ENGLISH VERSION: Headshot for a kidney

Nowhere so many peope are intentionally executed like in China. The reason for these horrible acts is that the trade with fresh human organs brings millions of dollars to those who sell them.

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The man who has skinned hundreds of people raises the knife slowly and slices through the fresh meat. »I'm a good cutter.« In his first life in the People's Republic of China he was a doctor. Today he works in a New York suburb sushi bar where he slices tuna, salmon, and mackerel. »Finally I can use my talents for something positive«, says Wang Guoqi.

»I'm frightened that Chinese agents will kill me«

However, the terrors of his past still haunt him in his nightmares: the lethal shots to the back of the head, the images of blood, the splatter of brain matter and the memories of sweat and fear. He misses his family which he had to leave behind in the seaport town of Tianjin; his wife who is a nurse and his six-year old son. In the fall of 2000, the burn victim specialist defected to the United States under an assumed name and with false papers by joining a group of Chinese tourists who were visiting Las Vegas and Disneyland.

»I'm frightened that Chinese agents will kill me,« says Wang. The slender man in his late thirties is the principal witness for a horrendous accusation: China systematically transplants and even sells executed prisoners' skin, hearts, kidneys and livers to foreigners (despite the fact that organ dealing is illegal in China). Authorities regularly close down websites on which impoverished farmers sell their kidneys. »This way the state maintains its monopoly, and the executed prisoners serve as its spare parts supply« says Harry Wu, Chinese dissident and human rights advocate. »The government has helped build an industrialized killing machine with high profits and an international, mafia-like network.«

On a warm day in October 1995 Wang and his team of doctors drive to Luannan County, 200 kilometers east of Beijing. Farmers use ox-driven carts to harvest corn in the fields, in the winter, they plant melons and lettuce in red brick greenhouses to be sold in the nearby capital. Banners propagate China's One-Child-Policy, white painted letters on walls advertise silverware and firewood. A poor but safe world in which an evening spent in front of the TV is the highlight of the day for the 600 villagers - unless there's an execution on the agenda.

A small cypress grove lies just one kilometer to the west of the village of Xigaocun. The trees were planted in order to curb the damage caused by sandstorms, this is also were the villagers used to bury their dead. A sign warns people: »Should anyone be seen damaging this property, please contact the police.« On this warm October day, military police arrive. They bring along a 30-year old farmer. »He had killed a neighbor in a fight« remembers Wang. His team's ambulance parks at the edge of the woods.

»Like a hen who just has her head chopped off«

The doctor is the last person who looks into the convicted man's eyes. He sticks a syringe through the man's pants and into his buttocks. »To calm your nerves«, lies a policeman. The prisoner thanks him effusively. In actual fact, the medication is ten milligrams of Heparin, an anti-coagulant, to ensure that the organs can be removed more easily afterwards. The executioner aims his gun from two meters' distance at the yuzhen, an acupuncture point at the lower rear of the head also known as the »jade pillow.« The head drops to the side, the body collapses. The prisoner coils up on the ground and survives for several agonizing minutes.

Until now, accusations against China were all solely based on the evidence given by Doctor Wang to a hearing by the US Congress. However, stern was able to find further witnesses in China. »There wasn't anything unusual about someone still twitching. Like a hen who just has her head chopped off«, says Zhang Shujiang. The melon seller has a restaurant at the edge of the grove. »Only one hundred meters from the execution site. I had a front row view«, he reports. »The doctors always had to hurry because of the organs.«

Surgeons' assistants drag the bleeding farmer boy to the ambulance. Three urologists slice through the shackles, the clothing and finally, the belly. It takes them less than two minutes to remove the kidneys. They hurry off to the military hospital in Tianjin. The kidney transplant will take place three hours later in the seaport town 180 kilometers away. »For a party official«, says Wang. This is the clinic he worked for ten years ago, before he fled the country.

Bribe Money for an executed body

After the surgeons', it's Wang's turn. But the seriously injured man is still alive. The court officials refuse to spare him his misery. »He won't survive very long without his kidneys. Let's save that bullet«, gloats one man. Wang uses a scalpel to slice open the man from the hips to the shoulders in order to remove the skin from the torso. Blood squirts into the incision. »All of a sudden, people were beating against the ambulance car, probably the man's family. They wanted to take the body back«, reports Wang. He's frightened of the villagers who are shaking the vehicle. »I was only able to remove half of the usual 60 square centimeters. We had to flee to Tianjin.« Later, Wang complains to his superiors that there was not enough police protection.

The military hospital is in the easternmost suburb of the ten million city; a four storey building with blue windows and white tiles. Women in the green People's Liberation Army uniforms bring their children for X-rays. Officers buy fruit and newspapers before they visit their relatives. A red flag with the five golden stars is flown from the roof. At the entrance, a sign announces: »Putting people in the center of our attention.« The provincial governor is treated here, in the best hospital of the region. The famous skin department is especially prosperous. »Up to 800,000 Yuan in profits annually«, says Wang - more than 100,000 Euros. Hospitals bribe judges and court officials, in this case, as little as 300 Yuan, 40 Euros, for the right to have an executed prisoner's body gutted. Just the skin is worth much more than that. Foreigners pay up to $25,000 to have a single kidney transplanted. The money goes to brokers and hospitals.

The skin bank Wang Guoqi used to head is on the third floor. Most nurses and doctors claim they don't remember Wang. One doctor mumbles: »He doesn't work here anymore.« Then he hurries off to the toilet.

After the farmer is executed and Wang has returned to his hospital, he cleans the dead man's skin which is smeared with blood and dirt, shaves away the hair, washes the skin in a saline solution, and soaks it in a disinfectant bath for fifteen minutes. He removes shreds of meat and fat from the inside of the skin before freezing it in liquid nitrogen at minus 196 degrees.

Wang has had enough. Too many of the several hundred executions didn't run according to plan. Like when Yan Xiuzhong, the director of the 5th Electrical Parts Factory in Tianjin, needed a transplant. Wang Guoqi and the Wang Zhifu, a surgeon, are sent to death row in Xiaoxiguan Prison. Amongst four inmates, they find one with the right blood type. The hospital informs the court as to when the execution should take place – executions to go. Wang and an intern are the designated pallbearers.

»No more kidneys left! But the heart is still beating«

As the urologists hurriedly remove the kidneys, one of the comments that Wang will never forget is made: »Look, no more kidneys left! But the heart is still beating.« Wang asks to be relocated. His superiors won't budge. In keeping with the traditions of Mao's Cultural Revolution, they force him to write a self-criticsm. The skin specialist decides to defect.

As he tells his tale in the US, Congresswoman Cynthia McKinney speaks of »Frankenstein Medicine«. Human rights groups published the information last summer just before the decision on Beijing's bid to host the Olympics. The Chinese government shrugs off Wang's story as »sensationalist lies and vicious slander« Skinning death row candidates while they are still alive sounds so monstrous that even critics of the Beijing dictatorship voice their doubts.

Yet we found the secret execution site eleven kilometers outside Luannan, the name of which the renegade Wang Guoqi couldn't remember either. Nestled in the cypress grove lie a pair of striped prisoner's pants, a gray jacket, underpants, and blue stockings. »Those are from the last execution«, mumbles an old man who gathers plastic garbage. Some of the twelve villagers we spoke to weren't sure. »Maybe they were just thrown away. It?s been a long time since the last execution.« But everyone can remember the execution in the fall of 1995. »The ground here is blood-soaked«, says Gao, a corn farmer. »Why do you care?« Another man whispers the name of the executed man: »That was young Mr. Qi. His parents wanted to go to court.«

In China, it is illegal to remove organs without the permission of the person in question or his family members. »We assume that this obligation is regularly violated «, says Dirk Pleiter from Amnesty International. »To date, the Chinese government has been unable to present even a single written agreement signed by a death row inmate. Even if such a declaration existed, its would be of questionable value due to the inhuman conditions in prisons.« Mudan Jiang, a doctor, reports of the conditions in a prison in the northern city of Hailin: »A naked inmate was lying with his face down, his wrists and ankles were chained to the floor.« He agreed to donate his organs when the guards promised to improve the conditions under which he was being held. From then until the date of his execution, he was given three meals per day instead of the one he used to receive. He was also allowed to move around freely in his cell with just his ankles and wrists fettered during the day.

Cotton, an empty package of rubber gloves, and a box marked »kidney conservation solution«

Because they are scared of the police and are ashamed of their children's crimes, most families remain silent even if they curse in their hearts the organ robberies. Traditionally, the Chinese believe that the organs contain a person's soul. In Xinyang, a city in the middle eastern Henan Province, Rao Enhuan, a self-confident pensioner with snow-white hair and horn-rimmed glasses fights against the authorities' arbitrariness. Out of jealousy, her son, Zhao, contracted a friend who was greatly indebted to kill his wife. In August 1999, both were condemned and sentenced to death. Officials pressure the families to agree to organ donations. »We refused, and they removed the organs anyway«, rails Rao. Lu Dean, a friend of the family, found bloody cotton, an empty package of rubber gloves, and a box marked »kidney conservation solution«. The witness photographed the evidence for the organ robberies. Stern has these pictures.

Since the execution, Zhao's mother has been trying to bring the case to court. The judges refused to hear her case, her lawyer gave up under the authorities' pressure. The national organ recycling system fueled by more than one hundred hospitals which transplant organs needs a constant supply. As the body is a gift from the parents which must remain in its entirety according to Confucian tradition, organ donors are a rarity in China. Tang Xiaoda, President of the Association for Dialysis and Transplantations has provided information stating that just fewer than 35,000 patients received new kidneys between 1960 and end of 2000. However, only 181 living donors were identified, less than 1% of the overall total. »Even if some kidneys were taken from accident victims, it is to be assumed that the vast majority was taken from executed prisoners« says the human rights advocate Nicolas Becquelin from Human Rights in China. Since 1990, Amnesty International has counted more than 22,000 executions; but the real figure is assumed far higher.

State officials; prison guards, judges, and doctors earn their share in organ dealings without ever having to worry about usually strict Chinese laws. Everything is kept securely in the closet. The 1984 »provisional regulations on the use of dead bodies and organs from condemned criminals« states that: »() must be kept strictly confidential; (...) vehicles with the logo of medical instituions are not be used; and white clinic garments are not be worn. After the dead bodies are used the crematory shall assist the units in timely cremation.«

Sleepy seaport towns are the centres for organ traffickers

China is internationally pilloried time and again for capital punishment and organ dealing issues. The practice itself is not disputed by the people, what is disputed is the selling of organs to foreigners. However, the most money is made by clinics in Hong Kong, Thailand, Malaysia which are full of distraught kidney disease patients from the Chinese Diaspora.

Malacca, a sleepy seaport town in the south of Malaysia which is best-known for its palm beaches, is one of the most important pooling centers for organ traffickers. They promise fresh and functioning kidneys for around $20,000.

St John Clinic is located in an alley on the outskirts of the city, not far from its largest mosque. The two-story building is surrounded by garages. Inside, 50 dialysis machines buzz day in and day out. Two televisions hang from the ceiling, music blares so loudly that sometimes the nurses don't hear the beep marking the end of the four-hour treatment. The chairman of St John Clinic emphasizes that: »nobody is encouraged to buy a kidney in another country.« The nursing staff, however, hand out agents' telephone numbers to the seriously ill patients. Theses agents channel them into Chinese treatment centers.

Rumor has it that many people lead a pain free life since they received their new kidneys. Yet stories such as Mrs. Chan's make the rounds as well. The woman, who has five children, was operated in Chongqing?s Tai Ping military hospital »I had to do something to go on living«, she explains. She was told the kidney would come from a young man who would be executed. She saw the execution on TV the evening before her operation. »I can live with that. The operation, however, was a nightmare«, she says. Mrs. Chan was only anesthetized locally.

Lethal injections for easy executions

»It is completely irresponsible to send people with kidney diseases to China«, deplores Professor Koh Eng-Thye, one of the leading kidney specialists in Malaysia. Just in the past 2 1/2 years, he has found 30 people who got their kidneys in China and have had life threatening blockages in the bisections of arteries which were traced back to transplanted kidneys. In three cases, patients were infected with the AIDS virus. »Since the kidneys have to be removed quickly at the execution site, the procedure can be pretty careless.«

Since the 1990's, China has been experimenting with the perfection of executions by lethal injection. Beside over one thousand animals, more than 24 death row inmates were used as guinea pigs until »Medication 2« was determined as the suitable lethal injection. Using »Medication 1«, it took 3 minutes and 45 seconds for death to be declared. In 1997, the newspapers reported of executions using lethal injections in Kunming, the capital of Yunnan Province. The six men were »between 25 and 30 years old, between 50 and 68 kilos with no traces of drugs.« The national press praised the »realization of humanitarian principals.« All six men died within one minute. As opposed to the shootings which took place in public, inmates are now be executed in a separate, purpose-built room. Bullets no longer tear up valuable organs; the poisons contained in the lethal injection can be easily cleaned out of kidneys and livers. »Sterile and clean. Doctors will have time to gut the bodies properly. The killing machine will stay open for business«, fears the Hong Kong human rights activist Nicolas Becquelin.

Aside from Kunming, scientists at the famous Tongji Clinic in Wuhan, the capital of central Chinese Hubei Province are also busy improving lethal injections. The clinic was founded in Shanghai at the beginning of the 20th century by the German doctor Erich Paulun and moved to Wuhan after the civil war and the revolution. »We're famous for something that foreigners aren?t even allowed to know«, whispers one doctor. The first successful kidney transplantation in the People's Republic of China took place at Tongji in 1961. This is where Wu Jieping works, China's most famous transplantation specialist. Stern was informed that more than 1,000 kidneys were transplanted at Tongji between 1990 and 1998. The majority of the kidneys came from executed prisoners. The Tongji Clinic boasts of its cooperation with the medical faculties of eleven German universities, amongst them Humbold University in Berlin, the Technische Universitaet Muenchen and the Essen University Gesamthochschule. The clinic's practices have been a known fact since 1994. However the doctor and student exchanges continue.

The pathologist Wu Zhongbi, an amiable 83-year old man who is an honorary doctor at Heidelberg University, is well-spoken in German and climbs the stairs with as much agility as a teenager. He was vice director of the university hospital which now has 7,000 employees. For many years, he was involved in research into organ conservation – an important link in the organ recycling industry. On March 20th, during a festive luncheon at the residence of the the German ambassador to China Zhongbi was awarded the large Distinguished Service Cross with star, one of the highest German decoration ever presented to a Chinese person.

Matthias Schepp/Rico Carisch