sizable population of that group? The possibility of this group being an ideal live organ supply base is very high. In particular, organ transplant hospitals for the army and armed police forces would view this as an ideal source. So which suppressed group fits this category?
Since the persecution of Falun Gong began on July 20, 1999, a large number of Falun Gong practitioners have been detained. These detained practitioners were quickly viewed as an ideal source of organs because:
They fall outside the justice system. Many practitioners are sent to forced labor camps without due process. Many practitioners who go to appeal for Falun Gong do not reveal their names and address to protect their families as well as to avoid implicating their workplaces. These practitioners are detained in large, concentrated numbers.
They represent a huge supply base. Practitioners are detained for no other reason than to be persecuted and executed. As a result, the waiting period for organs can be shortened to 1-2 weeks--a most attractive feature that has allowed China to become a center for global organ transplant tourism.
They are available for live organ donations. Live organs are always far better than organs from cadavers and are always the most sought-after by overseas patients who are willing to pay a premium. Use of live organs in transplants also increases the survival rate of patients; this means a live source is attractive to Chinese transplant doctors who are interested in furthering their careers.
The quality of their organs is very high. Contrary to most death row inmates who are addicted to alcohol, cigarettes, and drugs, Falun Gong practitioners are required to refrain from such substances and are generally very healthy. In particular, young practitioners from rural areas are thought to have become a key target for live organ harvesting.
3. Uncertain whereabouts of many Falun Gong practitioners
Since the Chinese Communist Party (CCP)-led campaign against Falun Gong started, practitioners have regularly visited local and Beijing government appeal offices or unfurled banners in Tiananmen Square to draw the world's attention to the violations of Falun Gong practitioners' human rights. The report "The Journey of Falun Dafa: A Bright But Arduous Path" on the Minghui/Clearwisdom website states, "According to internal information from the Public Security Bureau in Beijing, by the end of April 2001 there had been a total of 830,000 arrests of Falun Gong practitioners for appealing in Beijing for the right to practice Falun Dafa. This number does not include those who refused to give their names or were not recorded by the police at the time of arrest." [38] In its "2008 Human Rights Report: China (includes Tibet, Hong Kong, and Macau)," the U.S. Department of State stated, "Some foreign observers estimated that Falun Gong adherents constituted at least half of the 250,000 officially recorded inmates in RTL camps, while Falun Gong sources overseas placed the number even higher." [39]
The CCP adds "implication of workplace" to the ancient practice of "implication of the nine generations of a family"
A phenomenon worth mentioning here is that the CCP has adopted a vicious implication policy in its persecution of Falun Gong practitioners. Members of a practitioner's family can be fired from their jobs; supervisors at the person's workplace can be punished; co-workers can lose their bonuses; in some cases, even local government officials can lose their positions. Through this policy, the CCP isolates Falun Gong practitioners and turns everyone against them. As a result, others are more willing to participate in the persecution. Those who previously sympathized with Falun Gong become resentful when they lose their bonuses, and local government officials do everything they can to prevent Falun Gong practitioners from going to Beijing to appeal so they can save their positions. Local public security members have been dispatched to Beijing to stop local practitioners from appealing to the Central Office of Letters and Calls; the Beijing Office of the local government has turned into a police station to arrest and detain Falun Gong practitioners who have gone to Beijing.
Many Falun Gong practitioners who refused to reveal their names and addresses went missing
Many practitioners who went to appeal refused to reveal their names and addresses to the authorities. Based on practitioners' sharing articles on the Minghui website, resisting the demands to reveal identity and location became a common practice. What has happened to these practitioners? Many of them went missing and likely were detained in large concentration camps. In hindsight, the detention of these practitioners in large numbers would have helped facilitate large scale live organ harvesting.
In their book, Bloody Harvest, The killing of the Falun Gong for their organs, authors David Matas and David Kilgour interviewed many Falun Gong practitioners around the world who had been detained in China. These practitioners all mentioned that they had met many practitioners in detention centers who refused to reveal their names and addresses, and they eventually went missing. At the same time, many of the missing practitioners' families did not know that these practitioners had gone to appeal for Falun Gong and therefore had no idea of their whereabouts. The harsh reality is they do not know where to find their loved ones.
Guo Guoting, a Chinese lawyer living overseas, confirmed that one of his clients, Huang Xiong, whom he represented while he was in Shanghai, was in a similar situation. Huang Xiong went missing from his dorm in Shanghai Jiao Tong University, and his whereabouts remain unknown.
In "New Leads in the Investigation of the Sujiatun Concentration Camp," a practitioner stated, "After December 20, 2000, the number of practitioners sent to detention centers suddenly increased to dozens or even over a hundred each day, whereas previously only about one dozen practitioners would be sent there... All practitioners were assigned a number... Within a few days the cells were full. The guards interrogated them each day and asked for their names. They used electric batons and other forms of torture on the practitioners and also encouraged the inmates to beat the practitioners. Most of the practitioners still refused to tell their names. The guards finally stopped asking and said, 'Ok, if you refuse to tell me, I'll send you to a place where you will tell.'
"In early 2001, groups of practitioners were sent away in big buses in the early morning every other day. An 18-year-old girl from Shandong Province shared the same cell with me. Her number was K28. One morning her number was called by mistake. She got on the bus but later returned. She said all of the practitioners were being taken to northeastern China. Later, the guards openly told us that they were sending the practitioners to northeastern China. During that period, many of them were sent there from Beijing." [40]
Existence of "Concentration Camps"
An insider who worked in a mainland Procuratorate once told us that no forced labor camp or prison in China would detain an inmate who did not have a name or address for long because they could not complete the registration process. These inmates would be transferred to other locations.
Then what happened to those missing Falun Gong practitioners? In March 2006, a whistleblower alerted the world to the possibility of live organ harvesting from Falun Gong practitioners at the Sujiatun Detention Center in Shenyang City, Liaoning Province. Thus, a potential new source of organs was identified.
Shortly afterward, the word "Concentration Camp" began to appear in media reports to describe the facilities where a large number of Falun Gong practitioners were detained.
According to practitioners who were released from the detention centers and the forced labor camps, some detained practitioners who were extremely firm in their belief and refused to be "transformed" were transferred to unknown locations. The existence of the concentration camps provided a possible clue to their whereabouts.
Military-controlled concentration camps
Since the judicial system cannot accept inmates without names or addresses, based on the CCP's usual practice, they would likely let the military take over these cases. According to sources inside the CCP, concentration camps are directly linked to military-controlled areas.
After the allegation of live organ harvesting of Falun Gong practitioners was made public in March 2006, a senior military doctor in the logistics service in the army in Shenyang Military Zone wrote to The Epoch Times and revealed that there were several dozen of such concentration camps around China. He further reminded the outside world to pay attention to military facilities, because organ transplants were being administrated by the military, implying that many military facilities were being used as concentration camps. [41]
The advantages of having the military in charge of the source of organs will be elaborated on in later sections.
4. Blood testing of detained Falun Gong practitioners
Some Chinese prisons have a regulation to provide "periodic physical exams" for inmates. In reality that is hard to carry out. However, the health checklist for Falun Gong inmates is different from the one used for regular inmates. According to a 2004 Xinhuanet website report on the Shanghai Tilanqiao Prison, common physical exam items for regular inmates included "taking blood pressure, listening to the heart and lungs, palpating the liver and spleen area, and taking chest X-rays," which would cost roughly 60 yuan. [42] Blood tests are not done routinely on regular inmates. For detained practitioners, on the other hand, blood tests, which are a key step in organ matching, were very common.
In July 2009, during the taping of "Between Life and Death," New Tang Dynasty Television (NTDTV) interviewed several practitioners who had undergone such blood tests during their detention.
Ms. Gan Na, who currently lives in Toronto, Canada, was from Beijing. She was a former customs official at the Beijing Airport. In 2001, when she was detained for the third time at the Xin'an Women's Forced Labor Camp, she was given a blood test, X-rays, an electrocardiograph test, and eye exams. She told NTDTV, "It seemed very strange to me at the time. The guards at the forced labor camp had never treated us like we were human, yet we were given this thorough physical exam. It felt very strange."
Ms. Zhang Yijie, former director of the Foreign Affairs Office of the International Division of the Ministry of Foreign Trade and Economic Cooperation (MOFTEC), was detained seven times for practicing Falun Gong. The last time she was detained was in June 2001, when she was held at the Beijing Women's Forced Labor Camp. Ms. Zhang said, "MOFTEC used to offer cadres one physical exam every six months. For a routine liver function exam, usually they took a small tube of blood. The amount of blood they took was pretty consistent. But they took more than the usual amount of blood for the blood test in the forced labor camp. We all asked why they took so much blood."
In January 2000, Ms. Zou Yuyun from Guangzhou was taken to Chatou Women's Forced Labor Camp in Guangzhou, where she was detained for 22 months. After she was released from the labor camp, she was arrested and detained in five different brainwashing centers. Ms. Zou told NTDTV, "I was eventually transferred to the brainwashing center in the Tianhe District in Guangzhou. The doctor there took me to the hospital specifically for a very thorough physical exam. They did an electroencephalograph test, and, of course, a blood test, on me."
In Bloody Harvest, authors Matas and Kilgour also interviewed several Falun Gong practitioners who had been detained in China regarding the blood test issue. The blood testing and the physical exams are a puzzling issue for those who had firsthand experience. On the one hand, practitioners were subjected to inhumane torture and mistreatment while in detention. They were pressured to denounce Falun Gong and to sign statements to quit the practice. Since the "transformation" rate is directly linked to the political accomplishments of the local government, torture is commonly used on practitioners, many of whom have been tortured to death. On the other hand, the authorities also carried out systematic blood testing and physical exams on practitioners. Many practitioners have mentioned that the blood testing specifically targeted Falun Gong practitioners. What is more suspicious is that if, indeed, they found any health problem during the physical exam, the authorities would leave that practitioner alone instead of providing medical treatment. In other words, the physical exam was used to find healthy practitioners.
So far we have only gathered information on blood testing in forced labor camps and prisons. We have no information on the practitioners who were put in concentrated detention in undisclosed locations.
5. Detained Falun Gong practitioners - a reservoir for large-scale matching and live organ harvesting
We mentioned earlier that, in principle, in any given location at any given time, the organs from executed death row inmates can only be matched with the patients in that specific location at that specific time. Soon after death row inmates are executed, the organs are no longer usable. As an organ source, they have limitations, because executions take place in different locations at different times. Without an organ sharing system, death row organ matching is a "small sampling" process.
Detained Falun Gong practitioners, on the contrary, can be matched multiple times until a proper match is found. They are a "reserve resource." At the same time, a large number of them have been detained in concentration in several undisclosed locations in China, so they are also a "large sampling resource."
More importantly, the harvesting of organs from living Falun Gong practitioners provides an explanation for all the unique features of the organ transplant market in China between 2003 and 2006.
6. Bypassing "the courts" in the handling of Falun Gong practitioners to facilitate organ harvesting
A key player in using organs from executed death row inmates is the court, which is left out of the process in handling of Falun Gong practitioners, many of whom have been sent to forced labor camps or detained in concentration camps without due process. In addition, CCP authorities discourage Chinese lawyers from representing Falun Gong practitioners, thereby cutting out the judicial system. The practice of harvesting organs from living Falun Gong practitioners thus bypasses the courts and is handled directly between the hospitals and the detention facilities. The consequences are grave:
Without the involvement of the courts, Falun Gong practitioners potentially become a large, unrestricted source of organs.
Without court involvement, hospitals or organ intermediaries deal with the detention facilities directly, without the need to go through any legal procedures or the inconvenience of having to harvest the organ at the site of an execution. The process is much more efficient .
Without court involvement, the perpetrators are worry free. Going through legal procedures means that cases are handled out in the open, subject to restrictions from the outside as well as the families of the donors. The fact that the whereabouts of detained Falun Gong practitioners are unknown to their families makes them easy targets.
A point of clarification: The lack of court involvement only means that there is no legal protection for Falun Gong practitioners while they are being persecuted. It does not mean that the courts have not participated in the live organ harvesting.
Based on available media reports, we have illustrated the following flowchart, which shows the process of live organ harvesting of Falun Gong practitioners:
7. Live organ harvesting of Falun Gong practitioners follows the "military driven model"
A key feature in the harvesting of organs from living practitioners is that the source of organs is controlled by the military and the participating hospitals are dominated by the military or those that have close ties to the military. Due to the nature of military security, the truth is concealed from the outside world.
China has a vast military medical system. There is the General Hospital of the PLA, and each military medical university has its own affiliated hospital. The various branches of the military all have their own hospitals. Organ transplantation is one of the most rapidly developing fields in the military hospitals. Zhang Yanling, Minister of Health of the General Logistics Department of the PLA and former president of the Second Military Medical University, was quoted in a December 17, 2008, article on the Xinhuanet website: "In 1978, there were only three hospitals in the military that could perform kidney transplants. Now there are 40 hospitals in the military that can perform liver, kidney, heart, lung, and multiple organ transplants. This is one quarter of the national total." [43]
The most important enabler for the big leap in military organ transplants has been the control of organ resources.
Life Week magazine reported in April 2006: "98 percent of China's supply of organs is controlled by systems outside the Ministry of Health." In fact, whether it is harvesting organs from executed death row inmates or the harvesting of organs from living Falun Gong practitioners, military hospitals, including armed police hospitals, have the advantage. The non-military hospitals that do large-scale organ transplants all have close ties to military hospitals. In many cases their organ transplant surgeons are from military hospitals.
Military and Armed Police Forces hospitals, as well as hospitals along China's coastline, are the primary impetus behind live organ harvesting
After enjoying rapid growth over a short period of time, the former organ transplant center in the Tianjin No. 1 Central Hospital changed its name to the Oriental Organ Transplant Center, which is the largest in Asia. In 2003, Shen Zhongyang founded the "Liver Transplant Research Institute of the Armed Police Forces" in the General Hospital of Armed Police Forces in Beijing and became its first director. The fact that Shen Zhongyang (and the several transplant facilities he manages) has ready access to organ supplies is largely because this facility is part of the armed police forces.
Shi Bingyi is another key figure that is very active in China's organ transplant community and often in the media spotlight. He is the director of the Organ Transplant Center of the PLA, which is located in the General Hospital of the General Staff of the PLA, also known as the 309th Hospital.
In Bloody Harvest, Matas and Kilgour interviewed several patients who went to China for organ transplants. The surgeons of these patients all had military backgrounds. One of the patients was admitted at the Shanghai No. 1 People's Hospital. His surgeon was Dr. Tan Jianming, who is the chief surgeon of the Fuzhou General Hospital of the Nanjing Military Region (formerly known as the 93rd Hospital). Tan also does surgeries at the PLA's 85th Hospital of the Nanjing Military Region in Shanghai.
Another patient went first to Huashan Hospital in Shanghai (affiliated with Fudan University) for a liver transplant. He was placed under the care of Qian Jianmin, deputy director of the liver center at Huashan Hospital. When no matching organ could be found after several days, Qian suggested that he be transferred to Changzheng Hospital in Shanghai, which is affiliated with Second Military Medical University, saying that it was easier to get organs there. A matching liver was found for the patient on the day he transferred to Changzheng Hospital.
The authors also interviewed a patient who went to the Taiping People's Hospital in Dongguan City, Guangdong Province, for a kidney transplant. His surgeon was Dr. Gao Wei. Taiping People's Hospital is a non-military general hospital, but Dr. Gao Wei is also a doctor at the Kidney Transplant Department in Zhujiang Hospital, which is affiliated with First Military Medical University. Dr. Gao is also a part-time surgeon at the Shenzhen Armed Police Forces Coastguard Hospital in Guangdong Province.
Sound of Hope Radio interviewed Dr. Peng Xuemei in September 2009. Dr. Peng works at the Anesthesiology Department in the Guangzhou Overseas Chinese Hospital and assists in organ transplant surgeries. Dr. Peng revealed that the hospital had many channels through which it could get organs. She said, "In many cases, Nanfang Hospital would get the kidneys first and then send them to our hospital. That's why I said there are many channels. But we can't discuss this openly." Nanfang Hospital is the first affiliated hospital of Southern Medical University, which is the former First Military Medical University, which was handed over to the Guangdong provincial government in 2004.
In August 2008, the Minister of Health in China launched the "Chinese Scientific Registry of Kidney Transplantation," or CSRKT (www.csrkt.org). Its data center is run by the 309th Hospital. This gives us a clear idea of the role military hospitals play in China's organ transplant community.
As China became the center for global organ transplant tourism, hospitals along China's coastline were particularly favored for their location. Having attracted a growing number of patients, they needed to develop more channels for organ supplies. The organ intermediaries for these hospitals would do all they could to establish close ties to military hospitals or hospitals with a military background.
Although the outside world knows little about how the military conducts live organ harvesting, the active roles the military and armed police forces hospitals play in the organ transplant market and their advantage over organ supplies is the result of the control it has over the concentration camps and associated organ sources.
8. Additional open questions
Story behind the "Kidney for Sale" advertisement
While on the topic of organ resources, some readers may have seen a "Kidney for Sale" advertisement posted on utility poles. How big of a market can these donors, who are advertising one of their kidneys to make a living, create?
First of all, this type of organ trade is illegal. Those involved can be sentenced to jail. The potential kidney sellers are taking advantage of a legal loophole regarding live donors among relatives. In this case, the seller would need to forge a document to prove that the donor and the recipient are related. It is risky business, but the high profits have driven this widespread behavior. On January 14, 2004, the Xinhuanet website posted a report from the Morning News. The report said that restrooms in hospital wards were where most of the "Kidney for Sale" ads were posted. One nurse told the reporter, "There are 'Kidney for Donation,' 'Kidney for Sale' ads all over the place. They cannot be washed off with water and have to scraped off. There is nothing we can do to stop them." [44]
Another question is how many of these people successfully sold their kidneys. In reality, the probability of organ matching remains the biggest issue. Experts have stated, "The chances for two complete strangers to meet by accident and have matching organs are rare, unless the parties have done good preparation prior to hospital tests. But there exists another hurdle--no Chinese doctor would encourage or even get involved with this type of underground trade because it is illegal." [45]
Some doctors stated that the costs to harvest organs from executed death row inmates are low, and the process takes only a few minutes. In addition, there is no need to pay the donors, nor is there a need for post-procurement medical care for the donors (similar in the cases of live organ harvesting of Falun Gong practitioners). On the other hand, the cost to purchase a kidney from a private seller would be much higher. Not only does it cost between 10,000 and 30,000 yuan for one kidney, post-organ donation medical care, such as a hospital stay, also needs to be provided to the seller. In an interview with Huashang Newspaper in late 2004, Wu Gang, associate professor of the Organ Transplant Department at the First Hospital of China Medical University, told the reporter, "To rashly purchase kidneys illegally from total strangers solely based on ads is to risk losing money and wasting time on unusable organs." [46]
We should state that illegal kidney sales do exist, and there are people who have obtained kidneys through this channel. Nevertheless, it cannot be a sizable organ resource. Even the Chinese government admitted that the growth in China's organ transplant market is largely driven by the huge profits in this market. The introduction of private sellers' organs would increase costs, especially in comparison to organs harvested for free with no post-procurement medical care, and reduce the hospital's bottom line. AAlthough "Kidney for Sale" ads are found in many areas, private kidney sellers as organ resources cannot drive the "vigorous development" of China's organ transplant market. More importantly, between 2003 and 2006, detained Falun Gong practitioners provided a better source of organs. Wu Gang also revealed in the 2004 interview, "There is no market for those 'Kidney for Sale' ads because currently there are plenty of kidneys in Shenyang City!"
The China International Transplantation Network Assistance Center, or CITNAC, which is under the First Hospital of China Medical University, claimed on its website that the shortest waiting period for a kidney was one week, with an average waiting period of less than a month. If the surgery failed, a second surgery could be scheduled within a week. It also claimed that the waiting period for a liver was less than one month. (See Appendix 7) Where did these abundant organs come from? Obviously not from the "Kidney for Sale" ads posted on utility poles or in hospital restrooms. We also should note that, between 2003 and 2006, liver transplants increased significantly while few "Liver for Sale" ads were seen.
Starting in 2007, the source of organs from large-scale harvesting of organs from living Falun Gong practitioners began to disappear or decline. In order to develop a new source of organs, the Chinese government has launched vigorous propaganda campaigns to promote live donors among relatives. This might have opened a door for forged relationships and stimulated more rampant underground kidney trading, but this is a different issue. The focus of this report is on the period between 2003 and 2006, when China's organ transplant market skyrocketed.
Can the increase in the number of organ transplant hospitals drive the increase in organ transplants?
Some may wonder whether the big increase in the number of organ transplant hospitals was the cause of the big increase in the number of organ transplants. This is not the case. The shortage of organ supplies is the greatest bottleneck for organ transplants. If the supply of organs could not even satisfy a smaller number of hospitals, the increase in the number of hospitals would only worsen the situation instead of creating more donors. Furthermore, according to the estimation formula we discussed in previous sections, the number of organs from executed death row inmates is fixed. An increase in the number of hospitals simply cannot produce more donors.
Chapter VIII. Evolution of live organ harvesting
1. Isolated cases
Over the years, the process of harvesting organs from living Falun Gong practitioners evolved. The initial alleged cases of organ harvesting occurred on those practitioners who died in forced labor camps as a result of torture. As early as 2000 there were reports of death cases related to organ harvesting. This could explain why the number of organ transplants in mainland China began to increase in 2000.
On December 22, 2000, the Minghui/Clearwisdom website posted the following news from China: "According to insiders, some police officers in Mainland China are plotting with doctors and looking to sell the organs of Falun Gong practitioners for huge sums of money." "One source indicates that a certain hospital in the city of Shijiazhuang specializing in Chinese medicine has received six such requests." [47] This might have been the earliest report of the CCP's organ harvesting from Falun Gong practitioners.
On February 16, 2001, Ren Pengwu, male, 33, a technician at the Harbin City Third Thermal Power Plant in Heilongjiang Province, was arrested for distributing informational materials exposing the staged Tiananmen "Self Immolation" incident. He was detained at the No. 2 Detention Center in Hulan County. Before dawn on February 21, he was tortured to death. Without obtaining the family's permission, the police authorities removed all of Ren Pengwu's organs before hastily cremating his body. [48]
Hao Runjuan, female, a practitioner from the Baiyun District in Guangzhou City, was arrested in late February 2002. She died on March 18, 2002, after suffering brutal torture in the Baiyun Detention Center. The police autopsied the body while the family members were unaware of anything at all. When the family was notified to identify the body, it had been rendered unrecognizable. [49]
Sun Ruijian, male, 29, a practitioner from Ningde City, Fujian Province, was arrested in November 2000 when he went to Beijing to appeal for Falun Gong. On December 1, 2000, his family was notified that Sun Ruijian had died from "jumping out of a moving car" while under public security escort. When his wife saw Sun's body, it had been autopsied, and Sun's eyes had a noticeable bulge. [50]
Fu Keshu, 53, a practitioner and a retired teacher from the No. 1 Elementary School in Kaiyang County, Guizhou Province and her nephew, 34-year-old Xu Genli, disappeared in the Jinggang Mountain area in November 2005. In late April 2006, their bodies were discovered in the Wuzhi Peak area of Jinggang Mountain. Their heads had been shaved, and there were no eyebrows on their faces. Their eyeballs were missing. Xu's chest and abdomen had been cut open. Their families believed that their organs might have been harvested and their bodies disposed of. [51]
According to a person who was detained in the Baiyun District Drug Rehabilitation Institute, several drug addicts beat up a Falun Dafa practitioner, which was seen by the Institute's doctor. The doctor said, "Don't hit his kidneys, they're useful!" On several occasions he heard doctors there tell the drug addicts when they were suffering from withdrawal, "If you want some drugs, go beat up those Falun Dafa practitioners, but be careful not to touch their eyes and abdomens." [52]
2. Large-scale live organs harvesting
The transition of individual organ harvesting cases to large-scale live organ harvesting was enabled by the following conditions:
Condition 1: The appearance of "concentration camps"
We have discussed in previous sections that many practitioners who refused to reveal their names or addresses were detained in undisclosed locations. These military-controlled concentration facilities provided the physical conditions needed for large-scale, live organ harvesting.
Condition 2: Policy to "defame their reputations, bankrupt them financially and destroy them physically"
The persecution of Falun Gong was initiated by Jiang Zemin, who mobilized the entire state apparatus in his campaign. The 610 Office adopted a policy to "defame their reputations, bankrupt them financially, and destroy them physically" in an attempt to eradicate Falun Gong.
According to Li Baigen, former director of the Reconnaissance and Design Administration Division of the Beijing Municipal Commission of Urban Planning and Design, and who currently lives in the United States, on November 30, 1999, three senior officials at the 610 Office summoned 3,000 government officials and held a conference in the Great Hall of the People to discuss the persecution of Falun Gong, since more and more Falun Gong practitioners had continued to come to Beijing to appeal, despite several months of harsh suppression. During the conference, Li Lanqing, head of the central 610 Office, verbally relayed the new policy from Jiang Zemin, which was to "defame their reputations, bankrupt them financially, and destroy them physically."
This policy was never communicated as a written document. The outside world learned of this through practitioners who were detained in the brainwashing centers, forced labor camps, or prisons. Many of them stated in articles published on the Minghui website that, while in detention, they had heard the police or 610 Office personnel mention this policy.
A derivative of the policy is "beating them to death counts as suicide," another common practice of some police officers in dealing with practitioners who refuse to give up their beliefs. Although the number of death cases of practitioners who died as a result of the persecution continues to grow (by 2009, at least 3,300 practitioners are confirmed to have died), the police officers responsible for these deaths were never punished by the CCP regime. On the contrary, they were recognized as model officers of the anti-Falun Gong campaign and rewarded with promotions and financial incentives.
Condition 3: Huge financial profits from the organ transplants
As stated earlier, expensive fees make organ transplants tremendously profitable, which is a powerful motivating force, particularly in an officially atheist country.
Condition 4: Hatred instigated by slanderous propaganda, from the staged "Tiananmen Self Immolation" incident to live organ harvesting
Since the beginning of the persecution, the CCP regime has fabricated countless lies to slander Falun Gong. A typical example is the "Tiananmen Self Immolation," staged by the CCP regime in an effort to instigate nationwide hatred of Falun Gong. Live organ harvesting is part of the physical genocide of Falun Gong practitioners, driven by this hatred and the temptation of financial gain.
During the 53rd session of the Sub-Commission on the Promotion
and Protection of Human Rights, International Educational Development had discovered that the self-immolation cited by the Chinese Government, which was being submitted as "proof" that Falun Gong was an "evil cult," had in fact been staged. [53]
The CCP's overwhelming deceptive propaganda indeed instigated hatred among the general public in China, paving the way for those who participated in the live organ harvesting of Falun Gong practitioners several years later, but who otherwise may have refrained out of moral concerns.
It was the persecution by the CCP and the huge financial incentives that drove the individual cases of organ harvesting to large-scale live organ harvesting. According to insiders, large-scale live organ harvesting of Falun Gong practitioners began to surface in late 2001.
The following diagram illustrates this evolution:
At present, there are still a large number of Falun Gong practitioners detained in the hundreds of forced labor camps in China. Many reports published on the Minghui website reveal that families of those who died from torture could not see their loved ones' bodies, which were forcibly cremated by the police. We have enough reason to believe that organ harvesting still continues on practitioners who die from torture, and it will not end until the persecution stops and all detained practitioners are released.
3. A small step from "using death row organs" to "live organ harvesting from Falun Gong practitioners"
The initial reaction of many people when they first heard of the live organ harvesting from Falun Gong practitioners was, "How could that be possible? How could doctors do such a thing?"
If China had an organ donation system as many western countries do, and if there had never existed the practice of organ harvesting from death row inmates, then the allegations of live organ harvesting from Falun Gong practitioners might indeed seem far-fetched. However, organ harvesting from death row inmates has been in practice for several decades. Some executed death row inmates were not completely dead when their organs were removed. Their cases were close to live organ harvesting. With this as a backdrop, and after the CCP regime labeled Falun Gong practitioners as "enemies of the state" ( a worse situation than that of death row inmates), moving from "using death row organs" to "live organ harvesting from Falun Gong practitioners" was but a small step.
Testimony of Annie, whose ex-husband participated in live organ harvesting
In Bloody Harvest, The killing of Falun Gong for their organs, one of the authors, David Kilgour, interviewed Annie (pseudonym), the ex-wife of a Chinese surgeon who removed corneas from Falun Gong practitioners.
According to Annie, her ex-husband began to take corneas from Falun Gong practitioners at the end of 2001. His hospital was only responsible for the removal, not the transplant. He was a neurosurgeon but was asked to remove corneas. Before being pushed into the operating rooms, the Falun Gong practitioners were given an injection to cause heart failure. Initially he did not know these living people were Falun Gong practitioners. In the beginning, fearing information could leak out, different organs were removed by different doctors in different rooms. Each time after the surgery he would receive a large sum of money, and given cash awards several dozen times his normal salary. Later on, as the doctors continued to get money, they no longer feared repercussions. They started to remove the organs together. During one operation when he collaborated with other doctors, he learned that the bodies were Falun Gong practitioners. Annie learned this information in 2003. Later that year they divorced.
We can see that the customary practice of harvesting the death row organs played a key role in live organ harvesting from Falun Gong practitioners. With the policy of "beating them to death counts as suicide," plus the deceptive and slanderous propaganda against Falun Gong, doctors became insensitive towards the "donors," treating them as death row inmates.
Flowchart of Live Organ Harvesting
Based on information provided by Annie, the following diagram illustrates the flowchart of live organ harvesting.
Different parties are involved in different steps, as seen on the flowchart. The doctors who perform organ harvesting may or may not be the ones who do the organ transplant surgeries. Therefore not every doctor is likely to know the whole picture. If asked where the organs come from, different doctors may provide different answers due to their involvement at the different steps in the process. More importantly, given that the source of organs is controlled by the military, it is very difficult for the outside world to know the entire procedure.
"Death row inmates" used as an excuse to shirk responsibility
From what we have learned, the common mentality of most organ transplant surgeons in China is that they are unwilling to ask questions about the true identities and backgrounds of the donors. The more surgeries they do, the more money they make, the better they get recognized, the more research papers they can publish, the faster they get promoted, and the less they want to learn about the source of organs. They do not have any qualms as long as they can make themselves believe that the organs were indeed from death row inmates. They follow the process to perform surgeries and do not give too much thought to whether the donors are indeed death row inmates or Falun Gong practitioners.
Every party in this process chooses to believe that the organs were harvested from death row inmates to shirk their responsibility:
As a result of CCP brainwashing, the military police have treated Falun Gong practitioners as mental patients or death row inmates.
Doctors who performed organ harvesting chose to believe that the donor lying on the operating table was a death row inmate, even if the donor was still alive, since they were accustomed to harvesting organs from executed death row inmates who were not completely dead.
Doctors who did not participate in organ harvesting but performed organ transplant surgeries were more likely to believe that the organs they received were from death row inmates instead of Falun Gong practitioners.
In Annie's ex-husband's case, he initially believed that the donors were death row inmates. By the time he learned that they were Falun Gong practitioners, he had become indifferent and was driven by the desire to make more money. Since death row organ harvesting has become a common practice, participants in the live organ harvesting of Falun Gong practitioners tend to treat them as death row inmates.
Yet, those Falun Gong practitioners whose organs were harvested alive are not traditional "death row inmates." Live organ harvesting amounts to cold-blooded murder. As the truth became known, out of fear, those participants decided to keep silent, and this has added to their crimes.
Doctors addicted to organ transplant surgeries
On January 26, 2005, Jiefang Daily published a story entitled "Nine-Hour Miracle," on Xia Qiang, director of the Organ Transplant Center in the Shanghai Renji Hospital, who was "addicted to liver transplant surgeries." On one occasion, Xia drove 140 kilometers to take a 72-year-old patient to the hospital for a liver transplant. The patient had several life-threatening illnesses - cirrhosis, liver cancer, stones in both kidneys and renal failure, and had been bedridden for a couple of months. The patient needed a liver-kidney transplant. Xia was driven to break the liver-kidney transplant record in Asia, where the oldest recipient was 65. Xia told the reporter: "I am crazy about liver transplants. I am addicted to them. I have to see patients every day, otherwise I do not feel settled. I have to do at least two to five liver transplant surgeries a week, and I am not afraid of failures. I'll learn my lessons and continue the next day." [54]
It is a good thing for a doctor to be so committed, and there is nothing wrong with pursuing success. However, when a doctor is addicted to organ transplants and has to do several surgeries a week to get satisfaction, all he will care about is how to get endless organ supplies. In that case, how many of them would care whether the donors are death row inmates or Falun Gong practitioners?
"Life unworthy of life" - How the Holocaust happened
Many historians believe that the Holocaust was a natural result of Hitler's promotion of racial cleansing under the Nazis. In 1920, Karl Binding and Alfred Hoche introduced a new concept, "Life unworthy of life," in their book, Allowing the Destruction of Life Unworthy of Life. Those considered to be "deviant" or a "source of social turmoil" in Nazi Germany and the occupied areas of Europe fell under this designation, which included the mentally ill, people with disabilities, political dissidents, criminals, Jews, and "non-whites" or non-Caucasian peoples. [55]
According to psychiatrist Robert Jay Lifton, the author of Medical Killing and the Psychology of Genocide, the policy went through a number of iterations and modifications: "Of the five identifiable steps by which the Nazis carried out the principle of 'life unworthy of life,' coercive sterilization was the first. There followed the killing of 'impaired' children in hospitals; and then the killing of 'impaired' adults, mostly collected from mental hospitals, in centers especially equipped with carbon monoxide gas. This project was extended (in the same killing centers) to 'impaired' inmates of concentration and extermination camps and, finally, to mass killings in the extermination camps themselves." [56]
While it is a huge step from "respect of all lives" to "mass killing of Jews," it was only a small extra step from "destruction of life unworthy of life" to "mass killing of Jews."
Similarly, it would have been a huge step to "live organ harvesting from Falun Gong practitioners" had there never been organ harvesting from death row inmates. But it was only a small extra step from "harvesting death row organs" to "live organ harvesting from Falun Gong practitioners."
The following graph depicts the environment and conditions under which live organ harvesting could exist.
Chapter IX. Broadened definition of death row inmates
Some people remain incredulous of the live organ harvesting that Falun Gong practitioners have fallen victim to. With regard to the substantial increase of organ transplant cases, conventional thinking has driven these people to search for an answer among the donor source of death row inmates. Some have even broadened the concept of death row inmates. Then which groups of people fit the broadened definition? The following conversation, though fictional, accurately frames the issue while illustrating how many people try to avoid dealing with it.
1. Vulnerable groups broadening the definition of death row inmates
A: The CCP has done a lot of things wrong. Still, it's unlikely that they would harvest organs from living Falun Gong practitioners. After all, times have changed.
B: Times have changed--and things don't necessarily change for better. Haven't we had to deal with lots of fake products of poor quality? Poisonous food, poisonous milk powder for infants--these things are fairly recent. Put lowered moral standards and greed together, and what terrible things won't they commit? And speaking of organ harvesting, where have all these kidneys and livers come from?
A: Who else other than death row inmates? It's an open secret. Taking organs from living Falun Gong practitioners is too incredible.
B: Isn't it more incredible that the waiting period for organs is several years in developed countries, while in China it's only a week or two? How can something that incredible take place in China?
A: In China, things are rather complicated. You can't use the narrow definition of death row inmates, that it is only those sentenced to death and executed with bullets. Let me tell you, it is really easy for prison inmates to die, not just those who are on death row. Beat them to death, and they become death row inmates. This is a broadened definition of death row inmates, isn't it? Simply beat them, beat up the ones who the guards don't like or those who are not well connected. When the inmate is close to death, he or she is carried to the hospital for organ harvesting. It's even simpler than removing organs at the place of execution. You know how crafty some people can be. Like you said, driven by greed, what terrible things won't they commit?
B: What you described are isolated cases. The increase in organs had to account for a large number of people beaten to death. It would have to be group after group of prisoners killed.
A: Think of it this way: Those who are well connected won't be thrown into prison. The ones who end up in prison are among the vulnerable social groups in society. They have no power or influence whatsoever. It costs nothing to kill them. No court even takes up cases related to their deaths.
B: You mentioned vulnerable social groups in society. Which group is most vulnerable at present? You can't find any more vulnerable than Falun Gong practitioners, considering the way they have been slandered and have been deprived of their political, economic, and legal rights. The CCP has taken Falun Gong as its Number One enemy. Overwhelming propaganda in state-media has smeared practitioners to the extent that no matter how they are mistreated, no one is allowed to speak out for them. In addition, the number of practitioners unlawfully arrested is at least in the range of tens of thousands. Doesn't your broadened definition of death row inmates apply most fittingly and most conveniently to them?
A: Well, if you look at it that way, it could very well be the case.
2. Contrasting the tragedy of live organ harvesting with a "joyful moment" on the White House lawn
It was April 2006, shortly after the exposure of live organ harvesting from Falun Gong practitioners, when CCP leader Hu Jintao visited the White House. The Chinese Embassy in Washington D.C. organized a group of people to greet the delegation from China. Across the street, protesting groups were gathered, including many Falun Gong practitioners who demanded a thorough investigation into the alleged live organ harvesting. One news reporter from the Western media asked the organizer of the Embassy's welcoming group for his comment on the over 2,000 people protesting the visit right across the street.
The organizer replied, "The Chinese leaders' visit is a joyful moment. I don't know if their charges [of organ harvesting] are valid or not. However, to protest at this moment is inopportune."
In any county, things as wicked, cruel and serious as live organ harvesting are things the highest leadership of the nation would be informed of. Any reasonable government would order an independent investigation immediately to get at the root of the issue. But simply because the victims are Falun Gong practitioners, this organizer did not have the least bit of sympathy nor the least respect for life. His "joyful moment" was more important than the life of a fellow citizen, due to the fact that this citizen is part of a peaceful group that is being targeted by a nationwide propaganda campaign. This type of mentality has, in turn, facilitated the crimes of live organ harvesting.
3. Revelation of Gresham's Law - demonizing propaganda drives indifference to life
About 400 years ago, Sir Thomas Gresham, a British financier, made an interesting observation that "bad money drives out good" under legal tender laws, that is, when there are two forms of money in circulation with similar face value, people will collect the 'good' coins made of more precious metals and use the 'bad' coins made of cheaper metals as payment. Soon all the coins in circulation are 'bad' coins. This is known as Gresham's Law.
Under the unprecedented persecution, Falun Gong practitioners, who have followed the principle of Truthfulness-Benevolence-Forbearance, have been demonized as "bad money." The CCP had already indoctrinated the population with atheist propaganda for decades. Many people find it hard to have spiritual beliefs because the CCP has labeled them all as "feudal superstitions," and believers are thought of as fools. The overwhelming CCP smearing of Falun Gong practitioners, for example, accusing them of "committing suicide," "killing others," "self-immolation," and "being mentally deranged," has fostered hatred against them in society. The CCP regime went on to label Falun Gong practitioners' efforts to spread the facts about the persecution as "disrupting order by anti-China forces and reactionary organizations." These political labels have further damaged Falun Gong practitioners' reputations.
During the persecution, police officers and detention center, labor camp, or prison guards have not been held responsible after torturing practitioners to permanent disability or beating them to death. Practitioners have been prohibited from appealing to any levels of authorities, and have been arbitrarily dismissed from work or expelled from school. Practitioners have not even been able to hire attorneys to defend them because the few attorneys who have stood up to defend practitioners have faced persecution themselves. Falun Gong has been under fierce attack not only in work units and government organizations, but even in textbooks used in elementary through senior high schools that have been revised to carry dedicated sections demonizing Falun Gong and slandering practitioners. In labor camps and prisons, all other inmates have advantages over Falun Gong practitioners. It is not uncommon for death row inmates to be assigned to monitor practitioners in prison cells. Practitioners are deprived of any and all fundamental human rights.
One inmate who was released from prison told a chilling story. An elderly Falun Gong practitioner refused to renounce his belief and was tortured. He went on a hunger strike to protest. After he became extremely weak and his condition deteriorated, the guards dragged him to the hallway and left him there. Guards simply walked by, completely ignoring his existence. For days the elderly practitioner lay in the fetal position, his life withering. When he passed away in silence, he was carried away. This was the end of a life. This exemplifies the indifference and contempt of those carrying out "law and order" on behalf of the CCP.
When a college student was beaten to death in a temporary custody house in 2003 for not carrying and presenting his identification paper, there was outrage over the Internet against the custody and repatriation system in China. However, little has been heard over the brutality of this all-out suppression of Falun Gong that has lasted for a decade, impacting millions of innocent people. People do not believe that the abuse, torture, and killing have taken place on such a scale. When confronting charges of live organ harvesting, many are in self-denial without looking further into the issue, only because the victims and plaintiffs are Falun Gong practitioners. This unwillingness to look into this serious matter has, in turn, contributed to the persecution's taking place and continuation.
It would appear that CCP operatives suspected of killing Falun Gong practitioners figured that it was a lot more safe and convenient to harvest organs from Falun Gong practitioners, as in the current political climate they have been absolved of all legal responsibility. These live, low cost organs from young and healthy Falun Gong practitioners drove out the more costly organs from other sources per Gresham's Law.
The lies and slander spread by the CCP state-run media have created the environment for harvesting organs from living Falun Gong practitioners. Who makes up the broadly defined death row inmates? Falun Gong practitioners, treated as the Number One enemy by the CCP and unlawfully arrested and imprisoned on a massive scale, fit the broadened definition of death row inmates more than anyone else.
Gresham's Law also hints that during these years of persecution, it is likely that the organ source of traditional death row inmates could be on the decline, whereas more organs are being taken from living Falun Gong practitioners.
Chapter X. The killing of a beggar and a homeless person reveals lack of bottom line in Chinese doctors' ethics
If some people still question whether doctors could engage in harvesting organs from living Falun Gong practitioners, then let's take a look at some other cases. Chinese media have reported two instances in which doctors were suspected or implicated in killing a beggar and a homeless person in order to procure their organs. These incidents raise the question of which is more valuable in Communist China: human decency or human organs?
1. Organ deal behind the death of a beggar
South Wind Window magazine (Issue No. 14, in 2007) published a report entitled "Organ Deal Behind the Death of a Beggar." Tong Gefei was a beggar from Xingtang County, Hebei Province. The magazine reported that local resident Wang Chaoyang was alleged to have conspired with Chen Jie, a post-doctoral researcher at Tongji Hospital in Wuhan City, Hubei Province, and several other doctors from Wuhan and Beijing. The doctors spent about 20 minutes in a deserted electrical power substation. The operation was performed under the illumination of several flashlights. They harvested Tong's liver, spleen, pancreas, and two kidneys, a total of five organs. A doctor later surrendered himself to the authorities. Chen Jie of Tongji Hospital paid 65,000 yuan to Tong's family in compensation and expected his family not to implicate the doctors. It was reported that Wang Chaoyang lied to the doctors, saying that Tong was a death row inmate. However, all the doctors involved in this case should have known that to procure organs from a body, an official death certificate issued by the courts has to be presented, as well as a statement of consent from the donor him or herself. Of course, there were no such documents. If a death row inmate is executed, surgery to procure the organs takes place on the execution grounds, as the procedure has to start within a minute of the victim's death. Defendant Wang Chaoyang confessed at a court hearing, "After the procedure was underway, Tong Gefei suddenly raised his arm and grabbed a doctor's shoulder. Another doctor stepped on Tong's arm. The surgery was soon over." This can only be described as live organ harvesting. The report in South Wind Window portrayed the case as "an extremely horrible story, which will alarm anyone who hears about it." (See Appendix 11) [57] Many people were unable to believe that doctors could engage in such a despicable act as harvesting organs from living people for monetary gain until they learned about this case.
The Chinese-edition website of Deutsche Welle, Germany's international broadcaster, did an exhaustive follow-up on the tragic death of this beggar. It reported that Tongji Hospital put the issue to rest simply by removing only one employee--an inconsequential deputy director of the Organ Transplant Research Institute. According to people familiar with the case, Chen Zhonghua was director of the institute from 2000 to July 2006. During his tenure, the institute violated regulations by procuring organs from irregular and illegal sources. When the Deutsche Welle reporter reached Chen over the phone in the hope that he could explain the situation, Chen replied that he could not grant interviews. It is clear that the issue of organ sourcing has become a sensitive topic. [58]
2. Homeless person killed for his organs
Caijing [Finance and Economics] magazine (August 31, 2009 issue) had a cover story on someone else being killed for his organs. It revealed that a homeless person, nicknamed "The Eldest," died as a result of having his organs harvested in Weishe Town, Xingyi City, Qianxinan Prefecture, Guizhou Province. His body, abandoned in a reservoir, was discovered by local fishermen. The fishermen noticed that all of the body's organs had been removed. The report citied witnesses who said that, a few days before his disappearance, "The Eldest," who had worn dirty, worn-out clothes, was suddenly wearing clean clothes. His hair was shaved off and so was his beard. Others recalled that he was taken to a hospital for blood type matching. It was reported that the police found evidence that led them to the No. 3 Zhongshan Hospital in Guangdong Province. In the end, the police narrowed the suspects to Zhang Junfeng, deputy chief physician of the No. 3 Zhongshan Hospital, and two other doctors. Zhang is an M.D., the deputy chief physician, an advisor to graduate students, and a member of the editorial board of Chinese Modern Surgery Journal. He was a participant in the project "A Study of the Applications of Liver Transplants," which won the Ministry of Education's First Award for Scientific Progress and Promotion. Zhao Cheng, a physician who operates a private clinic in Weishe Town, was also implicated. A doctor from Weishe Hospital told Caijin reporters that a few days after the death of "The Eldest," Zhao Cheng went to the local countryside credit union to deposit 200,000 yuan in cash, which gave away his involvement in the abduction and killing of the homeless man. (See Appendix 12) [59]
Doctors are supposed to fulfill their duty to save lives. But as seen from these examples, driven by money and fame, some have become ruthless, willing to kill those whose lives they consider worthless (which includes beggars, the homeless, or those considered enemies of the CCP) just for their organs.
These cases dispel the notion that organ harvesting from living Falun Gong practitioners requires sophisticated medical equipment. In fact, that is not necessary. As mentioned above, the killing of beggar Tong took place in a deserted electrical power substation lit up only by flashlights.
Chapter XI. Additional evidence
1. Whistleblowers expose live organ harvesting
On March 9, 2006, The Epoch Times published an interview with a senior journalist with inside information, who revealed that the CCP had set up a secret concentration camp in the Sujiatun District of Shenyang City in northern Liaoning Province that rivaled those of Nazi Germany. Held in the camp were thousands of Falun Gong practitioners. [60] On March 17, 2006, The Epoch Times reported an interview with a female witness who worked at the Liaoning Provincial Thrombosis Hospital of Integrated Chinese and Western Medicine. She presented further evidence that the concentration camp was located underground, beneath the hospital. [61] When live organ harvesting took place, her husband at the time, a chief surgeon, participated in removing corneas from living Falun Gong practitioners. On March 31, a letter from a veteran military doctor was published in The Epoch Times confirming the existence of the underground concentration camp in Sujiatun District, Shenyang City. [62] By then, the dark curtain over the CCP's live organ harvesting atrocities had been lifted.
2. Recordings from telephone investigations
Following the initial live organ harvesting reports, several overseas organizations started to make telephone investigations. Presenting themselves as people seeking consultations for their relatives who might need organ transplantation surgeries, the investigators called organ transplant sections in numerous hospitals across China. They specifically asked whether the hospitals were able to acquire organs from Falun Gong practitioners. These investigations further validated the allegations that Falun Gong practitioners were killed for their organs.
Lu Guoping of Nanning City Minzu Hospital, Guangxi Autonomous Region acknowledged organs taken from Falun Gong practitioners
Independent investigators David Kilgour, Canada's former Secretary of State for the Asia-Pacific region, and David Matas, an award-winning international human rights attorney, published the transcript of a telephone conversation with Lu Guoping, a surgeon at the Nanning City Minzu Hospital in Guangxi Autonomous Region in Bloody Harvest - Report into Allegations of Organ Harvesting of Falun Gong Practitioners in China. During the conversation, Lu acknowledged several times that Falun Gong practitioners were the source of organ supplies. He said, "Some are from Falun Gong. Some from families of patients."
The following is an excerpt of the conversation between Lu and an investigator:
Investigator: Then did your classmate tell you that the [organ transplantation] operations they performed were all [with organ sources from] Falun Gong, is that right?
Doctor Lu: Some are from Falun Gong. Some from families of patients.
Investigator: Oh. Then if I want to find this type for my child, this type [of organ] from Falun Gong, do you think he can help me find any?
Doctor Lu: He definitely can find it for you.
[....]
Investigator: What you used before [organs from Falun Gong practitioners], was it from detention center[s] or prison[s]?"
Doctor Lu: From prisons.
Investigator: From prisons? And it was from healthy Falun Gong practitioners...?
Doctor Lu: Correct. We could choose the good ones because we assure the quality in our operations.
Telephone recording: http://organharvestinvestigation.net/Dr.Lu-Voice-Recording/2006-05-22-Dr.Lu-guangximinzuyiyuan.mp3
Transcript: http://organharvestinvestigation.net/Dr.Lu-Voice-Recording/Guangxi-mingzu-ch.pdf (English version: http://organharvestinvestigation.net/report0701/report20070131-eng.pdf)
Representative of the Chinese People's Liberation Army No. 307 Hospital brokered for kidneys from Falun Gong Practitioners
During the investigation, World Organization to Investigate the Persecution of Falun Gong (WOIPFG) investigators contacted a broker representative of the Chinese People's Liberation Army No. 307 Hospital in Beijing, in the name of helping family members and friends to find suitable kidneys for their transplant requests. The contact lasted for several weeks and the conversation time totaled several dozen minutes. WOIPFG has compiled a complete record of the conversations and other forms of evidence. If any interested organizations or individuals need further information, please contact WOIPFG. This report will be updated as new evidence becomes available in the future.
Excerpt of conversations:
Investigator: then you go ahead and help me check it out, whether....
PLA No. 307 Hospital Representative: I told you before, didn't I? I told you before that we told you the real story, we have done two cases. You know, we did two cases.
Investigator: You mean two operations involving Falun Gong practitioners as source?
PLA No. 307 Hospital Representative: That's right, we did two cases. The prison told us they did that with Falun Gong. I also told that lady that we indeed performed such operations. Now, however, it is getting more difficult than before.
[....]
Investigator: Where did you find the kidney sources before?
PLA No. 307 Hospital Representative: From Xicheng District [in Beijing].
[....]
Investigator: Alright, besides it, how could you be so sure he (the source) was a Falun Gong practitioner, did you find out for sure?
PLA No. 307 Hospital Representative: How to positively identify as Falun Gong practitioner, well, when the time comes --- when the time comes our side, our Boss will have people showing you information, you know, he will show you the information and data, you can be sure.
Investigator: Oh, that's fine.
Telephone recording: http://www.zhuichaguoji.org/cn/upload/audio/Investigation_Organharvest.mp3
Transcript: http://www.zhuichaguoji.org/cn/index2.php?option=content&task=view&id=1437&pop=1&page=0 (English version: http://www.zhuichaguoji.org/en/index2.php?option=content&task=view&id=175&pop=1&page=0)
Li Honghui, a director of Yuquan Hospital, or No. 2 Affiliated Hospital of Tsinghua University, admitted that organs were taken from Falun Gong practitioners
On April 28, a Sound of Hope journalist made contact with Li Honghui, director of the Kidney Transplant Department, Yuquan Hospital, also known as No. 2 Affiliated Hospital of Tsinghua University. Li admitted that organs were taken from Falun Gong practitioners.
Excerpt of conversation:
Li Honghui: It happened that for the past several years that donor organs were from Falun Gong practitioners.
Investigator: Do you mean that this type of donor was quite easy to get several years ago?
Li Honghui: That's true.
Telephone recording: http://media.soundofhope.org/audio01/2006/4/30/tsendu_military_hospital.mp3
Transcript: http://epochtimes.com/gb/6/5/1/n1304909.htm (English version: http://theepochtimes.com/news/6-5-2/41097.html)
More telephone recordings
WOIPFG subsequently published more telephone investigations, including phone calls to the following hospitals with call dates:
Director Song Wenli, Tianjin No. 1 Central Hospital, also known as the Orient Organ Transplant Center, March 15, 2006, telephone number: 86-13920128990
Zhongshan Hospital affiliated with Fudan University in Shanghai, March 16, 2006, telephone number: 86-21-64041990
Qianfoshan Liver Transplant Center in Shandong Province, March 16, 2006, telephone number: 86-531-82968900
Doctor Dai, Affiliated Hospital of Jiaotong University in Shanghai, March 16, 2006, telephone number: 86-21-63240090
No. 2 Affiliated Hospital of Hubei Province Medical University, April 2, 2006, telephone number: 8627-67813104 ext. 2960 or 2961
Tongji Hospital in Wuhan City, March 30, 2006, telephone number: 8627-83662688 ext. Kidney Transplant Section (or Urological Surgery Section)
Recordings and transcripts: http://www.zhuichaguoji.org/cn/index2.php?option=content&task=view&id=789&pop=1&page=0 (English version: http://www.zhuichaguoji.org/en/index2.php?option=content&task=view&id=167&pop=1&page=0)
3. Testimony from intermediaries
On November 17, 2006, Yediot Achronot, Israel's largest newspaper, reported that four men accused of pocketing millions of dollars that patients had paid for organ transplants were arrested in Israel. Yaron Izhak Yodukin, CEO of Medikt Ltd. and his associates, faced charges of not reporting incomes earned by mediating organ transplants for Israelis in China and the Philippines. The arrests followed months of investigation after the main suspect admitted to an Israeli newspaper that the organs were coming from Chinese death row inmates and prisoners of conscience, including Falun Gong practitioners.
4. Testimony from Falun Gong practitioners and other inmates
Many Falun Gong practitioners released from labor camps and prisons recounted that they were taken for blood tests while in custody. In July 2008, David Matas, co-author of Bloody Harvest, located someone released from a prison in Jiangsu Province, who is not a Falun Gong practitioner. Between March 2005 and early 2007, he was taken to 17 different prison cells. Inmates who had been held several years in the cells told him that over the course of 2002 and 2003, at least two or three Falun Gong practitioners in each cell were killed for organs. A video production, Between Life and Death, produced by New Tang Dynasty Television, published the telephone interview with this witness. [65]
5. Investigative report by David Matas and David Kilgour
David Kilgour and David Matas published the results of their extensive investigation in their report, Bloody Harvest. According to data in the public domain, the authors argued that the source of 41,500 transplants for the six-year period of 2000 to 2005 is unexplained. When they first published their report in July 2006, they had gathered 18 elements of evidence to substantiate the charges of the CCP's organ harvesting atrocities. When the revised edition of the report was released at the end of January 2007, the evidence had increased to 33 elements. The authors have traveled to over 40 countries around the world to report the results of their investigation, while continuing to gather new evidence. [66]
Bloody Harvest: The book
In November 2009, Seraphim Editions, a Canadian publisher released a revised, book form of Bloody Harvest: The killing of Falun Gong for their organs. This is the third edition of the investigative report by Matas and Kilgour. It now lists 52 different elements of evidence. Mr. Kilgour pointed out that although no element of evidence alone can prove the crime of live organ harvesting, all of the evidence combined almost irrefutably proves the allegations.
Chapter XII. The Chinese Communist government's reactions to allegations of organ harvesting from living Falun Gong practitioners
1. Sujiatun cover-up
Three people with inside information made the allegations of live organ harvesting in March 2006. One was a senior Chinese journalist in Japan with the pseudonym "Peter;" another was a woman with the pseudonym "Annie," whose ex-husband participated in removing corneas from Falun Gong practitioners; and the third person was an anonymous veteran military doctor from the Shenyang Military Area Command. Peter and Annie made a public appearance at a gathering in Washington, D.C., in April 2006. The specific crimes allegedly occurred at the Liaoning Provincial Thrombosis Hospital of Integrated Chinese and Western Medicine in the Sujiatun District, Shenyang City.
On March 28, Qin Gang, spokesperson for China's Ministry of Foreign Affairs, denied the charges for the first time--some 20 days after the allegations were made--and invited reporters to investigate on site. However, there was no record of this statement on the Foreign Ministry's official website. On April 14, the General Consul of the U.S. Consulate in Shenyang City, accompanied by city officials, paid a pre-scheduled visit to the Thrombosis Hospital of Integrated Chinese and Western Medicine for an hour. A spokeswoman for the U.S. Embassy in China stated subsequently that U.S. representatives "found no evidence that the site is being used for any function other than as a normal public hospital." Yet, this has not dispelled widely held suspicions that the CCP could have transferred inmates during the three weeks after the initial public exposure and conducted a cover-up. Sujiatun used to be an important military location. Back in the 1930s and 1940s, the Japanese Kwantung Army's largest weapons warehouses were located here, and there was a sophisticated underground defense fortification system. Zeng Kelin, who served as the commander of the No. 16 Military Sub-region of the Eighth Route Army, recalled that, on one occasion when they opened up the warehouses in Sujiatun, they found enough weapons to equip an army of hundreds of thousands of soldiers. In one such underground system found in the Sujiatun District, the tunnels were about 7 feet wide and 6 feet tall, with a total length of about 1¼ miles. [65] A visit to aboveground buildings would not disprove the existence of the underground tunnels. What the outside world is interested in is not the visit that took place three weeks later. They are interested in what the CCP did within those three weeks, as well what happened before public charges were brought against the hospital.
Sujiatun allegations lift the curtain on live organ harvesting
Common sense tells us that the person who reports a case does not have to be the one who solves it. To demand that the reporter come up with all the evidence and solve the case is putting the cart before the horse. The Sujiatun allegations are just a lead supported by three people with inside information. The importance lies not in the absolute accuracy of their descriptions. What is important is the possibility that live organ harvesting has actually taken place. For example, someone passes by as a murder is taking place. He is at a distance and does not see everything. Based on what he does see, he believes there has been a murder, so he rushes to report the case to the authorities, which leads to a full investigation into a criminal organization. Was the person able to describe the crime scene with 100 percent accuracy? Did he know how many people were involved, who the murderers were, how many were killed, and what kind of weapons were used? It is unlikely that he saw everything, yet he still deserves credit for reporting the case.
The Sujiatun allegations have lifted the curtain concealing this nefarious activity. People have started to pay attention to the tens of thousands of Falun Gong practitioners unlawfully held at hundreds of labor camps and other large-scale concentration camps. What happened to them? This series of reports has looked into the sudden increase in available organs for China's organ transplant market from 2003 to 2006. It has attempted to find out where the organs could possibly have come from. The statistics support the allegations that organ harvesting from living Falun Gong practitioners has indeed taken place.
On April 4, 2006, the Falun Dafa Association and the Minghui website published a notice announcing the establishment of The Coalition to Investigate the Persecution of Falun Gong in China (CIPFG). Governments, NGOs, media, and individuals were invited to conduct an independent, on-site investigation to gather evidence in China--without intervention--in order to comprehensively investigate the facts surrounding the CCP's holding of Falun Gong practitioners in labor camps and secret concentration camps for persecution.
2. Third party independent investigators denied visas
In response to the invitation from Qin Gang, China's Foreign Ministry spokesperson, journalists from independent media overseas started applying to go to China to investigate.
On the morning of April 19, 2006, Xu Lin, a senior journalist in charge of news reports on China from Sound of Hope radio, went to the consulate general to apply to enter China to investigate. She was denied a visa.
The following day, Zhou Lei, chief editor of The Epoch Times, went to the Chinese embassy in Berlin. Her visa application was denied.
On May 2, 2006, Zhang Fen, San Francisco bureau director of New Tang Dynasty TV, applied for entry into China. Her visa application was denied.
In June 2006, David Kilgour and David Matas applied for visas to enter China to conduct an investigation. Their applications were denied.
The outside world is aware that the invitation from China's Foreign Ministry was just for show. What is ironic is that those Chinese CCP supporters living overseas who have turned a blind eye to the CCP's long history of killing are disappointed in the CCP's decision to reject the visa applications, thinking it is an opportunity to discredit Falun Gong. According to their logic, if there is no live organ harvesting, independent investigators should be allowed to enter China since they would not be able to come up with any evidence, and the allegations would be disproved. Yet the CCP will not issue the visas.
3. Denying the validity of the evidence so far collected
In response to the live organ harvesting charges, the CCP has not allowed any outside investigations and has categorically denied the charges.
Bloody Harvest by Kilgour and Matas gives many accounts of solid evidence, including transcripts of telephone calls in which doctors from different Chinese hospitals acknowledge procuring organs from Falun Gong practitioners. After a period of silence, the CCP used Phoenix TV, its overseas media for united-front propaganda, to deny the charges in the TV program "Investigation of the [two] Davids' Investigation." The video shows doctors listed in Bloody Harvest making statements that actually turn out to support the evidence in the book, in addition to providing contradictory statements. The following are two such examples.
Shi Bingyi's data
Bloody Harvest uses data provided by Shi Bingyi, director of the Transplant Center of the People's Liberation Army (PLA). The article "The bar has to be raised for organ transplantation," which appeared in Jiankangbao [Health Newspaper] on March 2, 2006, quoted Shi's estimate that there had been a total of 90,000 transplant cases in China [by 2005]. He was asked to make a denial on Phoenix TV, avowing, "I did not say that. Why? Because there has been no such number in my head." It is known that Jiankangbao is the authoritative, organizational mouthpiece of China's Ministry of Health. If Shi had not given the total of 90,000 transplant cases by 2005, instead of refuting Kilgour and Matas, he should have argued with Jiankangbao. In fact, Shi knows the numbers have been increasing and has thus been active in taking media interviews. In this report, we have also quoted the numbers when he was interviewed by Science Times as well as Xinhuanet.com.
Telephone investigation involving Lu Guoping of Nanning City Minzu Hospital in Guangxi Autonomous Region
Among the transcripts of telephone calls published in Bloody Harvest, one was a conversation with Lu Guoping, a doctor who worked at Nanning City Minzu Hospital and acknowledged the use of Falun Gong practitioners' organs (see Chapter XI). In the Phoenix TV program, Lu was asked to deny what he said. However, Lu first admitted that it was he who took the telephone call on May 22, 2006. Kilgour and Matas consider this supporting evidence to the original telephone recording. Prior to this, the main doubt people had was whether it was actually Doctor Lu Guoping on the other end of the line. His identity has now been authenticated by the Chinese government.
In a follow-up report by New Tang Dynasty Television, snippets of Lu Guoping's speech on Phoenix TV were shown. [66] Viewers were able to compare the voice on Phoenix TV with the original investigator's phone conversation (see Chapter XI for links); both have the same pronounced dialect, which is hard to fake with current computer technology.
4. Suddenly expediting the overhaul of the organ market
After March 2006, the CCP expedited the overhaul of China's organ transplant market. It issued a qualification regulation, reducing the number of transplant hospitals to 164 from over 600. A temporary regulation on human organ transplants went into effect on July 1, 2006. On May 1, 2007, the (permanent) Regulation on Human Organ Transplantations took effect.
The international community welcomed regulations over and management of China's organ market. However, the introduction of regulations does not negate the crimes committed in the previous years. Simply brushing off the prior period by describing it as "chaotic" and praising the new regulations is nothing short of assisting a cover-up.
At the same time, the CCP closed down the websites of certain organ transplant hospitals and related organizations. The website of the Chinese Society of Organ Transplantation, affiliated with the China Medical Association, is one that disappeared. It went offline in March 2006 and has remained inaccessible as of November 2009 (see Appendix 10 for details). Also, major hospitals have removed statements regarding the extremely short waiting periods (as short as a week or two) that had been listed on their websites. And, the CCP has called off organ transplant tours targeting foreign organ recipients.
We cannot help but ask, what is the purpose of removing or changing the content of these websites? What is being covered up?
Note: Much of the data and relevant information cited in this report has been taken from Internet archives at the website http://www.archive.org, which is evidence that is outside the control of the CCP for deletion or revision.
5. Use of death row organs: from outright denial to a high profile admission
The CCP had been quite clear and consistent in denying the use of death row organs.
In March 2006, Qin Gang claimed in a press conference that reports of organs being removed from death row inmates in China were complete lies that had been fabricated to mislead the public.
On April 10, 2006, Mao Qunan, a spokesperson for the Health Ministry, denied overseas media reports that China arbitrarily took organs from death row inmates. He claimed that the primary source of organs in China was volunteer donors upon their passing away.
On October 10, 2006, in response to BBC reporter Rupert Wingfield-Hayes' article "Organ sales 'thriving' in China," China's Ministry of Foreign Affairs spokesperson Qin Gang said, "Some foreign media fabricate news when reporting on organ transplants in China to attack China's legal system."
However, on August 26, 2009, China Daily, China's official English newspaper, made a high profile admission for the first time that executed prisoners were currently providing two-thirds of all transplant organs. This was interpreted by the international community as the official number backed by the Chinese government.
However, the CCP's transition from categorical denial of the widespread use of organs from death row inmates to a high profile admission took place as serious charges were being brought against it: procuring organs from living Falun Gong practitioners. How can people today believe the CCP's denial of these serious new charges any more than its consistent denial of using organs from executed inmates?
Some Chinese organ transplant experts tried to increase the reported percentage of organs from executed prisoners as early as 2005. We cannot tell whether their purpose was to make public the use of death row organs or to cover up an even greater crime. However, the latter is a strong possibility, since these experts have been well aware of the facts of harvesting organs from Falun Gong practitioners.
Admitting the wide use of death row organs and denying allegations of organ harvesting from living Falun Gong practitioners, while resolutely opposing any independent investigation into these allegations, is the CCP's current stance. Its overly high profile campaign to reform death row organ procurement and its overly sensitive attitude to charges of live organ harvesting indeed raise suspicians of a systematic cover-up.
6. Another peak in organ transplants?
The establishment of an organ sharing system across China, the legislation to allow organ donation from brain dead patients, raising awareness of volunteer organ donation, and encouraging donation among family members may end up expanding China's organ market to surpass the large figures from 2003 through 2006. Given China's one and a half million patients waiting for organs, organ transplantation will continue to make headlines. Experts and scholars are expected to join the media effort to promote and extol the new rules and regulations. Through these efforts by the CCP, will the crimes against Falun Gong practitioners killed for their organs be covered up and forgotten?
During the drafting of this report, the authors have been reminded by kindhearted people that the CCP may publish carefully manipulated data to defend the skyrocketing of China's organ market during the years from 2003 to 2006. Regardless, given the fact that the CCP instigated the persecution of Falun Gong in the first place--and on such an unprecedented scale and with such cruelty--which led to allegations of live organ harvesting, any further actions the CCP takes can only diminish its credibility in the eyes of the Chinese and the world over and ultimately accelerate its demise.
Chapter XIII. What can you do?
"My God! I can't believe this is true!" This might have been your reaction when you first heard about live organ harvesting.
You are not alone. Sixty years ago, Felix Frankfurter, Supreme Court Justice, said something similar when he learned about the Nazi killing of Jews.
1. An excerpt from Karski: How One Man Tried to Stop the Holocaust
Today we all know the unquestionable veracity of the Holocaust, the systematic killing of Jews in concentration camps by the Nazis. We tend to assume that when it was happening, the existence of the Nazi death camps was a well-known fact. People may wonder: how come everyone knows about the Holocaust, while few people know the inside story of live organ harvesting in China? Some have used the different reactions of the outside world as a reason to refute the organ harvesting allegations.
As a matter of fact, when the Nazis were killing Jews, the outside world did not know about it at all, except for very few who were desperate to get the word out. Sometimes the descriptions were sketchy and conflicting. It was as hard then as it is today to get the facts out regarding the CCP's taking organs from living Falun Gong practitioners.
Karski: How One Man Tried to Stop the Holocaust gives a compelling story of extraordinary courage. Jan Karski, a Polish diplomatic courier, escaped a Soviet prison and endured Nazi torture. Karski snuck into the Warsaw ghetto and into a Nazi death camp so that he could witness the mass murder first hand. In 1942-43, Jan Karski reported on the extermination of Jews to British and American leaders. At the arrangement of Jan Ciechanowski, Polish Ambassador to the United States, Karski met Felix Frankfurter, U.S. Supreme Court Justice, at his first dinner upon arriving in Washington D.C. The following conversation took place after this dinner.
The Supreme Court justice sat opposite Karski, looking into his eyes.
"Mr. Karski," Frankfurter asked, "do you know that I am a Jew?"
Karski nodded.
"There are so many conflicting reports about what is happening to the Jews in your country," Frankfurter said. "Please tell me exactly what you have seen."
Jan spent half an hour patiently explaining how his missions to the Ghetto and the camp had come about and precisely, in gruesome detail, what he had witnessed. When Karski finished, he waited for the visitor to make the next move.
Frankfurter silently got up from his chair. For a few moments, he paced back and forth in front of Karski and the ambassador, who looked on in puzzlement. Then, just as quietly, he took his seat again.
"Mr. Karski," Frankfurter said after a further pause, "a man like me talking to a man like you must be totally frank. So I must say: I am unable to believe you."
Ciechanowski flew from his seat. "Felix, you don't mean it!" he cried. "How can you call him a liar to his face! The authority of my government is behind him. You know who he is!"
Frankfurter replied, in a soft voice filled with resignation, "Mr. Ambassador, I did not say this young man is lying. I said I am unable to believe him. There is a difference." [67]
Over 60 years later, this account is as pertinent as it was then. When you exclaim "My God! I can't believe this is true!" upon hearing accounts of live organ harvesting, you may make an additional comment, as Justice Frankfurter did, "I did not say [he] is lying. I said I am unable to believe him."
2. Even a single case of live organ harvesting amounts to a monumental crime
The CCP has consistently stonewalled outside investigations. It has guarded information related to death row inmates as state secrets. Efforts to analyze organ sources from death row inmates and living Falun Gong practitioners face a tremendous challenge. However, based on some public data and observations, the limitation of organs from death row inmates and the features of China's organ market, especially with witness accounts from those with inside information, extensive telephone investigation, and testimony by organ mediation agents have all led us to believe that the drastic growth of China's organ market from 2003 to 2006 has everything to do with organ harvesting from living Falun Gong practitioners.
Zhang Zhixin, a courageous young woman, was killed during the Cultural Revolution for questioning the CCP policy and its ultimate leader Mao Zedong. What shocked the entire nation was that before her execution, CCP officials cut Zhang's throat to prevent her from shouting out anything inconvenient to the regime. Later on, many thought that the Cultural Revolution was a thing of the past. However, in 1999, the overwhelming slander and persecution against Falun Gong revived what was going on during the Cultural Revolution. Zhang's reputation was restored, but the mechanism that killed her has not been dismantled in China. If the organ harvesting allegations are true, it represents, to quote Kilgour and Matas, "a disgusting form of evil which, despite all the depravities humanity has seen, are new to this planet."
A single occurrence of such an atrocity, not to mention its appearance on such a systematic scale, amounts to a monumental crime. These are the most blatant reflections on the authoritarian regime's utter disregard for life.
3. So-called "economic miracles" are no excuse for persecution
When discussing the CCP's human rights abuses, some people have cited China's economic growth as an excuse. Economic development cannot serve as an excuse or cover-up of the CCP's suppression of the Chinese people. It took Adolf Hitler less than three years to accomplish Germany's so-called "economic miracle". Hitler successfully reduced the unemployment rate to nearly zero from over 30%, which raised Germany's international status and made it a European power again in short order. However, the killing of Jews in concentration camps has defined Hitler's era. No one ever praises Hitler for economic growth during his rule.
China's growth in these years is much more fragile than that of Germany in the 1930's. It has been achieved at the cost of environmental devastation, resource depletion, and moral collapse, a price that will be paid for generations to come. What it all boils down to is a society's morality. If we do not raise our voices to stop such atrocities of live organ harvesting, China will have no future as a state or as a nation.
Many have been driven by economic interests and turned a blind eye to the CCP's brutal suppression of its citizens. However, more and more people are speaking out against such crimes. In his April 2006 letter to President George W. Bush, Dana Rohrabacher, ranking member of the International Organizations, Human Rights and Oversight Subcommittee of the House Foreign Affairs Committee, wrote, "The kind of moral complicity required for the non-consensual removal and sale of human organs is certainly unique. We as legislators, as statesmen and Americans, must not also become complicit in these crimes by keeping silent. History cares not whether we inked another trade deal or helped sell another Boeing 747, but history will judge us if we choose to look the other way when faced with truly indescribable human suffering on this scale."
4. What can you do?
We have seen that the CCP has responded to organ harvesting charges by regulating China's organ market to fool the outside world, while strictly preventing independent outside investigations from being conducted in China. This blatant rejection of outside investigations is an indication that the CCP is involved in a cover-up. The CCP is also hoping that others will forget the drastic growth of China's organ market from 2003 to 2006 against the backdrop of the all-out campaign to suppress Falun Gong.
Czech writer Milan Kundera once described the struggle against Communism as "the struggle of memory against forgetting." What the CCP wants is for people to "forget." What the people of China are struggling for is to "remember."
The CCP of the past cut Zhang Zhixin's throat with impunity, just as the CCP of today can harvest organs from living Falun Gong practitioners. As long as the CCP, which is the source of decades of China's misery, continues to exist, tomorrow's victim could be anyone.
Everyone can do his or her part, in gathering evidence, demanding that the CCP allow independent, outside investigations to be conducted, exposing the truth about this episode in history, and putting an end to the persecution of Falun Gong, the persecution of Truthfulness-Benevolence-Forbearance.
If you are a doctor who has participated in harvesting organs from living Falun Gong practitioners, we hope you will not be blinded by immediate interests. Your involvement in live organ harvesting was brought about by the CCP. Without the overwhelming slanderous campaign and the policy of "beating [Falun Gong practitioners] to death will be counted as suicide," the environment for live organ harvesting would not have existed. What has happened has happened. Keeping your lips sealed and guarding the CCP's secrets cannot alleviate the gravity of these crimes or your remorse. By bringing out the truth, you can live up to your conscience, and reduce or even offset the crimes that were committed knowingly or unwittingly. It is the only way out.
Appendices
1. Technical difficulties in organ transplants
Organ transplantation is a form of live transplantation. Three technical difficulties need be solved.
The first difficulty lies in the immediate vascular connection as soon as an organ is transplanted into the recipient's body. This restoration of blood circulation is critical to supplying nutrition so that cells can stay alive. This requires a different set of surgery techniques from the stitching of regular tissues. This technique for vascular anastomosis was not developed until 1903 by Alexis Carrel, a French surgeon, biologist and eugenicist, who was awarded the Nobel Prize in Physiology or Medicine in 1912.
The second difficulty is to keep the harvested organ alive after it becomes isolated. Under normal temperatures, an organ dies between a few minutes and an hour, which will prevent it from being transplanted into the recipient's body. However, to complete the transplantation within such a time constraint is impossible. Innovative techniques are needed to keep organs alive. The solution is to lower the temperature during a process called perfusion. The lower temperature reduces the nutrition level needed by the cells, which extends the survival time of an isolated organ. Perfusion achieves nutritive delivery of blood. It was not until 1967 and 1969 that F.O. Beizer and G.M. Collins independently developed practical perfusion solutions, which could keep an isolated organ alive for 24 hours. This has gained enough time for organ transplant surgery operations.
The third difficulty lies in the foreign source of the organ being transplanted. Any recipient has an inborn capability and mechanism (immune mechanism) which can recognize, control, destroy and eliminate foreign tissues or organs transplanted into the body. This physiological immune process is clinically manifested as rejection reaction, which can result in damage to transplanted organs and failure of transplantation. Transplanted organs, like other cells in a human body, are composed of two major types of antigens: ABO blood type and Human Leukocyte Antigen (HLA). Together, they determine the rejection reaction associated with homograft. There are only four ABO blood types (O, A, B, and AB). It is not that hard to match suppliers and recipients of the same ABO blood type. However, HLA is extremely complex. It has been discovered that there are seven groups of HLA. They are HLA-A, HLA-B, HLA-C, HLA-D, HLA-DR, HLA-DQ, and HLA-DP, with a total of 148 antigens. The possible permutations are well over 2,000,000. Except for twins from the same egg, it is practically impossible to locate a supplier and a recipient with identical HLA matching. As a result, rejection reaction always follows a homograft. It has to be reversed with intense immune suppression. Immunosuppressant drugs that are clinically effective were not discovered until the 1960s. They include: azathioprine (1961), prednisone (1963), anti-lymphocyte globulin (1966), and Cyclophosphamide (1971). With the advent of these immunosuppressant drugs, organs could be kept alive long enough after transplantation. In 1962, J.E. Murray, who was awarded the Nobel Prize in Physiology or Medicine in 1990, accomplished the extended survival of a human kidney transplant for the first time. It marked organ transplantation as being clinically feasible.
Three types of transplant rejection:
Hyperacute rejection - Hyperacute rejection usually takes place within 24 hours of the transplant. It is the outcome of a xenotransplanted organ in non-immunosuppressed recipients. Hyperacute rejection is a particular risk in kidney transplants. This is commonly addressed by a prospective cytotoxic cross match prior to kidney transplantation to ensure that antibodies to the donor are not present.
Acute rejection - Acute rejection is the most common rejection observed. It usually takes place several days to several months after the transplant. It is caused by mismatched HLA. Most acute rejection cases can be alleviated by immunosuppressant drugs.
Chronic rejection - Chronic rejection usually takes place several months to several years after the transplant. It is a poorly understood process of chronic inflammatory and immune response against the transplanted tissue.
2. Liver transplant charts from two hospitals with close ties to the Chinese military
This chart is taken from the homepage of the Orient Organ Transplant Center in Tianjin. [68] Watermark in Chinese: 'Our accomplishments.' Numbers indicate liver transplants. It claims to have performed the highest number of liver transplant surgeries of all hospitals around the world in 2004. [69]
Number of liver transplant cases at the No. 2 Hospital of the Second Military Medical University (also known as Shanghai Changzheng Hospital) in 1996, 2001, 2002, 2003 and 2004. [70]
3. Published organ transplant statistics by Chinese experts
There are no accurate statistics for the annual number of transplants in China. Estimates provided by various experts based on data at hand differ from one another. However, all statistics have pointed to the significant growth of China's organ transplantation market. For example, Jiankangbao [Health newspaper] reported that Shi Bingyi, member of the standing committee of the Chinese Society of Transplantation, which is a division of the Chinese Medical Association, and director of the Transplant Center of the People's Liberation Army (PLA), estimated that there had been a cumulative count of 90,000 transplant cases by 2005, with close to 10,000 kidney transplant cases and close to 4,000 liver transplant cases in 2005 alone. [71] Shi Bingyi said in another interview by Science Times that the number peaked in 2006, with 20,000 transplant cases in that year. [72] When Shi was a guest at Xinhuanet.com in September 2009, he said that between 8,000 and 9,000 kidney transplant surgeries were conducted in China each year, while liver transplant surgeries numbered between 3,000 to 4,000 each year. [73] Huang Jiefu, deputy minister of China's Ministry of Public Health claimed transplants reached a peak in 2004, with close to 15,000 cases of liver and kidney transplants. [74] Another source, China's Caijing magazine, revealed in Issue No. 18, 2009 that by the end of 2008, cumulated kidney and liver transplants had surpassed 100,000 cases. [75]
The above is an article published by the website of Jiankangbao [Health newspaper]. It is an interview with Shi Bingyi, director of the Transplant Center of the People's Liberation Army (PLA), who estimated that there had been a cumulative count of 90,000 transplant cases by 2005. This article has since been deleted from the website. The screen capture was taken from an archive at http://web.archive.org/web/20060826070646/http: //www.transplantation.org.cn/html/2006-03/394.html.
4. Organ transplants in underground hospitals
Many underground hospitals sprouted up, driven by the high profit margin. This crowded the organ transplant marketplace.
Life Week magazine published a report in its April 2006 issue named "The difficulty of organ transplant regulation." Zhu Youhua, president of the Transplantation Research Institute of the PLA and director of the Organ Transplant Center at Shanghai Changzheng Hospital, told Life Week reporters, "181 kidney transplants and 171 liver transplants were performed in 2005. We also took between 20 and 30 patients who suffered transplant failure from underground hospitals..." The article also quoted Shen Zhongyang, of the Orient Organ Transplant Center, that between 10% and 20% the total number of cases at the transplant center were people who previously had transplant surgeries performed by non-standard measures in underground hospitals. [76]
Therefore, we need to point out the existence of underground organ transplant hospitals. Transplants conducted at these hospitals are likely not included in the statistics by Huang Jiefu, deputy minister of the Ministry of Public Health, and others. As a result, the number of actual transplants that took place between 2003 and 2006 could very well surpass the estimates we have discussed in previous chapters.
5. Organ transplant statistics provided by Huang Jiefu and Shi Bingyi
Huang Jiefu, deputy minister of China's Health Ministry, and others published the article "Government Policy and Organ Transplantation in China" in The Lancet. [77] It contains the following chart:
If we transpose liver transplant cases on top of kidney transplant cases, we get the following chart, with the red line indicating the trend of changes. Note: Huang Jiefu's data between 2003 and 2006 is based on incomplete statistics. Estimates from other experts are much higher.
In fact, Huang Jiefu's data is on the conservative side among statistics we have gathered from organ transplant experts in China. Shi Bingyi, director of the Organ Transplant Center of the PLA, estimated that there were close to 10,000 kidney transplant cases and close to 4,000 liver transplant cases in 2005 alone. Shi Bingyi said in another interview with Science Times that the number peaked in 2006, with 20,000 transplant cases in that year. When Shi was a guest at the Xinhuanet.com in September 2009, he said that currently between 8,000 and 9,000 kidney transplant surgeries were conducted in China each year, while liver transplant surgeries were between 3,000 and 4,000 each year.
6. Organ transplants in other countries
During the same period, the volume of transplant surgeries have been relatively stable in other countries. The number of transplant surgeries increased from about 1,600 to about 2,250 in Canada between 1997 and 2007. [78] In the United States, the number increased gradually from a little over 20,000 to slightly below 28,000. [79]
Number of organ transplants in Canada from 1996 to 2007
Number of transplants by donor type in the U.S. (Jan. 1, 1997 - July 31, 2009)
7. Average waiting period for organs in Chinese hospitals
The following are average waiting periods for organs as taken from websites of Chinese hospitals.
Average waiting period of two weeks at the Orient Organ Transplant Center (Tianjin) (Original content deleted; screen capture from an archive at: http://web.archive.org/web/20060207021805/http://www.ootc.net/)
Average waiting period of one week for liver transplants at the No. 2 Hospital of the Second Military Medical University (Shanghai Changzheng Hospital) (Original content deleted after the exposure of live organ harvesting by overseas media; screen capture from an archive at: http://web.archive.org/web/20050210151434/www.transorgan.com/apply.asp
See the following chart for changed text on the hospital's website.)
The text was changed to: "Operations will be arranged as soon as a patient checks into our hospital." (http://www.transorgan.com/apply.asp)
Average waiting periods for liver and kidney transplants at the China International Transplantation Network Assistance Center of the No. 1 Affiliated Hospital of the China Medical University in Shenyang City, Liaoning Province (original content deleted; screen capture from an archive at: http://web.archive.org/web/20041023183012/zoukiishoku.com/cn/jueding/index.htm)
8. Cost of organ transplants
Cost of transplant surgeries listed at the website of the China International Transplantation Network Assistance Center of the No. 1 Affiliated Hospital of the China Medical University in Shenyang City, Liaoning Province (original website in Japanese, Russian, English, and Chinese languages was closed after overseas exposure of live organ harvesting; screen capture from an archive at: http://web.archive.org/web/20060422143018/en.zoukiishoku.com/list/cost.htm)
9. Guarantee of donor quality
The China International Transplantation Network Assistance Center of the No. 1 Affiliated Hospital of the China Medical University in Shenyang City, Liaoning Province published answers to most frequently asked questions on its website emphasizing live organs being used in organ transplants.
The Chinese text circled emphasizes that the organs are live organs. The China International Transplantation Network Assistance Center website has since been taken offline. Screen capture from an archive at: http://web.archive.org/web/20041023193430/zoukiishoku.com/cn/wenda/index.htm.
10. Disappearance of the Chinese Society of Organ Transplantation website
After the exposure of organ harvesting from living Falun Gong practitioners on March 9, 2006, the website of the Chinese Society of Organ Transplantation (www.cstx.org) affiliated with the China Medical Association soon disappeared. It was redirected to the website of the China Medical Association (www.cma.org.cn). As of November 2009, the cstx.org website remains offline. The Internet Archive indicates that the cstx.org website was last updated in February 2006, at which time it clearly stated that it was sponsored by the Chinese Society of Organ Transplantation and implemented by the Organ Transplantation Research Institute of Tongji Medical School of the Huazhong University of Science and Technology.
The website of the Chinese Society of Organ Transplantation affiliated with the Chinese Medical Association before it disappeared. Screen capture from an archive at: http://web.archive.org/web/20051201024138/www.cstx.org/xhjj2.htm.
11. "Organ deal behind the death of a beggar" - South Wind Window magazine
Cover and headline "Organ deal behind the death of a beggar" of South Wind Window magazine, Issue No. 14, 2007.
12. "Where did the organs come from?" - Cover story from Caijing magazine revealing a case of killing for organs
Caijing [Finance and Economics] magazine, Issue No. 18, 2009 (published on August 31, 2009), carried a cover story "Where did the organs come from?" which revealed the case of killing of a homeless person for his organs. Original link: http://magazine.caijing.com.cn/2009/cj245/ appears to be broken. A copy of the report was also found at http://www.transplantation.org.cn/zyienizhonghe/2009-09/3906.htm.
Note: Caijing magazine has been known for its courage in exposing the dark side of Communist bureaucrats and publishing sensitive news reports. However, a human resources shakeup took place in the second half of 2009, and over 150 editors and reporters, which was almost the entire staff, resigned during this period.
References
[1] The Epoch Times, "Unsolved: Organ Harvesting in China, Interview with Manfred Nowak," http://theepochtimes.com/n2/content/view/20596/
[2] United Nations Committee Against Torture, Forty-first session, Geneva,3-21 November 2008, "CONSIDERATION OF REPORTS SUBMITTED BY STATES PARTIES UNDER ARTICLE 19OF THE CONVENTION: Concluding observations of the Committee against Torture," http://www2.ohchr.org/english/bodies/cat/docs/CAT.C.CHN.CO.4.pdf
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[5] China Daily reported that live organ transplants account for 15urgery cases in 2006. The number has now approached 40%, 65% which are from death row inmates. China Daily, "Public Call for Organ Donations," http://www.chinadaily.com.cn/china/2009-08/26/content_8616938.htm
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[55] Karl Binding and Alfred Hoche, Die Freigabe der Vernichtung Lebensunwerten Lebens (Allowing the Destruction of Life Unworthy of Life), 1920.
[56] Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide, 1986.
[57] South Wind Window magazine, No. 14, 2007, "Organ Deal Behind the Death of a Beggar," http://www.qikan.com.cn/Article/nafc/nafc200714/nafc20071413.html
[58] Chinese-edition website of Deutsche Welle, "What responsibilities the medical community has - Organ deal behind the death of a beggar," http://www.dw-world.com/dw/article/0,2708033,00.html
[59] Ouyang Hongliang and He Xin, "The case of killing for organs," Caijin [Finance and Economics] magazine, http://www.transplantation.org.cn/zyienizhonghe/2009-09/3906.htm
[60] The Epoch Times, "Exposing Shocking Horrors Inside Sujiatun Concentration Camp," March 9, 2006, http://epochtimes.com/gb/6/3/9/n1248687.htm (English version: http://theepochtimes.com/news/6-3-11/39169.html)
[61] The Epoch Times, "New Witness Confirms Existence of Chinese Concentration Camp, Says Organs Removed from Live Victims," March 17, 2006, http://epochtimes.com/gb/6/3/17/n1257362.htm (English version: http://theepochtimes.com/news/6-3-17/39405.html)
[62] The Epoch Times, "Sources Reveal Other Chinese Concentration Camps," March 31, 2006, http://epochtimes.com/gb/6/3/31/n1271996.htm (English version: http://theepochtimes.com/news/6-3-31/39910.html)
[63] Minghui.net, Between Life and Death, a video production by New Tang Dynasty Television, http://minghui.ca/mh/articles/2009/9/1/207542.html
[64] David Matas and David Kilgour, Bloody Harvest, 2007, http://organharvestinvestigation.net/report0701/report20070131-ch.pdf (English version: http://organharvestinvestigation.net/report0701/report20070131-eng.pdf)
[65] CCP Sujiatun District Organization Department, "Japanese Army Fortification System Appears in Our District," August 8, 2005, http://www.sjtdj.gov.cn/xuancuan/show.asp?ids=2643
[66] New Tang Dynasty Television, "Doctor Lu Guoping's Voice at the 18th minute of the Phoenix TV footage," Zooming In, No. 94, http://www.ntdtv.com/xtr/gb/2009/04/08/a278863.html#video
[67] E. Thomas Wood and Stanislaw M. Jankowski, Karski: How One Man Tried to Stop the Holocaust, Wiley and Sons, 1996
[68] Orient Organ Transplant Center in Tianjin, chart on the center's own webpage has been deleted, and screen capture is taken instead from an archive at http://web.archive.org/web/20060412162605/http://www.ootc.net/
[69] Orient Organ Transplant Center in Tianjin, "Center's Accomplishments" web link, http://www.ootc.net/CenterContent.aspx?newsID=12
[70] No. 2 Hospital of the Second Military Medical University (also known as Shanghai Changzheng Hospital), chart on the hospital's own webpage has been deleted, and screen capture is taken instead from an archive at http://web.archive.org/web/20050317130117/http://www.transorgan.com/about_g_intro.asp
[71] Jiankangbao [Health newspaper], March 2, 2006, "The bar has to be raised for organ transplantation," an article which has been deleted from the newspaper's website after the exposure of organ harvesting, and screen capture is taken instead from an archive at http://web.archive.org/web/20060826070646/http://www.transplantation.org.cn/html/2006-03/394.html
[72] Science Times, "Organ shortage is the bottleneck of the growth of the transplantation course," http://www.sciencenet.cn/html/showsbnews1.aspx?id=182075
[73] Xinhuanet.com, "Transcript of an interview with Shi Bingyi: A discussion over organ transplantation in detail," http://news.xinhuanet.com/mil/2009-09/11/content_12035251_2.htm
[74] Huang Jiefu, Mao Yilei, and J. Michael Millis, "Government Policy and Organ Transplantation in China," The Lancet, http://download.thelancet.com/flatcontentassets/series/china/comment11.pdf
[75] Wang Xuan, "Where do organs come from?" Caijing magazine, http://www.transplantation.org.cn/zyienizhonghe/2009-09/3905.htm
[76] Life Week magazine, "The difficulty of organ transplant regulation," http://www.lifeweek.com.cn/2006-04-17/0005314976.shtml
[77] Huang Jiefu, Mao Yilei, and J. Michael Millis, "Government Policy and Organ Transplantation in China," The Lancet, http://download.thelancet.com/flatcontentassets/series/china/comment11.pdf
[78] Dr. Lilyanna Trpeski, "Report on CORR Performance and Recent Trends in Donor, Transplant and Waiting Statistics in Canada-Preliminary Results," http://www.cihi.ca/cihiweb/en/downloads/Clinical%20CAT224a1cresentation_donors_2008_fial.ppt
[79] U.S. Department of Health & Human Services, http://optn.transplant.hrsa.gov/latestData/rptData.asp
Category: Organ Harvesting
