August 10, 2014
By Doctors Against Forced Organ Harvesting
[Abstract]
Introduction
During the process of exploring the large body of evidence on forced organ harvesting in China, one extraordinary factor stands out: widespread, costly medical exams forced upon labor camp workers. The initial investigative reporting of David Kilgour and David Matas in 2006, and Ethan Gutmann’s in-depth interviews with dozens of Falun Gong practitioners, revealed that many were subjected to extensive blood testing and medical exams while in detention and in labor camps.
Strikingly far-fetched is the combination of imposed diagnostic medical testing, meant to provide health care to “patients,” being delivered in the context of adverse living conditions in China’s notoriously abusive Laogai prison system. Life in the camps is defined by years of isolation, full separation from family, extensive working hours, brain washing, rape and torture. These factors, in combination with medical diagnostic tests performed to this extent, are implausible and appear to be unprecedented in the history of labor camps.
In order to study this phenomenon, we conducted an exploratory pilot study using a case study approach to select one victim group, the Falun Gong. A search for reports of medical testing among this group of prisoners of conscience was done retrospectively for the years 2000 to 2014. Investigative data on forced organ harvesting from Falun Gong detainees is most comprehensive among the different victim groups in China.
Background
The Starting Point: Labor Camps
The Laodong Gaizao, or Laogai, translated as “reform through labor,” are prison labor camps and farms in which the People’s Republic of China has imprisoned more than 50 million people over the last fifty years. Current prison populations in China are estimated to make up roughly half the number of slaves in the world today. Once an open system, it became a classified topic after the 1997 revision to China’s Criminal Procedure Law. In 2010, Chinese government-sponsored websites were actively advertising Laogai products and services. Despite the fact that exporting Laogai products is illegal under Chinese Law, this extensive network of forced-labor camps has been producing consumer goods for export to Europe and the United States for many years. In 2012, a prominent news organization was expelled from China for publishing information about the Laogai system. In October 2013, most Americans heard about the shocking reality of Laogai and the persecution of the Falun Gong on the news when a woman from Oregon bought a box of Halloween decorations at Kmart and found inside a letter calling for help from a Laogai prison inmate.
Conditions in these prisons are considered primitive, lacking essentials with only buckets for toilets, overcrowding, endemic diseases, infestations of bedbugs, lice, fleas and roundworms and inadequate food resulting in severe malnutrition. Prisoners are forced to work long hours every day to make strict work quotas. Working conditions are sub-standard, harsh and often dangerous. Despite this, the Chinese government boasts that the Laogai system is an effective way to control prisoners and further China’s floundering economy.
Methodology
Independent researchers have described numerous single witness accounts from formerly detained Falun Gong practitioners. This study considers a collective body of evidence as reported by camp survivors. A large convenience sample was accessed through Minghui, a non-profit volunteer organization that has, on a daily basis since 1999, reported independent first-hand victim accounts and news about the Falun Gong community. Falun Gong practitioners use the website to share stories of their experiences of persecution, including reports about their time in detention in Chinese labor camps. The Minghui.org website is accessible in multiple languages via the web outside of China.
Using the Minghui.org website search functionality, the researchers used one or multiple keywords in Chinese language and recorded the total search result. When searching with multiple keywords, only those items with all the keywords included showed up in the search result.
Results:
Keywords (English translation of the search words in Chinese) — Number of reports
| Medical exam (体检): | 5,301 |
| Medical exam, forced (体检 强制): | 1,465 |
| Draw blood (抽血): | 1,159 |
| Blood test, doctors (验血 医生): | 243 |
| Draw blood, liver (抽血 肝): | 243 |
| Draw blood, kidney (抽血 肾): | 214 |
| CT, medical exam (CT 体检): | 94 |
| Draw blood, heart EKG (抽血 心电图): | 89 |
| Draw blood, x ray (光 抽血): | 48 |
| Blood test, urine test (验血 验尿): | 33 |
| CT, blood test (CT 验血): | 23 |
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NOTE: Individual reports may contain testimony involving multiple victims in a single location, unit or prison. Thus, the amount of cases is larger than the listed number of reports. Some of the surivors stated that many or all inmates of the labor camp underwent medical exams and blood tests.
Discussion
This pilot study has several limitations including the selective time period of posted reports for 2000-2014, the single data source and lack of previous studies. The study lacks rigor in terms of the convenience sample and is limited in its retrospective approach. The vast amount of data collected can open up possibilities for bias. The list of keywords used for the search might be limited and miss additional related reports. One factor that minimizes potential misinterpretation, or misreading of the victim accounts, was the availability of the data on the website throughout the duration of the study for validation.
In screening of the survivor reports it was noted that medical exams were not unique occurrences. While single cases as outliers might lack significance, this data reveals a large number of victim accounts that are not isolated instances, and suggests a systematic use of various medical exams imposed upon detained Falun Gong practitioners.
The array of medical exams and the repeated tests—some speak of blood tests two or three times a year—are costly at an estimated U.S. $500-$1,000 per Falun Gong detainee. The exams included multiple vial blood tests, urine tests, x-rays, ultra-sonograms, electrocardiograms, computerized tomography and physical exams. Estimated to involve tens of thousands of Falun Gong practitioners over the past 15 years, the financial burden of these medical exams is huge. It is unlikely that these medical exams in forced labor camps were covered by the impoverished Chinese health system, which has reduced the health budget over recent years and urged hospitals to find alternative revenue sources. During this time frame the emerging transplant business became one of these alternative sources of revenue.
There is certainly no interest in the wellbeing of the detainees who exist under inhumane conditions. Detainees undergo medical exams and tests without their consent, and neither are they informed of the results. This combination of factors is implausible, and raises several questions: If not for the purpose of providing health care, why would such a large investment in medical diagnostics be made in this particular group of detainees? As the labor camp workers are exploited as slave laborers, why waste financial resources for medical exams? Where will such a cost-intensive investment amortize?
It appears to be unprecedented that labor camps would spend this amount of money for medical exams on detainees while they are exploited and forced to live under adverse and extreme conditions. Due to lack of transparency and governmental accountability the captive Laogai population could easily be exploited for profit as a living organ bank to meet the huge demand for transplantations in China.
The reports posted on the Minghui.org website are personal witness accounts. Most of the authors do not present as experienced writers, thus, their experience reports are often written in a simple language. Yet, these authors authentically and consistently describe their experiences in detail. While reading the personal witness reports, one cannot help but recognize the discrepancy and conflicting combination of adverse detention conditions and medical exams.
The underpinnings of the organ harvesting crisis and the growth of transplant medicine in China raises questions about organ sourcing. The Chinese government published transplant numbers showing an exponential increase in the first decade of the century. The numbers for kidney and liver transplants published by former vice minister of health Huang Jiefu in 2008 and 2010 are now raising more questions about the source of organs.
The transplant spike noted between 2003 and 2008 is alarming, and coincides with announcements by Huang Jiefu who stated on several occasions since 2005 that most of the transplant organs come from executed prisoners. Contrary to the soaring transplant numbers, the execution numbers declined since 2003. On March 7, 2013, Huang Jiefu told Southern Metropolis Daily that ten years ago, the number of prisoners being executed in China started to decrease by 10 per cent every year and that there are now very few prisoners being executed. How could the numbers of transplantations be increasing when, at the same time, the numbers of executions that China reports as being the main source of organs are in reality decreasing?
Thus, the question of supply and demand emerges. What was the source of organs that supported the remarkable transplant spike between 2003 and 2008? With such large numbers of transplant surgeries and the inadequate official explanation identifying mostly executed convicts as the source of organs in China, the data suggests that the organs are coming from an alternative source, such as prisoners in the Laogai labor camp system.
China has built an extensive and costly infrastructure of transplant centers and trained medical staff to create a national transplant industry. Of note is that wait times for organ recipients in China are much lower than anywhere else in the world, and there is extensive evidence that the execution of prisoners for their organs is timed for the convenience of the waiting recipient. A large pool of organs from readily available sources is needed to ensure enough organs for the 10,000 transplant operations performed every year in Chinese hospitals. The ECONOMIST described the problem: “As long as demand exceeds supply, death-row inmates are worth more dead than alive.”
Conclusion
This exploratory study of medical exams performed on detained Falun Gong practitioners in the Chinese labor camp system suggests there is widespread use of forced medical diagnostic testing among this victim group.
Given the exponential growth of transplant numbers in China during the years that coincide with this report many factors point to the possibility of a large population of victims held as a living organ pool. The vilification and persecution of the cohort group coincides with the growth of transplant medicine in China. Without a clear source of organs China has been cited by medical oversight groups to lack transparency in organ procurement. The widespread and systematic use of implausible medical exams among tortured labor camp inmates could be used to further strengthen the common conclusion drawn by many investigations that there is a potential for abusive organ sourcing that could explain the large transplant numbers in China.
Short wait times for patients needing organs make the use of detainees as a source of organs even more likely. In order to supply a correctly tissue-typed organ within 1-4 weeks—as advertised by Chinese hospitals—a large genetically diverse pool of living donors is required.
In countries with objective judiciary systems, those that hold the promise of equal justice under the law, the legal and institutional mechanism of the death sentence is complex and varies region to region. Death sentences, and with it the executions as the source of transplant organs, would be unpredictable under such systems. In contrast, China’s judicial system lacks the rule of law without a realistic option for appeal. Under these conditions, China, as the world’s top executioner, could lend itself to capitalizing on prisoners as a commodity.
The estimated high costs of medical exams for labor camp workers could be amortized through the commercial trade of organ transplantation.
These findings demand further investigation. Future mixed method research will collect both quantitative data and seek to understand the qualitative experience of victims facing the threat of forced organ harvesting.
Ethical standards in medicine demand that prisoners of conscience and labor camp workers are not to be used as a living pool of organs ready to be harvested on demand. Voluntary, free and informed consent remain the only acceptable standard for ethical organ procurement for transplant medicine.
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Appendix: Examples of witness accounts found on the Minghui.org website
“Around March 20, 2006, I was ordered to take a blood test. I was thinking then that I was not a sick person …. I knew I didn’t need that blood test. …. I told them, “I’m very healthy and I don’t need that test.” Right then, four policemen came up to me, trying to push me to the ground. Three of these four police are very big – almost six feet tall. They are Instructor Zhang Bin, Deputy Head Xue Yuan, Li Zhiyong and Ma Jingbo. After they tried for some time, they couldn’t push me to the ground. Then, another two policemen came over. The six policemen pushed me to the ground. They stepped on me. Some twisted my arms. Some stepped on my back, and I couldn’t breath because of this. They striped my clothes off of my arm and took my blood by force.”
2) Discrepancy of blood tests and torture:
“Once in 2003, almost all the Falun Gong practitioners were asked to have a physical examination, including a blood test, electrocardiogram, etc. ….They also sent Falun Gong practitioners to secret places to be tortured. Later when these Dafa practitioners were brought back, they were seriously injured in both body and mind.”
3) All Falun Gong labor camp workers were subject to blood tests:
“Every Falun Gong practitioner detained in the Beijing Women’s Forced Labor Camp is forced to have a physical examination. Before they arrive at the camp, all detainees are given a code number. Then upon arrival, they are taken to the clinic for a physical. Guards wearing helmets and holding electric batons would torture anyone who refused. …The physical includes a blood test and chest CT scan. Practitioners are always checked before the criminal inmates.”
4) Blood tests on all detainees:
“I was arrested again on November 4, 2001 and taken to Shandong No. 2 Women’s Forced Labor Camp located in Wangcun Township in Zibo (commonly known as “Wangcun Labor Camp”). On the way, I was taken to the labor camp hospital (83 Hospital). I was carried in by police. The checkup was not like a normal one which would usually check one’s height, weight, blood pressure, etc. They only did two things: blood test and organ examination. I was pressed on a bed for a type-B ultrasonic scan. When I refused to allow them to draw my blood, a male doctor said with a sinister face, “If you do not cooperate, I will use a thicker syringe to draw more blood from you.” I resisted with all my strength and they failed to draw any blood from me.
After I was taken to the forced labor camp, I went on hunger strike. On the seventh or eighth day of my hunger strike, the guards took me for another health checkup, saying that they found some symptoms in my body from the first checkup. I was tricked and thought it was a genuine checkup and allowed them to take blood samples. They seemed to be very pleased with the test results. When I asked to take a look at the laboratory sheet, they said, “This has nothing to do with you.” Later I heard from them that it was a compulsory checkup that everyone had to take before being admitted to the labor camp.”
Around August and September of 2005, all 35 practitioners imprisoned at the Weining Forced Labor Camp in Benxi City, Liaoning Province, were taken to the “Legal Education Center” in Benxi City. The staff from the forced labor camp’s health clinic took a large tube of blood from each practitioner and sealed it in an envelop with the practitioner’s name on it. The forced labor camp claimed it was for AIDS testing.”
