You’re suffering from chronic renal disease: your kidney is dying. You are dying. It’s not quick and painless – quite the contrary. But at least time is on your side.

In the United States, it might take 10 years before receiving that new kidney. Your chances of dying during that time are approximately 50%. It’s frightening, but it’s not hopeless. In China, under the same circumstances, you would be one of 1.5 million Chinese needing a new kidney, liver or heart. Last year, only 10,000 of them found donors, the majority of which were through illicit means.

Source: abc.net.au

The morbid stories that emerge from China in relation to organ trafficking have been well documented. China Daily estimated close to 60% of all transplanted organs came from executed convicts. Prisoners on death row have blood tests taken regularly, and are at the mercy of someone with the sudden need and ample wherewithal to negotiate with doctors and guards like clients haggling with the local butcher. The criminals are executed with a bullet to the back of the head and often the organs are removed in an ambulance present at the execution grounds.

Harrowing tales of impoverished Chinese, desperate for money, selling their organs to survive represent a large chunk of the remaining 40% of donations. A few months ago, Chinese news reported the experience of 26-year-old Hu Jie, from Henan, who considered selling one of his kidneys to a black-market broker for 40,000 RMB to pay his debts. He backpedaled at the last moment, but was nevertheless bound to an operating table, sedated. He woke up to a body stolen of its left kidney, not a Yuan richer, and with no post-surgical care. 

These cases are all too common in China, and while none can blame those turning to the black market for organs (indeed, when your life or that of a loved one is at stake, would you not look everywhere for a solution?), the venality and absence of morality of the doctors and middlemen should be condemned. Only this February did the Standing Committee of the National People's Congress, China's top legislature, criminalise underground organ trafficking.

Underground trafficking thrives

So why is it still rife and thriving? First, because as long as there’s a demand, there will be a profit to make. And with the supply so infinitesimally small, the potential gain is huge. The real problem lies therein: the quasi non-existent supply.

At the moment, the only thing that has led people to willingly donate their organs is desperation. Even in the advent of accidental death, the prevalent stance still runs counter to donation. Just over two months ago, the government in Shanghai included an organ donation clause for new drivers. The driving licenses would give Chinese the option of ticking a box, so that in the event of an accidental death on the road, their organs would go out to those in need of transplants. The move ignited a virulent wave of anger from people, furious about being told to contemplate their own death, thereby inviting bad luck, but also furious about the government attempting to apply Western methods in a Chinese society whose values are not compatible.

Percolating down from the many teachings of Confucius is the belief that one should not alter the body. The sage once described deference and respect to one’s parents being best shown by not damaging that which they gave us. Compounded with the absence of information available on organ transplantation, it’s not surprising people refuse to donate, and accounts for an organ donation pilot program, spanning across 11 provinces between March 2010 and February of this year, showed only 37 voluntary organ donations.

Source: cbsnews.com

In light of this dramatic disparity between those in need and those who give, a gap that can only grow wider, China’s health ministry has proposed new incentives for potential donors, including tax rebates, lower medical costs, medical insurance, and free burial costs in case of accidental death.

Undoubtedly, this is a move in the right direction. Altruism isn’t a myth, but it also isn’t common; providing financial incentives to donors is a sensible approach. But it’s not enough, and as it stands, it will not work.

Why? Because in order to get people to accept a radical ethical and cultural change, they don’t just need to be rewarded for it, they also need to believe it. As it stands, the feeling shared by many Chinese towards their government is one of constant doubt and suspicion. Lack of transparency and accountability have made public endeavors the targets of immediate skepticism and distrust among the population. Case in point, the state-owned Red Cross society in China, in charge of the aforementioned organ donation pilot programme, recently ignited fury online and made headlines in the international media for repeated accusations of corruption. How do you trust a government when even its philanthropic arm is corrupt?

Change is needed

The medicine is bitter to swallow, but at least it’s there. Revise laws, to avoid loopholes from being the only obstacle to people buying and selling organs. Offer social and financial incentives to those who register for posthumous organ donation. Examples abound on the international scene: scholarships, business grants, increased health insurance etc.

But most importantly, make the system of organ donation as transparent as possible. Show how the collection and extraction of organs is done, how the selection process works for those demanding a transplant. As clearly as possible, convince people that the doctors responsible for transplants have no authority in choosing who gets what.

Maybe then, the Chinese people will shed their doubts, discard an archaic concept that lingers while thousands suffer, and finally accept to help each other, and in so doing help themselves.

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Keywords: Organ donation China organ trafficking China China organ transplants