DAILY NATION Tuesday August 14, 2012

human organ industry

CORNEA Used in reconstructive eye surgery, a single cornea is sold for as much as Sh2 million in the black market. Organ gangsters are selling corneas of executed Chinese prisoners.

A CUT ABOVE THE REST

Circumcision linked to cosmetics industry

ONE OF the most unlikely human body parts that has attracted a lot of attention is the foreskin of the male organ, which is used in the production of skin treatment medication and products. And with WHO estimating that 30 per cent of the worlds males are circumcised, and that millions undergo the minor surgical procedure annually, it is clear that the supply curve will keep rising. Treated as a medical procedure in the West and a rite of passage in many Third World countries, the global demand for circumcision was triggered by a United Nations and Centre for Disease Control report in 2007 that advised that removing the foreskin reduces the risk of contracting HIV during penetrative sex. Riding the wave, the United States donated Sh960 million shillings towards Kenyas ve-year nationwide free circumcision campaign, but while a lot of attention has been focused on the cut, few have bothered to ask what happens to the foreskins of the millions of males who are circumcised around the world every year. Besides being an important ingredient for numerous skin care products and interferon drugs, foreskin is also used in the production of broblasts (skin cells used in the regeneration of new skin). Due to their biological properties, broblasts are used in all kinds of medical procedures, from eyelid replacement, growing skin for burn victims and those with diabetic ulcers to making anti-wrinkle creams and other products in the cosmetics industry. Scientic research has shown that one foreskin, which contains millions of broblast cells, when treated through a process called culturing, can be used for decades to produce miles of new skin for burn victims and those undergoing plastic surgery. A single foreskin contains enough genetic material to grow approximately 250,000 square feet of new smooth skin. With this lab-developed skin said to cost around $3,000 (Sh246,000) per square feet, just one piece of this seemingly insignicant part of the male esh can generate thousands of dollars in revenues over a prolonged period of time. According to the Caltech Undergraduate Research Journal, published by the California Institute of Technology, infant foreskins are preferred because they have more potential for cell division and less incidence of tissue rejection since they have not fully developed their individual identifying proteins. The inner lining of the foreskin is usually fused with the glans at birth, making infant circumcision a precarious process. Although modernity has tried to alleviate the pain through contraptions like clamps, opponents of the practice among newborns argue that, besides exposing the baby to unbearable pain and possible permanent tissue damage, it is also a violation of the young ones human rights. Intercytex, a tissue generation company based in Cambridge, United Kingdom, has raised the foreskin utility business several notches higher by developing an injection-based drug called Valveta. Dubbed a fountain of youth in baby foreskins, Valveta rejuvenates and smoothens skin withered by age, wrinkles or damaged by scarring from acne, burns and surgical incisions. One vial of this medication, enough to treat an area of skin the size of a postage stamp, consists of about 20 million live broblasts, cells that produce the skin-rming protein called collagen, which becomes increasingly scarce with age. The number of Valveta vials that a patient needs is determined by the surface area of skin destroyed. However, the drug, which goes for about $1000 (Sh82,000) per vial, is not approved for use outside the United Kingdom, where it was introduced in 2007. Despite spirited resistance from activists across the world, infant circumcision remains popular in several parts of the world, which ensures that baby foreskin remains in constant supply. In Where is My Foreskin? The Case Against Circumcision, Paul Fleiss, an American pediatrician and author known for his unconventional medical views, says parents should be very wary of anyone who tries to cut their childs foreskin since the marketing of purloined baby foreskins is a multi-million-dollar-a-year industry. And there might be a point to these allegations, given that Dermagraft-TC, one of the many products grown from cells extracted from infant foreskins and used as a temporary wound covering for serious burn patients, sells for about $3,000 (Sh246,000) per square feet, according to some American medical journals.

LUNGS The average cost of a lung transplant in the US is Sh33 million. This has resulted in an illicit scramble for the organ in the black market, where middlemen sell at Sh9 million.

SKIN After being mashed up to remove moisture, some is destined to protect burn victims from life-threatening bacterial infections or, once rened, for breast reconstructions after cancer. KIDNEYS Going for Sh7.5 million each, these organs have proved to be the most sought after in the world

BONES Cadaver bone, harvested from the dead and replaced with PVC piping for burial, is sculpted like pieces of hardwood into screws and anchors for dozens of orthopaedic and dental applications.

and cultured organ industry, partly because there are no ecient and reliable emergency services to preserve the bodies and organs in good shape awaiting surgical removal, and partly because cultural beliefs discourage organ harvesting. But that is not to say that we have been spared the ravages of this multibillion-shilling industry. Chances are that, as families mourn the loss of loved ones, somebody somewhere is celebrating all the way to the bank. In fact, the report notes, while most European cadavers are from people who died in hospitals, people tracked from other parts of the world, like Africa, might be killed to obtain vital organs and tissues since the demand is on the rise. That rise in demand has translated into a rise in earnings per harvested cadaver. Ordinary hustlers wheelerdealing with morgues in the United States can make up to $10,000 (Sh82,000) per corpse, and RTI Biologics, a tissue and organ selling multi-national, is said to have raked in $169 million (Sh13.8 billion) in 2011 from harvesting body organs from dead persons. A fully processed disease-free body, with all the organs recovered and applied to the various end uses, can generate between $80,000 (Sh6.56 million) and $200,000 (Sh16.4 million). A case in point on how global organ trade has become a blood goldmine in the last few years is that of Phillip

Joe Guyett, arguably Americas largest freelance organ harvester ever nabbed. Bragging of how senior executives from multi-national tissue companies treated him to $400 (Sh32,000) meals and ve star hotel stays in order to clinch his services, Guyett writes in his peculiarly named memoirs, Heads, Shoulder, Knees and Bones, of how he started seeing the dead with dollar signs attached to their body parts . The party for him, however, ended in 2006, when he was handed a prolonged jail term for falsifying death records of his victims . Most of this multi-million dollar

In Kenya, the most commonly harvested cadaver parts are corneas, which are used in reconstructive eye surgery. These are mostly donations that happen with the consent of the dead persons family. Dr Eric Walong, Pathologist, UoN

blood gold empire has been going on for years without the knowledge of the victims relatives, most of whom just pick the bodies of their loved ones from the morgues and head straight to the cemetery without minding to check the cadavers conditions.

One of those families would have been that of Lubov Frolova, a Ukranian woman whose sons organs and tissues were harvested. On the way to the cemetery in the hearse, one of the shoes slipped o (my sons) foot, she told the ICIJ. (The foot) seemed to be hanging loose. When my daughter-in-law touched it, she said it (felt) empty inside. Police investigations revealed that two ribs, two Achilles tendons, two elbows, two eardrums and two teeth were among the organs missing in the body. Frolovas eerie discovery, coupled with tens of other incidences, led to the uncovering of a huge syndicate of illicit organ trade involving Ukrainian morgues and US human tissue multinationals. This has led to an outcry in the medical eld because, besides violating the dead without the familys consent, the shadowy trade also exposes the recipients to the dangers of infections since most of the tissues are not subjected to proper medical tests to establish the donors medical history. While blood donations and intact organs like hearts and livers are barcorded and strongly regulated, its hard to verify the sterility of products made from skin and other tissues since there are no particular structures set in place to regulate the industry. Many countries leave the responsibility of identifying and conrming the identities of tissue donors to drugs makers and tissue banks. However, this might change soon

since the World Health Organisation (WHO) plans to track human tissue traded for transplants in order to ensure safety of donors and prevent illegal collections. The ICIJ says that a work group to look at the issue has already been set up and will have its rst sitting in France at the end of this month. The group intends to use codes for medical materials and other products derived from human tissues . Althoug h the United States is the biggest trader of products from human tissue, its authorities are unable to quantify the number of imported tissues, their country of origin or where the products subsequently go. Many countries, especially in the Third World, including Kenya, do not have regulations on the use of human tissue. Where they have such legislation, the codes are weak, ineective or unimplemented. The big boys are not fairing well either. For instance, although it supplies about two-thirds of the global human tissue product market, the United States, through its Food and Drug Administration (FDA), has the inspection records of only seven per cent of the 340 tissue banks registered with it. When the FDA registers you, all you have to do is ll out a form and wait for an inspection, Dr Duke Kasprisin, medical director for seven US tissue banks, told the ICIJ. For the rst year or two, you can function without having anyone look at you.