ERBIL, Kurdistan Region – “Ready to sell my blood, which is O+,” the Facebook post reads. The page’s profile picture features a human kidney.
Hamid*, who posted the message along with his phone number, is a divorced father of one, living in Baghdad. His mother has cancer and he needs money, fast. He decided to put a kidney up for sale and said he got multiple offers ranging from $10,000 to $25,000.
The man buying his kidney also lives in Baghdad, but the surgery will take place in the Kurdistan Region’s northern city of Duhok.
A family member will come with Hamid to the hospital to receive the payment. Hamid will only lie down on the operating table once the cash is handed over.
He is one of many trading in Iraq’s underground market in human organs that is driven by recipients in dire need of life-saving operations and donors desperate for cash in a country of high poverty and unemployment. Like many other types of trafficking, the organ market largely takes place on social media.
There is a long history of organ transplant surgeries in Iraq, starting in the 1970s. Through the country’s decades of conflict and troubles, however, most of Iraq’s experts in the field have migrated to the more stable Kurdistan Region, which is now a centre for transplants.
In most cases, donating a kidney is not a risky venture and medical research has not shown long term health problems. The operation typically takes four to six weeks to recover from and the remaining kidney usually enlarges to do the work of two.
But going under the knife for any procedure always comes with some risk. The donor could experience a multitude of problems including blood clots, damage to surrounding organs, and infection. In the United States, three in every 10,000 kidney donors die after the surgery, 3-6 percent of patients experience major complications after the operation, and 22 percent report minor complications.
Unlike other parts of the world where many opt to donate their organs when they die, all organs in Iraq are harvested from living donors. “I think it’s cultural more than anything else,” explained a senior medical professional working in a transplant ward at an Erbil hospital, who spoke on condition of anonymity.
In order to prevent the illegal trade in organs, the Kurdistan Region a decade ago established an eight-member committee to assess every case. The committee operates under the auspices of the Ministry of Health and is made up of independent doctors and police officials. The health professionals assess the medical suitability of both donor and recipient, and the security officials ensure nothing untoward is going down, including the exchange of money.
This process is “not bulletproof,” the medical professional said, despite it being more thorough than similar procedures in the United States. But every system is open to abuse.
Erbil’s Directorate to Combat Human Trafficking, has seen three cases of organ sales since opening its doors on June 1. One incident involved a minor, according to people with knowledge of the case. The donor and recipient were examined and investigated by the committee and were approved. After the surgery, there was a problem with money – the donor did not receive the payment they had expected, and the donor’s mother brought the case to the directorate. The matter has been referred to the criminal court.
Some transplant wards have banned all but immediate family from donating organs. “We don’t accept anyone but first degree relatives so there are no selling or purchasing issues,” said the medical professional of the ward where he works. But even that is not foolproof. They face the problem of falsified identity documents. People are able to get very realistic papers to establish a fake relationship, he explained.
Transactions are frequently done through brokers who know how to work the system. Abu Saman* recently made a deal for a 15 million dinar ($12,600) kidney. He sent the money to the donor’s family in Baghdad, taking a cut for himself, and the surgery was done in Erbil. The first contact was made through Facebook where he posts organs for sale.
Not all donors consent to the operation. In early November, police broke up a trafficking ring in Mosul which was “luring unemployed young people aged 15-20 years with the promise of providing them with jobs, and later they drugged the victims to harvest their organs, particularly their kidneys,” an intelligence source told Kirkuk Now.
Poverty and unemployment in corruption-rife Iraq are two of the factors that have driven thousands of mainly young people into the streets for weeks of determined protests despite deadly crackdowns. The unemployment rate stands at an estimated 11 percent, though is likely far higher, especially among the youth, and some 23 percent of the country lives in poverty.
Efforts to reduce poverty were thwarted by the conflict with the Islamic State (ISIS). Though the group has been territorially defeated, it has left a legacy of poverty and unemployment rates higher than the national average in areas it once controlled.
Persons displaced by the war with ISIS and refugees sheltering in the country are another vulnerable group desperate for money who have turned to the organ black market for cash. “The displaced people here are marginalized and they may be more willing to accept the fact that they could sell their own organs, or their relatives’ organs, in order to cover costs of their basic needs,” Tafkah Omar from the Kurdistan Region’s Human Rights Commission told Niqash.
Authorities in the Kurdistan Region are keen to downplay the extent of the problem.
“Nobody has sold any kidneys in Sulaimani,” said Captain Sarkawt Ahmed, spokesperson for Sulaimani police, in an interview on November 6. In August, the police uncovered a group trying to coordinate the sale of kidneys and arrested three men before any organs were bought or sold, he explained. All three have been sent to court. One was convicted and the other two are awaiting sentence.
But with a long waitlist for organs, the practice continues unpoliced in plain sight on Facebook.
“A kidney donor is needed with O+ in Baghdad who is accompanied by his parents,” read a post by Mohammed*. His brother is sick and needs a new kidney. Mohammed hasn’t found a match yet, but after weeks of searching, he said he expects to pay between $10,000 and $12,000 and the surgery will likely take place in a private hospital in Erbil or Sulaimani.
Human trafficking is taking place on social media across the Middle East. A recent BBC investigation found slave markets advertising the sale of domestic workers on Instagram in Kuwait.
In Iraq, “the media reported in 2018 that trafficking gangs increasingly used social media sites, particularly Facebook, to buy and sell women and girls for sex and labor exploitation,” according to the US Department of State.
A search on Facebook brings up pages advertising domestic workers available for hire. Anyone can scroll through public posts that include photographs of the women, detailed personal information, and even copies of their passports. Comments on the posts include statements like “we’re scared of contagious diseases,” to which the page owner replied, the workers are “all checked on arrival in Baghdad”.
“They are a problem of course,” Major Sardar Fadhel Yahya, director of the Erbil office of the Ministry of the Interior’s Directorate to Combat Human Trafficking, said November 5 of the Facebook pages that host traffickers.
Most of these pages are based in Baghdad and some of the foreign workers are then brought to the Kurdistan Region, he said. He doesn’t, however, have a handle on the size of the problem because he doesn’t have specialized staff who can investigate it. He plans to hire expert IT staff to police the internet, but the Kurdistan Region is currently under a hiring freeze brought in as part of austerity measures.
Misuse of social media falls under a general and now outdated law addressing communication tools passed in 2008. “These laws must be updated,” said MP Ashna Abdullah Qadir. “When this law was passed in 2008, the issue of the use of social media was not as widespread as now.”
An update, however, is not on the parliament’s agenda.
The accountability of social media for content published on its platforms is an ongoing global debate. “If Google, Apple, Facebook or any other companies are hosting apps like these, they have to be held accountable,” Urmila Bhoola, the United Nations special rapporteur on contemporary forms of slavery, told the BBC.
Creating or managing a website used to traffic persons or doing a deal over the internet is banned under the law in Iraq and the Kurdistan Region and comes with a minimum three years in jail and/or a fine of at least 10 million dinars ($8,400).
*Hamid is a pseudonym used to protect the organ donor's identity
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