VZCZCXYZ0001
PP RUEHWEB

DE RUEHEG #1188/01 1621221
ZNR UUUUU ZZH
P 101221Z JUN 08
FM AMEMBASSY CAIRO
TO SECSTATE WASHDC PRIORITY 9507

UNCLAS CAIRO 001188 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO KCRM EG
SUBJECT: POVERTY, LEGAL LOOPHOLE FUEL EGYPTIAN ORGAN TRADE 
 
Sensitive but unclassified.  Please handle accordingly. 
 
¶1. (SBU) Summary: Recent years have seen increased Egyptian 
and international media reports of both the consensual sale 
and theft of human organs in Egypt, earning the country a 
spot on the World Health Organization's 2007 list of the 
world's top five organ trafficking "hotspots". Rising poverty 
rates are leaving many Egyptians desperate for money, which 
can be earned quickly by selling, stealing or brokering 
organs. Yet continued disputes among legislators have 
prevented the passage of a law to criminalize any aspect of 
the organ trade. These circumstances contribute to an 
ever-growing black market in organs, in which brokers can 
earn more money than those dealing in drugs, without fear of 
legal ramifications. This market has attracted both rich 
organ-buyers and poor organ-sellers from neighboring 
countries, making Egypt a regional hub for the illicit trade 
in organs.End summary. 
 
--------------------------------- 
True Scope of the Problem Unknown 
--------------------------------- 
 
¶2. (U) There are no official statistics gauging the scale of 
organ trafficking in Egypt. The Egyptian Physician's 
Syndicate stated in late 2007 that its Medical Ethics 
Committee reviews about 500 to 1,000 organ sale cases 
annually. Yet a number of indicators point to a much higher 
figure: frequent local press coverage of new cases and a new 
Ministry of Health crackdown, which has resulted in the 
closure of numerous clinics and hospitals. However,as an 
Egyptian journalist who went undercover in the organ trade 
emphasized, the number of cases actually reported to either 
the press or the police will remain unrepresentatively low as 
traffickers use a combination of bribery and violence to 
prevent their victims from speaking out. 
¶3. (U) Much of what is known about the organ trade in Egypt 
has come from those who have come forward after willingly 
selling an organ or falling prey to organ theft. From these 
sources, two scenarios have emerged to explain how organ 
traffickers operate. In March 2008, the LA Times reported on 
the first scenario, in which people desperate for money are 
approached by brokers who openly offer up a tempting trade ) 
an organ (usually a kidney or part of a liver) for an amount 
between 10,000 LE and 40,000 LE (1,870 USD and 7,570 USD). 
Knowing this sum (a veritable fortune by Egyptian standards) 
would take many years to earn otherwise, many agree to 
undergo the procedure, often under sub-standard conditions 
which seriously jeopardize the donor,s health. A World 
Health Organization study indicates 78% of paid kidney donors 
in Egypt experience a significant deterioration in their 
health status after the procedure. 
 
¶4. (U) The second scenario, detailed in the current affairs 
publication Egypt Today, involves traffickers posing as 
businessmen who approach people looking for work and offer 
them lucrative jobs abroad. For the ostensible purpose of 
obtaining work permits and visa approval, the fictional 
employer requires a series of medical examinations during 
which the unsuspecting victims are sedated and their kidneys 
or parts of their livers are removed. Afterwards, the victims 
are typically told the procedure was necessary for their own 
health and are coerced into remaining silent. Despite the 
recurrence of organ theft stories in the Egyptian media, an 
Egyptian representative of the Transplantation Society told 
embassy representatives experts attribute most of the organ 
trade to voluntary donation driven by poverty, while 
elaborate organ theft schemes are less common. 
 
--------------------------------------------- ------ 
No Legal Regulations for Organ Transplants or Trade 
--------------------------------------------- ------ 
 
¶5. (U) The willing sale and theft of organs are facilitated 
by a legal loophole. The only laws explicitly concerning 
organ transplants forbid transplants from deceased donors and 
regulate cornea transplants. The law does not regulate 
legitimate transplants in which a close relative is the donor 
and no compensation is involved. Dr. Refaat Kemal, Egypt's 
leading liver transplant surgeon and an advisor to Egyptian 
lawmakers on transplant issues, has been pushing for the 
legalization of cadaveric transplants to be included in any 
law concerning organ transplantation and trade. Dr.Kemal says 
many Egyptians remain morally opposed to the practice; even 
though it is accepted in 19 Muslim countries and would 
significantly increase the availability of organs for 
transplantation. 
 
¶6. (U) As a consequence of this legal vacuum, the Center for 
Organ Failure Solutions reports the investigation and 
prosecution of organ traffickers is exceedingly difficult. 
Egypt's leading professional association for medical doctors, 
the Physician,s Syndicate, has assumed the responsibility of 
 
defining ethical transplants as those utilizing organs from 
close relatives without any form of compensation. The 
Syndicate enforces these regulations by suspending or 
revoking the medical licenses of physicians caught performing 
unethical transplants. According to a ministry spokesman, the 
Ministry of Health stepped in recently to support the 
Syndicate's work by raiding hospitals and clinics involved in 
organ trafficking. Since the guilty parties cannot be 
prosecuted for the actual transplant procedures or even the 
sale of the organs, the Ministry is forced to come up with 
other charges, such as falsification of documents, in order 
to hold them accountable. In rare cases, if the donor is 
proven to be an unwilling party in the procedure, the 
physician can be charged with misdemeanor assault. Dr. Kemal 
claims it is unlikely that anyone charged for involvement in 
organ trafficking will face more than light fines and six 
months to a year in prison. 
 
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A Regional Hub for the Organ Trade 
---------------------------------- 
 
¶7. (U) Given the conduciveness of the Egyptian legal 
framework to organ trafficking, Egypt is emerging as a 
regional hub for the illicit trade in human organs. Dr. Hamdi 
al-Sayyed, head of the Physician's Syndicate, acknowledged 
that wealthy Arabs came from the Gulf to Egypt to acquire 
organs at low prices. On the supply side, an Egyptian Society 
for Medical Ethics report indicates desperate Egyptians are 
not the only ones offering up their organs for sale. From 
Sudanese to Syrians, poor people from across the region are 
making the trek to Egypt to trade their organs for a chance 
at a better life. In many instances, traffickers identify 
these donors in their home countries and facilitate their 
transport to Egypt for the procedure. The Transplantation 
Society representative confirmed sellers, buyers, brokers and 
corrupt physicians of many nationalities are converging in 
Egypt as the black market in human organs grows. 
 
--------------------------------------------- - 
Passage of Draft Law May Require International 
Pressure 
--------------------------------------------- - 
 
¶8. (U) Dr. Kemal hopes that a new draft law permitting 
cadaveric transplants will be passed in the next session of 
parliament (November 2008 - June 2009). Increased public 
demand for ethical transplants, the personal involvement of 
the Minister of Health and an apparent compromise on the 
cadaveric transplant issue are fueling these predictions 
after more than ten years of fruitless Parliamentary debate 
concerning transplantation. Dr. Kemal claims the new law, if 
passed, will codify the Physician's Syndicate standards for 
ethical transplantation and impose a 20-year minimum prison 
sentence for anyone involved in organ trafficking. 
 
¶9. (U) Potential obstacles remain as some continue to use 
religious pretexts to oppose the law. Dr. Kemal believes the 
passage and enforcement of this law could depend on whether 
or not the international community decides to pressure Egypt 
to crackdown on organ trafficking. Such pressure has 
previously met with positive results in other organ 
trafficking "hotbeds" like China, Pakistan and the 
Philippines. In these countries, efforts by the World Health 
Organization (WHO), the Transplantation Society (TTS) and 
various health and human rights organizations have 
contributed to the development of stricter laws and 
enforcement measures. The WHO and the TTS are expected to 
issue an Istanbul Declaration highlighting the importance of 
international action to combat the illegal organ trade. 
Statements of USG support for this declaration and specific 
mention of Egypt and other major organ trafficking markets 
could serve to demonstrate USG concern and facilitate further 
dialogue with relevant governments and NGOs. 
SCOBEY