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Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings TRAFFICKING IN HUMAN BEINGS FOR THE PURPOSE OF ORGAN REMOVAL IN THE OSCE REGION: Analysis and Findings OCCASIONAL SERIES PAPER 6 NO. Organization for Security and Co-operation in Europe ISBN: 978-92-9234-440-5 Published by the OSCE Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings Wallnerstr. 6, 1010 Vienna, Austria Tel.: + 43 1 514 36 66 64 Fax: + 43 1 514 36 62 99 e-mail: [email protected] © 2013 OSCE/ Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings Design: Sebastian Traxl, Vienna Cite as: OSCE Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings, Trafficking in Human Beings for the Purpose of Organ Removal in the OSCE Region: Analysis and Findings, Occasional Paper Series no. 6 (July 2013). Copyright: “All rights reserved. The contents of this publication may be freely used and copied for educational and other non-commercial purposes, provided that any such reproduction is accompanied by an acknowledgement of the OSCE/Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings as the source.” The Organization for Security and Co-operation in Europe (OSCE) is a pan-European security body whose 57 participating States span the geographical area from Vancouver to Vladivostok. Recognized as a regional arrangement under Chapter VIII of the United Nations Charter, the OSCE is a primary instrument for early warning, conflict prevention, crisis management and post-conflict rehabilitation in its area. Its approach to security is unique in being both comprehensive and co-operative: comprehensive in that it deals with three dimensions of security – the human, the politico-military and the economic/environmental. It therefore addresses a wide range of security-related concerns, including human rights, arms control, confidence- and security-building measures, national minorities, democratization, policing strategies, counter-terrorism and economic and environmental activities. PARTICIPATING STATES: Albania | Andorra | Armenia | Austria | Azerbaijan | Belarus | Belgium | Bosnia and Herzegovina Bulgaria | Canada | Croatia | Cyprus | Czech Republic | Denmark | Estonia | Finland | France | Georgia | Germany Greece | Holy See | Hungary | Iceland | Ireland | Italy | Kazakhstan | Kyrgyzstan | Latvia | Liechtenstein | Lithuania Luxembourg | the former Yugoslav Republic of Macedonia | Malta | Moldova | Monaco | Mongolia | Montenegro Netherlands | Norway | Poland | Portugal | Romania | Russian Federation | San Marino | Serbia | Slovakia | Slovenia Spain | Sweden Switzerland | Tajikistan | Turkey | Turkmenistan | Ukraine | United Kingdom | United States of America Uzbekistan ASIAN PARTNERS FOR CO-OPERATION: Afghanistan | Australia | Japan | Republic of Korea | Thailand MEDITERRANEAN PARTNERS FOR CO-OPERATION: Algeria | Egypt | Israel | Jordan | Morocco | Tunisia The materials in this publication are for general information purposes only, provided on an “as is” basis, without warranties of any kind, including fitness for any particular purpose. The OSCE, specifically, does not make any warranties with respect to the accuracy or completeness of the information in this publication. The views, findings, interpretations and conclusions expressed herein are those of the author(s) and do not necessarily represent the official position of the OSCE and/or its participating States. To the extent permitted by law, the OSCE does not accept any liability for any loss, damage, liability or expense incurred or suffered, which may arise as a result of, or in connection with, the use of information contained in this publication. Office of the Special Representative and Co-ordinator for Combating Trafficking in Human Beings TRAFFICKING IN HUMAN BEINGS FOR THE PURPOSE OF ORGAN REMOVAL IN THE OSCE REGION: Analysis and Findings Organization for Security and Co-operation in Europe TABLE OF CONTENTS FOREWORD 5 ACKNOWLEDGEMENTS 8 ACRONYMS 9 CHAPTER I: INTRODUCTION 10 1.1 Overview 10 1.2 Mandate and Terms of Reference 11 1.3 Methodology 12 1.4 Disclaimer 13 1.5 Terminology 13 CHAPTER II: THE LEGAL AND POLICY FRAMEWORK 14 2.1 The Concept of THB/OR in law 14 2.2 The Policy Context of THB/OR 16 CHAPTER III: RESEARCH FINDINGS ON THB/OR 17 3.1 Global Context 17 3.2 OSCE Region 19 3.2.1 Scope and Scale of THB/OR 19 3.2.2 Gender Issues 21 3.2.3 Children 21 3.2.4 Cases Analysed in the OSCE Region 22 3.3 Financial Scale 23 CHAPTER IV: MODUS OPERANDI OF THB/OR NETWORKS 27 4.1 Introduction 27 4.2 Modus Operandi in the OSCE Region 27 4.2.1 Establishing a THB/OR Network 28 4.2.2 Victim-Donor Recruitment 28 4.2.3 Means 28 4.2.4 Transplant 28 4.2.5 Consequences 29 4.2.6 Logistics 29 4.3 Elements of THB/OR Networks 29 4.3.1 Participants 29 4.4 Victims of THB/OR 31 4.5 Organ Recipients 31 4.6 Variation and Flexibility in THB/OR Networks 31 4.7 Links to “traditional organized crime” 32 4.8 An Alternative Look at THB/OR Modes 32 CHAPTER V: CRIMINAL JUSTICE RESPONSE AND CHALLENGES 34 5.1 Over view 34 5.2 General Analysis 34 5.3 Regulatory/Administrative Measures 35 5.3.1 Legal Qualifications / Charging 35 5.4 Challenges Arising from the Transnational Dimension 36 5.4.1 International Legal Assistance 37 5.4.2 Need for Co-operation 37 5.4.3 Promoting Information Sharing 39 CHAPTER VI: MEDICAL ETHICS AND OTHER ISSUES 41 6.1 Role of Medical Professionals 41 6.2 Medical Professionals and Transplant Surgeries 41 6.3 Pre-operative and Post-operative Care 43 6.4 “Transplant Tourism” 45 6.5 Potential Linkages to Trafficking of OTC 46 CHAPTER VII: ADDRESSING VICTIMS’ RIGHTS AND NEEDS IN PRACTICE 47 7.1 Overview of the Rights Framework for Victims of THB/OR 47 7.2 A Preliminary Assessment of the Needs of Victims of THB/OR 50 7.3 Considerations for Addressing Victims’ Needs 52 7.3.1 Outreach work 52 7.3.2 Health care 53 7.3.3 Psychological counselling 54 7.3.4 Legal counselling and representation 54 7.3.5 Vocational training and labour inclusion 55 7.3.6 Accommodation 57 7.3.7 Partnership and multi-agency work 57 7.3.8 Research 57 CHAPTER VIII: CONCLUSION AND RECOMMENDED NEXT STEPS 59 8.1 Conclusion 59 8.2 Recommended Next Steps 60 ANNEX A: SUMMARY OF CASES 63 ANNEX B: LIST OF EXPERTS CONSULTED 70 ANNEX C: MAIN REFERENCES 71 OSCE/Blanca Tapia OSCE/Alberto Andreani FOREWORD Since the beginning of my mandate in 2010, one of my research because it is not within my mandate. Firstly, priorities has been to address some of the most invisi- our research does not address allegations of organ ble forms of trafficking in human beings (THB). Traf- trafficking related to alleged war crimes, since they do ficking for the purpose of organ removal is included in not involve trafficking in human beings. Secondly, it is the United Nations Palermo Protocol on Trafficking of important to clarify an important distinction between 2000 in its definition of trafficking in Article 3, but in what is known as organ trafficking, and trafficking in fact this form of trafficking remains one of the most human beings for the purpose of organ removal. My unknown and least addressed. In recent years however, mandate is of course based on trafficking in human we have seen an increase in attention to the subject, in beings; organ trafficking is a separate issue as has been part due to several high profile cases within the OSCE recognized by the United Nations and the Council region, as well as due to the long-standing efforts of of Europe 4, it raises a whole other set of factual and investigative journalists, academics and victim advo- legal considerations. Furthermore, our research does cates who have gone to great lengths to shed light on not cover trafficking of tissues and cells, as it is not this phenomenon. widely recognized to fall within the meaning of “organ removal” within the relevant definition of trafficking Trafficking in human beings for the purpose of organ for organ removal. 5 removal (THB/OR) is, like all other forms of traffick- ing, a violation of the fundamental human rights and This Occasional Paper is based on actual reported dignity of individuals, while also clearly representing incidents or cases of THB/OR that have been inves- a grave form of transnational organized crime. My tigated to different degrees, and in some cases, fully mandate to address this form of trafficking stems prosecuted. To the best of our knowledge, this is the back to the OSCE Action Plan to Combat Traffick- first research paper based on an analysis of available ing in Human Beings 1. Other OSCE commitments case studies in the OSCE region. It is thus not pos- throughout the years refer to all forms of trafficking; 2 sible to make any comparisons to the global context most recently in the Vilnius Declaration 3, participat- of the crime, even though the 2012 Global Report on ing States expressed their deep concern for this form Trafficking in Persons has identified a similar scope of trafficking. and scale of the crime. 6 A brief annex of cases where It is important to note at the outset what has not 4 See for instance, Council of Europe and United Nations, Trafficking in organs, tissues and cells and trafficking in human beings for the been included within the terms of reference for this purpose of the removal of organs, Joint Council of Europe/United Nations Study (2009). 1 OSCE Permanent Council, Decision No. 557/Rev. 1 OSCE Action Plan 5 The paper thus does not consider, for instance, the trafficking of to Combat Trafficking in Human Beings (Vienna, 7 July 2005).
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