Raul Fain was dying of kidney failure, and doctors told him he would have to wait 12 years to receive a transplant in his home country of Canada. Desperate, he turned to an international organ trafficking ring. He traveled to Kosovo, where he paid $105,000 to receive a kidney transplant from a Turkish surgeon. The kidney came from a Russian donor who volunteered to sell her organ.
"To sell an organ, it's a terrible thing," Fain says. "But on the other hand, maybe it saves a life – like it saved my life."
"Tales from the Organ Trade," an HBO documentary released this month by Emmy award-winning filmmaker Ric Esther Bienstock, shows Fain's story and that of many others who face a dilemma of how to get an operation they need to stay alive given a global shortage of kidney donations. The film reveals the morally gray areas of black market organ trafficking and explores the perspectives of patients, doctors, prosecutors, organ donors and brokers who arrange the business end of the exchange, including finding donors, travel and selecting a surgeon. At the center is a world in which patients desperate for a kidney trade with those desperate for money.
Every month, more than 2,000 new names are added to the national waiting list for organ transplants, which had 120,675 patients as of publication, according to the Department of Health and Human Services. About 18 people die every day while waiting for an organ transplant in the United States.
Walter Rassbach, in desperate need of a Kidney. Denver, Colo.
"It's not living, it's existing," says Walter Rassbach, a patient with kidney failure from Denver, in the film. He admitted he was facing the ethical dilemma of whether to buy a kidney illegally. Doing so on the international black market could cost $100,000 and involves traveling to developing countries like Kosovo or the Philippines. People who sell their kidneys receive only a small amount of what the patient pays because a significant sum goes to the broker, medical team performing the operation and travel for all those involved. In the Philippines, for example, sellers receive $1,600 to $2,500 for their kidneys. In exchange, they save a life.
Director Ric Esther Bienstock interviewing a surgeon in Turkey.
Bienstock, 54, shared with U.S. News what she learned as a result of making the film, saying that she wanted people to go through the same ethically nuanced journey she did when it came to understanding how people could bring themselves to buy or sell a piece of the human body. Her responses have been edited:
Why did you decide to make a documentary about this topic?
I was making another film about sex trafficking, in which I followed a man whose wife was trafficked to Turkey. At one point he said: "I would sell my kidney to get her back!" I wondered how prevalent it was.
At the same time, my co-producer had a friend who needed a kidney. He found an altruistic donor, and the hospital was suspicious that the donor was getting paid. The issues started brewing. I thought it would be a meaty story. Unlike other illegal trades – like sex trafficking, human trafficking and drug trafficking – many people involved in this elicit operation are law-abiding citizens. The people selling their kidneys live in poverty, but they're not criminals.
There is a co-dependency that occurs in the exchange of a kidney for money: People depend on the organ to survive, but those selling their kidney are often desperate for money to survive. Can you elaborate on the exchange?
When I began work on this film I thought I was doing a story about exploitation. It was only when I started meeting the people involved that the arena became much more morally ambiguous. I don't think the people who buy a kidney on the black market do so in a cold-hearted way. They are characterized as wealthy Westerners harvesting the organs of the poor, but the reality is that they are patients with kidney failure who are going to die.