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Europe's poorest country supplying organs to its neighbours 9/7/01
SERGHEI TIMUS (TRANSLATION):
I woke up and it was all over
without me knowing. I had a feeling
that something inside me was
missing. My whole body was aching.
DR MICHAEL FRIEDLANDER:
Hadassa University Hospital)
There are middle men making a lot
of money, it's one of the worst
things that is happening in the
I was aware that to buy a kidney
transplant is illegal everywhere
in the world.
Our story begins in the former
Soviet Republic of Moldova,
which abandoned Communism,
flirted with capitalism and has
elected a Communist government
back again. Not that it's done
them much good. 90% of the
people earn less than $2 a day,
less than they earned under
Soviet rule. Moldova is officially
the poorest country in Europe,
which brings it, economically,
on a par with the developing
world. Those countries have
survived on one major asset,
cheap labour. But in Moldova,
as in much of the former Soviet
Union, manufacturing industry
has collapsed, leaving people
here with only one asset of
any economic value, their bodies.
It was two years ago that
Niculae found himself with a
pregnant wife, a child with another
on the way, and heavily in debt.
In despair, he asked around.
NICULAE BARDAN (TRANSLATION):
I'd heard about this business
from another villager. He'd gone
there and when he returned home,
I saw he had a car. I asked him,
"Where did you get the money
to buy a car?". And he said,
"Ask Nina down the road, she sent
me to Turkey and I sold one of
arranged for Niculae to sell his
kidney. She charged him $100, as
did her partner, Nina Scobiola,
who met him in Istanbul. After
spending $100 on travel, Niculae
was left with $2,700.
I bought this house, but
what's the use? I'm no longer
the person I used to be, I gave
away my health.
Serghei didn't want to sell his
kidney, he wanted a job in Turkey.
He was sent to Istanbul, where
he was met by Nina Scobiola. She
told him that the job was off, and
that the only way she knew that
he could get the bus fare back to
Moldova was by selling some
blood. She took him to a private
They put me on an operating table
and gave me an injection. It must
have been an anaesthetic because I
didn't feel anything. I woke up,
and I had a feeling that something
was missing inside me. My whole
body was aching. I couldn't get
up, I lay there for two days on a
drip. It was New Year and I was
on an operating table! I was
furious. I had a big row with
Nina. But she presented me
with a fait accompli and offered
me money. She said, "Either
you take the $2,700 I am
offering or you get out of this
predicament by yourself." Of
course, I had no alternative
but to agree. I was already
$1,500 in debt, so I payed
it off, and the rest soon went.
Six months later, all I had left
was a pain in my left side, and
a stamp in my passport. That
Serghei, who never wanted
to surrender a kidney, is
now worried about his health.
He has an appointment with
Dr Adrian Tanase, Moldova's
leading kidney specialist.
Using an ultrasound, Dr
Tanase takes a closer look
at Serghei's remaining kidney.
DR ADRIAN TANASE (TRANSLATION):
On the right side, we can
see his kidney, it's there. Its
size and structure are normal.
On his left side, the kidney is
not there. It is absent from
the place where it should be.
Serghei is reassured, for the
time being. Dr Tanase thinks
a medical time bomb is counting
down in Moldova, problems. He
fears a future in which those with
only one kidney will develop
renal problems, and there will
be little anyone can do for them.
Stories involving kidneys are
familiar to the Moldovan police.
In the village of Mingir alone,
they have interviewed 14
young men who'd sold their
kidneys through the two Ninas,
as the women are now known.
MAJOR VALERIU GALIT (TRANSLATION):
(Department of Organised Crime)
The working relationship
between the two women was
as follows, people who wanted
to sell their kidneys went to Nina
Ungureanu in the village, who
would sort out their documents
and travel. Then she would call
Nina Scobiola in Turkey. Once
she gave the go-ahead, these people
would be taken to Istanbul where
they'd be operated on to order.
A warrant has been issued for
Nina Scobiola's arrest, but the
police don't know where she is.
However, the other Nina, Nina
Ungureanu is still at her home
back in Mingir. Victor, in the
white T-shirt, wants Nina's help.
He'd borrowed money to look
for work abroad, but lost all his
documents in a fire, and now his
creditors are after him.
There's no other way I could
pay back my debts. In our country,
you don't mess around with things
like that. Things could happen, to
me, to my family. In this country,
you could disappear. Of course I
am afraid. I'm afraid about how I'll
get there, how the operation will
go. I am afraid that I might be
cheated out of my money or worse
Despite his fears, Victor goes
to the village of Mingir to try and
strike a deal with Nina Ungureanu.
One of our team accompanies him
with a secret camera. Victor asks
her how many people she usually
sends to Istanbul.
NINA UNGUREANU (TRANSLATION):
Four, five, sometimes six people.
Just one person at a time?
No, that would be a waste of
a journey. We put them on the
coach to get there. It was routine.
Up until recently, people would go
over there and make good money.
Those who knew how to look
after money got a good start in
life. The drunks just wasted it.
It sounds a bit illegal to me.
Totally illegal! It was illegal
and now someone's gone and
spilled the beans and they've
dragged us into it too. At least
I've made some money from
it. Thank God! I need it badly.
But we have had to stop for a while.
The police are going to make us
sweat for a bit, and then they'll
just drop it.
Clearly, Nina Ungureanu won't
be able to help for now, but
Victor reckons if so many
people have done it before, he'll
try his luck in Istanbul on his
own. Nina has told him that
wealthy Israelis are currently
paying around $200,000 for
the operation. He can only
expect to get about 1% of that,
but he hopes it'll be enough
to pay off his debts. He's got
some names of Moldovans
who may be able to help him
when he gets to Istanbul.
He asks us to keep out of the
way, he doesn't want anything
to spoil his chances. While
Victor sets out on his own,
we set about finding the doctors
and agents who are charging
thousands of dollars for kidney
operations and who are, apparently,
operating openly and with
impunity. It's well known in
Turkey who the "Dr Big" in the
illegal transplant business is, Dr
Yusuf Sonmaz, referred to by
fellow doctors in Turkey as "our
very own Dr Frankenstein". Dr
Sonmaz was first exposed four
years ago, but is still operating.
Part of the problem is that video
material is not admissible as
evidence in Turkish courts. Dr
Sonmaz has been secretly filmed
negotiating with donors and telling
them to sign papers stating that
they are voluntarily donating their
kidneys, to make it look legal.
After this was broadcast, he was
arrested, investigated and later
released. Dr Sonmaz was banned
from working in the public sector
for life because of his illegal work,
by the Istanbul Health Authority,
who also told us that no private
clinic is licensed to perform
kidney transplants in the city.
So how is it that Dr Sonmaz
has continued to operate?
OSMAN KARAASIAN (TRANSLATION):
(Director, Istanbul Health Department)
If organ trading is the issue here,
I must insist that it is not the state
that is doing it. It is this individual's
concern. But even if this individual
is doing it, we are not allowing
him to do it within the existing
law. This person is not doing
what he is doing with any kind
of permission from the health
department! If he is doing it, he
is doing it illegally.
The health authority told us that
they'd shut down every hospital
where Dr Sonmaz has been
found carrying out kidney
transplants, including this
one, where he was found
performing operations earlier
in the year. But we found the
windows were open and people
were going in and out. A
caretaker told us that Dr Sonmaz
came to hospital daily. We left
a letter asking him for an
interview. When we called again
two days later, we got a frosty
reception. I asked why, if the
hospital was closed, were there
so many people in and around the
UNNAMED NURSE (TRANSLATION):
No, ma'am, the hospital is closed.
Can you please tell her the hospital
is officially closed and that they are
committing an offence. It is sealed!
It is officially closed!
There is a car outside making
UNNAMED MAN (TRANSLATION):
It's the lunch, they carry in the
lunch. There is a clinic upstairs
and the food goes there.
So the hospital is still working?
What is your job at the hospital?
I am a nurse here.
For kidney transplants?
No. I am a nurse at this hospital.
Dr Sonmaz has a different crew.
The caretaker told us that Dr
Sonmaz comes here every
I really don't know how he came
to be here, or how he picked up the
letter you left. I just don't know.
We were asked to leave, and
told there'd be no interview
with Dr Sonmaz. The police in
Istanbul told us that they believe
he's still working in the city,
and has been ever since he was
so publicly exposed. Back in
Moldova, Serghei is testament to
this. He'd had his kidney stolen
after the medical authorities took
Yes, yes, this is Dr Yusuf.
I know him. He carried out
the initial medical examination
before my kidney was stolen.
And after the operation, he was
the first person I saw. It's him!
Yes, it's him, the doctor who
took out my kidney.
A picture is emerging of Dr
Yusuf Sonmaz as a talented
but arrogant man, who's been
going around Istanbul saying
that he plans to carry on
operating indefinitely. There
are infinite possibilities for a
skilled surgeon living in
Turkey, with a country of
desperate poverty to the north,
and a country with a queue
of wealthy, eager kidney
patients to the east. Nearly
all the donors we spoke to
said that the recipients of their
kidneys were from one country.
Mike Levinsky was one of the
first Israelis to travel to Istanbul
to Istanbul to get a new kidney
from Dr Sonmaz. A security man,
Mike didn't have enough money
to pay the $60,000, the going rate
four years ago. He called on the
local mayor and his rotary club
to help raise the money. What
did Mike think of Dr Sonmaz?
thought he was excellent. He
was a very sympathetic person.
Did you know that what he
was doing is illegal in Turkey?
I was aware of the fact that
to pay for a kidney transplant
is illegal everywhere. But there
is a Jewish saying, "Don't pass
judgement on another person
before you've been in their
situation". Any solution that
frees you from the prison of
the dialysis machine is the
answer, no matter what.
As a pioneer of the Turkish
solution to the problem,
Mike now gets letters from
kidney patients in Israel,
begging for advice. He is
able to reassure them that
funding is no longer the
problem it was five years
ago, when he had to raise the
money. In Israel, the medical
insurance companies, known
as sick funds, are part financed
by the Government. These
companies now partly reimburse
patients who have gone abroad
for kidney transplants. Israel
also has the lowest number of
donors per head of population of
any country in the developed
world. It's widely believed here
that you must go to the grave
intact. Little wonder that
hundreds of Israelis have created
a production line that starts in
the villages of Moldova, where
men today are walking around
with one kidney. Professor
Yonatan Halevy is the director
of the Israeli National Transplant
Centre. You cannot deny that
public funds being used in Israel
to fund illegal kidney transplant
PROFESSOR YONATAN HALEVY:
(Director, National Transplant Centre)
Well, indirectly, I don't deny it, I
condemn it. I don't deny it, but the
sick funds are facing an enrollee
who says, "I have no chance of a
to get, in the foreseeable future,
a transplant in Israel. At least pay
me what you would have paid
my hospital in Israel to perform
the transplant". And they give
him the money. In an indirect way,
this is public money that may be
going towards purchasing of
In a queue of patients waiting
for check-ups in the kidney unit
at Jerusalem's Hebrew Hospital,
almost half those who've had
transplants have had them abroad.
The leading doctor supports them,
but isn't he condoning a crime?
DR MICHAEL FRIEDLANDER:
Hadassa University Hospital)
I am not condoning. I do not
have to condone, it is the patient's
decision. The paternalistic idea
that we used to have a doctor
who told a patient what to do is
gone. Patients come to me with
much more information about
the subject than I have myself.
But it's becoming absurd in the
last year. We have patients
coming back from the US,
having bought kidneys from
paid donors. As far as I can
ascertain, there are 20-40
centres in the US who don't ask
too many questions a patient.
They don't want to know.
Dr Friedlander wants the whole
business to be put above board.
For the next year or two, we
will allow donors to come
and be paid not by the patient
but by a sick fund or the
Government. Middlemen are
making a lot of money. It's
one of the worst things happening
in the illegal market. If you make
the system legal, you cut out
The middlemen are kept busy.
With 800 patients on the list
for transplants in Israel, and
with very few legal organs from
cadavers, the brain dead, there's
a four-year wait for kidneys
here. With a secret camera,
we arrived for an appointment
at the smart Tel Aviv offices
of one of the middlemen. I
was posing as the wife of a
very ill kidney patient, so ill
that he wouldn't stand a chance
of a transplant operation in
Britain. But I was told that
a "private transplant" for my
husband could be easily
arranged. Mr Dayan was
anxious to make it all sound
We only work with cadavers
and we will do it in Europe.
It'll take three or four months.
How long might he have to
Three months, four months,
let me see.
I don't understand, in London,
I've been told there's no hope
as the waiting list is so long.
But this is our business to do
That is wonderful. The operation
could not be done in any of the
countries of the European Union,
where there are strict rules in
force and years-long waiting
lists. We can only guess as to
where in Europe Mr Dayan is
currently sending his clients.
Who knows? It could even
one day be to Moldova where,
it's rumoured, Israelis are
negotiating to buy this hospital,
to convert it into a private
kidney transplant clinic. The
production line could be
coming full cycle. The idea
of legitimising the kidney
business remains anathema
to most medical establishments.
More likely, the business
will remain clandestine and
illegal, with the main
beneficiaries being the
middlemen, the doctors, and
the kidney recipients.
The important message I
want to give to you and
the outside world is that it
is our duty to take a person
who is not productive,
and who is dependent, and
to bring him back to being
a citizen who can contribute
to the community.
I do not know exactly who
received my organ. There
were two men and one
woman there, all Israelis.
It would have been one of
them who got my kidney.
What can I say to that
person? Even though they
got it through deceit, what
is done is done. Let him or
her be healthy, but let it be
on their conscience.