by Marley Markham1 Aug 2024

María Amalia Matamoros found herself in a difficult position in late June 2024, when she got a message from her friend Marcos*, asking if it was possible to sell an organ for as much as $200,000.

Matamoros, a Costa Rican surgeon and former president of the Latin American and Caribbean Transplant Society (Sociedad de Trasplante de América Latina y el Caribe – STALYC), told Marcos it was illegal and warned him about the dangers of exploitation and botched operations. 

But she knew that Marcos, who immigrated to Costa Rica from Nicaragua without authorization, had few other opportunities to quickly make such a large amount of money. 

“You don’t exist, you don’t have a single piece of paper, you don’t have a ticket, you don’t have anything,” Matamoros said of Marcos’ precarious situation. 

Growing rates of informal immigration in Latin America make the region increasingly vulnerable to human trafficking for organ removal. But the criminal dynamics underlying this predatory industry are poorly understood due to underreporting and other difficulties facing authorities trying to combat the problem.

How It Works

The organs in question are almost always kidneys, which are in high demand due to rising rates of renal disease related to diabetes. 

The number of people between the ages of 20 and 79 with diabetes in Latin America rose from 8,533,300 in 2000 to 32,497,100 in 2021, according to the International Diabetes Foundation. This has not been mirrored by a rise in the supply of legally available kidneys, creating increasingly long waiting lists and a black market for illegal transplants.

Matamoros said the financial incentives for medical professionals to perform illicit organ transplants are significant.

“When I was managing a private hospital in Costa Rica in 2012, a group of American brokers arrived and told me that they had around 1,000 patients in Arizona, each with a donor, but that they could not perform the transplants in the United States. So, they offered to pay me around $59,000 per patient for as many patients I could do per week,” she said.

Although Matamoros said she refused the offer, the brokers had likely already arranged meetings with a long list of private surgeons in Costa Rica, a country whose advanced private medical sector provides fertile ground for this industry.

SEE ALSO: Costa Rica Struggling to Stop Repeated Organ Trafficking Cases

“Amongst senior doctors there are bad people, people who see easy money,” Matamoros said. “Without them, it would not be possible.”

The victim’s kidney may sell for many thousands of dollars, but they usually receive only a fraction of the profit, and in some cases may not receive money at all. In other cases, victims have payment withheld from them as an incentive to recruit others. 

In 2017, four doctors, a Greek businessman, and a local police officer were arrested in Costa Rica for running a trafficking network that recruited kidney donors with promises of hefty payments. In 2022, four Guatemalan doctors were arrested for misdiagnosing a patient in order to extract his kidney. But underreporting and a lack of investigations means other concrete cases are few.

A Misunderstood Form of Human Trafficking

The high social standing of doctors in Latin America helps veil these transactions as altruistic and consensual, though in reality they can be highly exploitative. Victims are generally men who are targeted for recruitment by trafficking networks due to their socially and economically marginalized status.

If the individual’s decision to sell an organ is influenced by fraud, psychological coercion, or abuse of a position of vulnerability, then their consent is invalidated, and they are a victim of human trafficking, even if they receive money, according to Aimée Comrie, project coordinator at the United Nations Global Action against Trafficking in Persons and the Smuggling of Migrants (GLO.ACT).

Comrie explained that victims are rarely able to access check-ups for their remaining kidney. This is often compounded by feelings of shame and being socially outcast, driving the victim towards a cycle of poor health. 

But authorities focus much more attention on human trafficking for sexual or labor exploitation.

“No one is looking for this crime,” Comrie told InSight Crime. “It’s invisible in the world of human trafficking.” 

According to Comrie, this is because law enforcement often views “organ trafficking” as a discrete crime rather than a form of human trafficking. The former simply refers to the illegal sale of an organ, while the latter allows for the fact that they may have been coerced.

Many victims may not know they were involved in a crime, which leads to underreporting and a poor understanding of the scope of the problem.

“Very few are aware that they could also be considered a victim of human trafficking, including on the law enforcement side,” Comrie said.

“There are still a lot of people who work on the issue of human trafficking who speak about organ trafficking like an urban myth,” Carlos Pérez, a program officer at the Panama office of the United Nations Office of Drugs and Crime (UNODC), told InSight Crime.

Migration Fuels the Market

Continuing waves of migration within and through Latin America have provided human traffickers with a vast supply of potential organ recruits. In some cases, victims become recruiters themselves.

Matamoros’ friend Marcos, like thousands of others, is the ideal target for organ donor recruiters due to his precarious financial and migratory situation. Matamoros said he was approached by a fellow Nicaraguan migrant who offered to put him in contact with doctors who could do the procedure in a “secret place.”

Additionally, a lack of education or familiarity with the local context can make migrants susceptible to lies and deception.

In some cases, for example, victims have been falsely told that they have three kidneys or that kidneys regenerate, according to the US State Department.

But authorities, overwhelmed by the scale of the migration issue, have focused little on the illicit organ industry.

At the same time, advocates and experts are working to increase awareness. The UNODC introduced a toolkit in 2022 to encourage this refined legal understanding and encourage more fluent communication between legal and medical professions on this issue.

Fueled by vulnerabilities and enabled by corruption in the medical sector, human trafficking poses a far deeper organized criminal problem for the region than commonly accepted.  

*Name has been changed to protect the person’s identity.