http://www.thestar.com/article/1119337--toronto-man-who-bought-kidney-abroad-is-key-witness-in-transplant-sale-trial-in-kosovoToronto man who bought kidney abroad is key witness in transplant sale trial in Kosovo
Julian Sher
When Raul Fain boarded Turkish Airways Flight 1017 from Istanbul to Kosovo on July 25, 2008, he was no ordinary tourist. The ailing investment consultant from North York had just paid $127,000 to purchase a kidney and, according to European investigators, was engaging in the controversial but growing practice of transplant tourism.
Also on board that flight was Anna Rusalenko, a 45-year-old woman from the isolated stretches of eastern Siberia. She and other victims had been lured by “false promises” of money they never got from a sophisticated organ-trafficking ring that spanned three continents and trapped impoverished people into selling their body parts, according to a court-filed indictment in the Kosovo capital of Pristina.
Within hours of landing, Fain and Rusalenko were whisked to the Medicus clinic in a rundown neighbourhood of the city, where a team led by Dr. Yusuf Sonmez, a notorious Turkish surgeon dubbed “Dr. Vulture,” quickly removed a kidney from Rusalenko and transplanted it into the Ontario man's body.
Jonathan Ratel, the European Union's special prosecutor in Kosovo in charge of organized crime, is spearheading a high-profile trial against seven people linked to the clinic. They are charged under Kosovo law with several counts of “trafficking in persons . . . for the purpose of exploitation — namely, the removal of organs.”
“Western nations are fuelling this burgeoning illicit trade in human body parts,” says Ratel, a native of North Vancouver. “We are now engaged in the illegal harvest of the poor and vulnerable for their body parts, to the exclusive benefit of the wealthy.”
If desperation forces people to sell their organs, patients in Canada who will die without a new kidney are also desperate.
There are more than 3,300 Canadians on waiting lists for a kidney transplant — almost double the number 20 years ago — and close to a third of them are from Ontario, according to the Canadian Institute for Health Information. More than 300 people from Ontario on those lists have died in the past decade.
Fain, who declined repeated requests from the Star for an interview, now finds himself embroiled as a key witness in the Kosovo trial, set to resume in two weeks. He is not charged with any crime, and there is no suggestion he was involved with the alleged organ-trafficking ring.
His son, Sylvan Fain, a dentist in Miami, told the Star on Thursday that his father did not want to be interviewed.
“I spoke to my father,” Sylvan wrote in an email. “Please DO NOT contact him or myself by any means including mail, fax, Facebook, email or phone. I appreciate you honouring his request.”
Rusalenko and the two dozen other victims recruited by the ring walked away without the money they were promised and got no follow-up care to monitor their health, according to prosecutor Ratel.
Fain, meanwhile, flew home to enjoy a healthy and active life, if the regular postings and photos on his Facebook page are any indication. In the three years since his transplant, he has taken a helicopter tour of the Grand Canyon, visited the sights in Prague and Moscow, and partied at a Brazilian carnival in Miami.
“Life is a beach,” he wrote on his Facebook page beneath a photo showing him relaxing by a large pool lined with palm trees in sun-drenched Miami.
Buying organs is illegal in Canada, but no Canadian law prevents citizens from purchasing body parts abroad.
Still, the Kidney Foundation of Canada and several major medical associations have endorsed the 2008 Declaration of Istanbul, a non-binding international statement of principles which denounces transplant tourism.
“You can't justify the commercial trade in organs and transplant tourism,” says Paul Shay, national executive director of the Kidney Foundation of Canada. But he understands why someone would be tempted to buy an organ abroad.
“If you had a son or a daughter whose kidneys had failed you would probably be ready to make tremendous sacrifices to find a kidney,” he says. “We have to be extremely sensitive to the dilemma of people living in situations of tremendous angst and stress waiting for a kidney. But that doesn't lead us to say that buying a kidney is a solution to that.”
The World Health Organization estimates that organ trafficking accounts for as much as 10 per cent of the approximately 70,000 kidney transplants performed annually throughout the world.
No one knows how many Canadians are going abroad to buy organs. “It is not the kind of thing people are reporting,” says Shay, but he notes the Kidney Foundation has “lots of anecdotal evidence” of Canadians shopping overseas for an organ.
Ontario has one of the longest wait lists in the country for a kidney transplant, a median time of 4.5 years.
As an “independent financial services professional,” as he describes himself on his LinkedIn profile, Raul Fain presumably had the cash and the connections to shop around for a better — and faster — deal abroad.
Fain's involvement with Sonmez is outlined in disturbing detail in a wide-ranging, 46-page indictment filed in the Kosovo courts which exposes a complex network that moved people, money and organs across the world.
According to a summary of his witness statement given in Canada to the RCMP at the request of EU prosecutors, the North York man — facing “serious medical problems” with failing kidneys — was told by family members in Israel in 2008 that “arrangements could be made . . . for a kidney transplant in Kosovo.”
He was introduced to Moshe Harel, who is described in court documents as Sonmez's middleman and the financier of the operation — and is now listed as a “wanted person” by Interpol for “people smuggling” and trafficking offences in Kosovo.
According to Fain's statement outlined in the court record, he sent his medical records to Harel “for analysis in Turkey” and was soon notified that “a kidney suitable for transplant had been found.” On July 15, 2008, Fain transferred 87,000 euros (about $127,000 Cdn.) to Harel's bank account in Israel through the Bendix Foreign Exchange Corp.
About nine days later, Fain flew to Istanbul with his wife. There, according to the indictment, he underwent “further medical testing” with Sonmez.
Sonmez, who has also been called “Dr. Vampire” and “Dr. Frankenstein” in the European press, boasts on his website that he has performed close to 2,400 kidney transplants — all of them legal, he insists. In an email exchange with the Star, he declined to answer questions about his career unless money was paid to a charity of his choice. “Thank you for your interest in my story but I have also my rules,” he wrote.
“Sonmez is a key figure in the global trade of human organs — an enigmatic individual driven by greed and profit,” says Ratel.
Less than two weeks after meeting Sonmez, Fain — along with another client, from Germany — was en route to Kosovo. On board their Turkish Airways flight were the prospective donors, Anna Rusalenko and another woman from the former Soviet Union.
Rusalenko and Fain were met at the Pristina airport by the Medicus staff. The next day, according to the court papers, Sonmez removed kidneys from Rusalenko and the second woman and transferred them into the bodies of Fain and the German man. Fain left Kosovo July 30 and returned to Canada via Turkey.
The indictment does not spell out what happened to Rusalenko, who came from a small town near Vladivostok, but prosecutor Ratel says the victims are inevitably dispatched on a plane back to Istanbul, where “they are cut loose without any post-operative care.”
Rusalenko's story fits the pattern of the other so-called “donors” from Russia, Kazakhstan, Moldova and Turkey who hoped to escape “extreme poverty or acute financial distress,” according to the indictment. Ratel says his investigation revealed the victims find out through the Internet or from someone in their village that they can make money for an unspecified “medical procedure.”
They are encouraged to send in blood samples. Emails and phone calls eventually lead to face-to-face meetings. “They are slowly warmed up to the idea of selling their organs,” Ratel says. “They are the vulnerable poor and induced by false promises of vast payments.”
The people who do make a lot of money are what Ratel calls “a brand new echelon of organized crime — medical professionals engaged in organ trafficking.”
He says they work closely with the more traditional gangs who provide the victims, “low-level mob-type organized crime engaged in trafficking narcotics, weapons, sex slaves — and now organs.
“Profits are obscene,” he continues, noting an accomplished surgeon like Sonmez could perform several transplants a day, charging over $100,000 for a kidney from donors who will see little if any of the $20,000 they were promised.
Ratel says Sonmez's operations in Kosovo came to light in November 2008 when a sickly Turkish man fainted at the Pristina airport and authorities discovered a fresh scar on his abdomen.
“He blurted out the words, ‘Somebody stole my kidney,' ” Ratel explains.
United Nations and Kosovo police then raided the Medicus clinic, uncovering medical files, emails and financial statements — including correspondence between Fain and middleman Harel as well as the North York man's medical records.
On July 6, 2009, Ratel filed a request for what is called “international legal assistance” with the Department of Foreign Affairs in Ottawa, identifying Fain as a client of the Medicus clinic, which was under investigation. The RCMP was dispatched to interview Fain.
The trial — presided over by three judges and with seven Kosovars as defendants, including a prominent physician and a former top government health official accused of granting the clinic an illegal licence — finally got underway in October.
If all goes well, Fain will testify by video link, sworn in under oath in the Supreme Court of Ontario, sometime after the proceedings resume in Kosovo on Feb. 6.
“He is a key witness, not a suspect in any way,” notes Ratel.
The doctor who performed the transplant on Fain is not so lucky. Ratel traveled to Istanbul to interview Sonmez several times as a suspect and handed the authorities 26 binders of evidence. Sonmez was arrested in Istanbul last January for illicit organ trafficking and is currently out on bail. According to local press reports, the Turkish public prosecutor has requested a 171-year prison sentence.
Sonmez has always insisted all the donors who supplied the kidneys for his operations signed consent forms and were never coerced. “There is no such crime. There is no organ trade,” Sonmez told reporters, according to Turkey's semi-official Anatolian News Agency. “There can't be evidence for something that doesn't exist,”
Sonmez, who lives in a seaside villa in Istanbul and enjoys skiing in Austria, has been arrested several times in the past by Turkish authorities but never convicted.
Moshe Harel, the alleged financial broker, remains at large, but Ratel travelled recently to Israel and authorities there have reportedly started their own probe. Israel passed a law in 2008 setting stiff penalties for buying and selling organs.
“We have had excellent co-operation with authorities in both Turkey and Israel with regard to these two fugitives from justice,” says Ratel.
Ratel got indictments in the Kosovo courts against Sonmez and Harel last June for “trafficking in persons” and “organized crime,” but they are not part of the current court case because they are not in the country.
Ratel studied law at the University of Victoria but has spent most of his career in trouble spots like Kosovo. The organ-trafficking trial is just one of several organized crime cases being handled by the Canadian prosecutor, who has been tasked by the EU to help rebuild Kosovo's justice system. But his outrage is evident.
“There is a moral bankruptcy in the exploitation of the human body,” says Ratel.
He has tried unsuccessfully so far to locate and find out what happened to Anna Rusalenko. “We have no information about her health.”
Back in North York, Raul Fain shows no signs of slowing down, thanks in part to the kidney he bought. A recent picture on his Facebook page shows him standing proudly next to a Mercedes-Benz C-Coupe.
Last July, he posted a message celebrating the third anniversary of his transplant operation in the Kosovo clinic. “My 3d transpalniversary (sic), it feels great!!!!!” he wrote.
The rise in kidney failure
Kidneys play a vital role filtering toxins out of the bloodstream. Failure in both kidneys means a quick death unless a person is hooked up to a dialysis machine or gets a transplant.
38,000 Approximate number of Canadians living with kidney failure in 2009, more than triple the number (11,000) living with the disease in 1990. Diabetes is the main cause — one in three Canadians with kidney failure has diabetes
5,400 Number of newly diagnosed Canadian patients with kidney failure in 2009, more than double the number of newly diagnosed people in 1990
592 Number of kidneys transplanted in the first half of 2011, more than all other organ transplants combined. Almost half of those came from living donors, mainly relatives
Source: Canadian Institute for Health Information
Be a donor
Only one in five people in Ontario is registered to donate their organs if they die — one of the lowest rates in the country.
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