Black market organ trade is Baghdad's new growth industry
By Saleh Al Jibouri and Colin Freeman
Ali Hameed quit his job as a taxi driver because he no longer felt safe on Baghdad's streets. Increasingly desperate for money to help him get married, he hit on a once-in-a-lifetime business opportunity - selling one of his kidneys.
Last week, in a shabby ward in the city's Al Karama hospital, he lay bandaged on a bed, one kidney lighter and $1,400 (about £765) richer after a three-hour operation.
In a nearby room, his body similarly bandaged, lay the man who had paid for it - the other player in a grim new black market trade in organs that is one of Iraq's few growth industries.
"I abandoned my taxi driving job because of the security situation," Mr Hameed, 22, told The Sunday Telegraph. "I thought about joining the police or the army, but that is even more dangerous. There were no more options, so I decided to sell my kidney. I am still a young man, so I want to marry and begin a business."
Mr Hameed received a good price for his kidney. Would-be buyers with an eye for a bargain can now pick up a new kidney for as little as $700, given the desperation of fit and healthy Iraqis for money.
Young men like Mr Hameed can be seen loitering around many big hospitals in Baghdad these days, open to bids passed on via networks of shadowy middlemen who lurk in nearby cafés.
With unemployment in Iraq at about 60 per cent, the chance to earn money by touting body parts is a more calculated risk than, say, becoming a $150-a-month rookie policeman at the mercy of suicide attackers.
In the main their customers are other Iraqis, for whom kidney problems are common thanks to decades of poor diet, water and medical care.
As news of the black market trade has spread, however, wealthier transplant "tourists" from around the Arab world have started flocking to Baghdad, attracted by the rock-bottom prices.
If car bombs, kidnappings and robberies are a deterrent, the price compares favourably to the $5,000 cost of a kidney on the black market in Turkey, or $3,000 in India. In Iraq, the operation itself typically costs $2,000. Even so, the risks are considerable. Baghdad's hospitals are filthy and under-resourced.
If a patient succumbs to post-operative infection or other complications, high-quality care cannot be guaranteed. The expertise needed to carry out what is a relatively simple surgical procedure is in abundance, however - the legacy of an era 15 years ago when Saddam Hussein's national health service met First World standards.
While many medics disapprove of the trade outside their hospital, if a transplant patient turns up with a willing donor, they tend not to ask too many questions.
"Many of the unemployed young men undergo this kind of surgery to get money," said Dr Huthaim Al Saidi, who removed Mr Hameed's kidney. "I am against the sale of organs, so I have a condition that I will only accept donors who are relatives of the person needing the transplant. But the private hospitals don't care who they get the organs from."
In Arab society, however, the term "cousin" is often used to describe someone who is a friend or a fellow tribe member. At Al Karama hospital, it is not clear how rigidly the relatives-only rule is applied.
The recipient of Mr Hameed's kidney, Ammar Muhammed, a 20-year-old college student, describes himself not as a blood relative or even an in-law, but a "friend". In many cases, "friend" appears to mean someone whose relationship with the donor was struck up at the doors of the hospital. "I was hit by shrapnel in a car bomb explosion on my way home in Fallujah. It affected both of my kidneys," he said. "Due to the lack of good health care, they got worse. I don't care how much I pay - I want to survive."
The organised crime department of the Iraqi interior ministry has formed a special unit to clamp down on the traders, whom it says frequently dupe people into becoming donors.
Col Abdul Jabbar Abo Natiha, the head of the unit, said: "We caught one donor from Basra who had originally come to Baghdad searching for a job. A group of guys befriended him, gave him lodgings and then insisted he paid a large amount of money in rent. They obliged him to sell his kidney to pay it. He only got $70 out of the deal."
In 2001, the going rate for a donor was $2,000. The fact that the price has tumbled, some doctors say, suggests that Iraqis are even more desperate for money now than they were under Saddam.
"It wasn't easy two or three years ago to find a donor," said a senior nurse at another Baghdad hospital. "Now patients' relatives need to make no big effort."