Unsettling Tales From The Organ Trade

Selling body organs is illegal in most countries, but thousands of people around the world buy and sell the most sought-after organ -- the kidney -- on the black market each year.

Tales From The Organ Trade, directed by Ric Esther Bienstock and narrated by Canadian film director David Cronenberg, had its North American premiere last week at Toronto's Hot Docs Canadian International Documentary Festival. It features people who buy, sell and perform the operations that transfer kidneys from donor to recipient and presents multiple views that shows the moral dilemma involved in this underground practice. After all, 182 people around the globe die from kidney failure in the 82 minutes this documentary plays out -- many of them while on long waiting lists to obtain a legally donated kidney.

Forty-four-year-old Filipino kidney seller Joboy in Manilla lives in a crawl space with no electricity underneath someone else's shack and says the $2,500 he can make for his kidney -- more than he can earn in a year from working as an unskilled labourer -- will go towards fixing his house for his wife and two sons. Eddieboy, a rival potential donor who says he earns $2.50 per week, is coached by organ broker Diane (who's already sold one of her own kidneys) on what to say when he's questioned by authorities on why he's donating a kidney. He's ultimately chosen by a doctor and recipient since he's half of Joboy's age.

A small town five hours outside of Manilla is a hotbed for black market kidney donors, so much so that they've even formed support a group. Some of them say they weren't paid all they were promised for their kidneys because brokers got some of the money, but all claim to have sold them willingly.

One donor shows signs of kidney disease and his remaining kidney is failing rapidly, however, just like the one he donated to a person he'll never meet probably is. It apparently isn't uncommon for people who've received black market kidneys to receive infections from them.

On the other side of the world, we meet two people in Toronto and one in Denver who desperately need new kidneys to enable them to live a normal life.

Mary Jo Vradis has been living on dialysis via a machine in her bedroom which she needs to use for eight hours every second day while she's been waiting for a kidney transplant for six years. Her mother's been on dialysis for 18 years and it's taken a major physical toll on her, and her brother started dialysis three years ago. There's an increased mortality rate for people on dialysis, so it's heartening when the film's epilogue informs us that Mary Jo eventually received a kidney from a cadaver after waiting for nine years.

Walter Rassbach needs a transplant in the next year or two or will likely die within eight years. He's been on a transplant list for two years and, since his daughter doesn't want to donate her kidney, he seriously considers going the black market route even though he admits that it's unfair to take advantage of people's poverty in this way. But a woman he's never met agrees to donate a kidney to him for free just because she wants to help someone live a better life. Such altruistic donors, we're told, are said to be one in a million.

Raul Fain mortgaged his house and went to Kosovo, where he paid $100,000 for a black market kidney transplant that has given him a new lease on life. He has no qualms about it and, when the filmmakers track down his donor, she says she has no regrets either.

Dr. Yusuf Sonmez, who has performed more than 2,000 black market kidney transplants, was driven out of Turkey and went to Kosovo for his operations. He faces numerous charges, but has returned to Turkey (which won't extradite him to Kosovo) and stopped his surgeries.

Prosecutors are still after him, however, just like they are with Israel's Zaki Shapira, who does his first on-camera interview in this film. The respected surgeon has done more than 3,600 kidney transplants, about 850 of which are considered illegal, and like Sonmez was jailed in Turkey for a few months before being released. He's now retired and claims that performing black market transplants is more moral than standing by and letting people, who could go on to relatively normal lives with donated kidneys, die.

As a person who's been living with one (thankfully healthy, so far) kidney all my life and may eventually need dialysis or a transplant, Tales From The Organ Trade made me think about what I'd do if faced with a similar situation. And at this point, I can't give a definitive answer.

But even if you don't have a vested interest, this film will open your eyes to a subject that's quite likely to have a bearing on someone you know. So even if it's for purely empathetic reasons only, Tales From The Organ Trade is worth seeing.