[Reader-list] Organ Stealing: Fact, Fantasy, Conspiracy, or Urban Legend?

[Monica Narula]

After my last posting on urban legend i was sent a link of a possible 
"visualization". Enjoy!
http://elfwood.lysator.liu.se/zone/g/r/gregory4/martianlc.jpg.html

And further gleaning from the web brought out the following paper, 
which is a fascinating look into another kind of urban legend.

best
Monica

Organ Stealing: Fact, Fantasy, Conspiracy, or Urban Legend?

Nancy Scheper-Hughes
Professors, Department of Anthropology University of California, Berkeley,


"What's true? What's false? Who knows how to evaluate anymore?"

  Seu João Gallo, Brazilian shantytown resident, 1990

  	Descend with me for a few moments into that murky realm of 
the surreal and the seemingly magical, into the maelstrom of grisly 
stories, fantastic allegations, and hideous rumors of kidnap, 
mutilation, dismemberment, blood and organ stealing -- and to taste 
the terror and panic that these stories occasion in the 
nervous-hungry residents of urban shantytowns, tent cities, squatter 
camps, and other "informal settlements" in the third world.

	My primary illustrations will come from the shantytowns of 
Brazil, where I have conducted long-term, intermittent ethnographic 
research since the mid 1960s. (Scheper-Hughes 1992,1995). But I also 
draw on related instances from elsewhere in South and Central 
America, and I will also refer to the current
situation in and around Cape Town, South Africa where I am currently 
engaged in a study "everyday" violence, some of it political, some of 
it criminal, and some of it medical.

The Rumor

	A ghoulish rumor first surfaced in the shantytowns of Brazil 
in the mid-1980s, and it has been circulating there ever since. The 
whisperings tell of the abduction and mutilation of children and 
youths who, it is said, are eyed greedily as fodder for an 
international trade in organs for wealthy transplant patients in the 
first world. Residents of the shantytown Alto do Cruzeiro in NE 
Brazil, the primary site of my research, reported multiple sightings 
of large blue and yellow combi-vans [of the type used as Gypsy taxis 
by the poor the world over] , driven by Americans or Japanese agents, 
who were said to be scouring poor neighborhoods in search of stray
youngsters. The children would be nabbed and shoved into the trunk of 
the van. Their discarded and eviscerated bodies -- minus heart, 
lungs, liver, kidneys, and eyes -- would turn up later by the side of 
roads, in between
rows of sugarcane, or in hospital dumpsters.

	'They are looking for 'donor organs'. You may think this is 
just nonsense", said my friend and research assistant, "Little Irene" 
in 1987. " But we have seen things with our own eyes in the hospitals 
and the morgues, and we know better."

	"Bah! These are stories of the poor and illiterate", 
countered another of my friends, Casorte, the skeptical new manager 
of the municipal cemetery of the plantation town I call Bom Jesus da 
Mata. 'I have been working here for over a year and never have I seen 
anything. Where are these bodies? [Yet, even as we spoke on the 
following day, a municipal truck arrived at the gates of the cemetery 
with the body of a "desconicido", the remains of an unknown, 
unclaimed man found murdered in an abandoned field not far from town. 
The eyes and genitals had been removed. "Death squads", whispered 
Casorte, by way of explanation, and he made the gesture of a throat 
being slit ].

	The body snatching rumors were picked up by newspapers in 
Recife and were reported on the radio. Most of news reports mocked 
the credulity of simple people. But the media coverage, meant to 
dispel the rumors, actually exacerbated them. "Yes, it is true, wept 
Dona Aparecida, wringing her hands on the doorstep of her shack on 
the garbage strewn street called the Vultures' Path. "I heard it on 
the radio". Consequently, small children were
kept securely locked in at home while their parents were out working. 
I found one terrified little girl tethered like a goat to a wobbly 
table leg.

Globalization of the Rumor

	Soon after I began writing and delivering papers that 
interpreted the Brazilian organ stealing rumors in terms of the 
everyday violence practiced against the bodies of the poor and the 
marginal, I began to hear other
variants of the organ theft stories from anthropologists working in 
Argentina, Colombia, Peru, Guatemala, Honduras, Mexico, India, and 
Korea. The rumor -- as we now know -- has trans-national, indeed 
global dimensions. Media reports of the seizure and sale of children 
( and of fetuses) for organ transport surfaced in domestic and 
international newspapers [ see Maite Pinero, Le Monde Diplomatique, 
1992, for a listing of some of the most noteworthy news stories 
between 1987-1992]. The rumors were investigated by various 
international human rights organizations, and the practice was 
condemned in a resolution approved by the European Parliament in 
November l988.

	 Though most of the stories came from Central and South 
America, there were reports of the organ theft rumor surfacing in 
Poland and Russia where it was reported that poor children's organs 
were being sold to rich Arabs for spare parts surgery. (Czubala 
1991). Historian Luise White (1993) published stories of blood 
sucking/blood stealing human vampires in East and Central Africa, and 
South African anthropologist, Isak Niehaus (1993) has recorded blood 
and organ stealing rumors in the Transvaal collected during fieldwork 
in 1990-1993. The African variants often tell of blood sucking 
"firemen" or of "medical" agents driving red combie-vans looking to 
capture unsuspecting people to kill (or to drug) in order to drain 
their blood ( or to remove organs) for magical ("muti") or medical 
purposes (to sell to local hospitals).

	In Italy (of all places!) Paolo Toselli (1991) wrote a series 
of news features concerning rumors of poor children kidnapped for 
transplant surgery that surfaced in August 1990 and quickly achieved 
wide circulation. As many as 231 children were reported kidnapped in 
Italy during 1990. In the Italian instance, the stories focused on a 
"black ambulance" as the kidnap vehicle. Other Italian rumors warned 
of a mobile operating surgery touring the countryside north of Rome. 
And, there were rumors of a blackmarket trade in poor Brazilian 
children said to be illegally imported to Italy as a source of "spare 
parts" for organ transplants. Here we have, full circle, the rumor 
that began in Brazil , the "donor" nation, finding its counterpart 
some two years later turning up in the "receiving" nation. [Like the 
children's game 'Telephone']

  	But, I was stymied just a few days ago, when my husband and I 
went out to dinner with our son, Nate, and his Argentinean buddy, 
Mattias, both university students. I apologized for being preoccupied 
and explained I was a bit worried about a presentation I had to make 
in in Italy on organ stealing rumors. Mattias immediately perked up 
and asked asked what I was going to say. "Do you have any 
information?", I asked slyly. "Well", Mattias began, " this Mexican 
lady who works in the kitchen of 'Noah's Bagels' told me about a 
friend of hers who had gotten drugged and abducted from Spengler's [ 
a seafood restaurant ]. The guy was just sitting at the bar and 
minding his own business when a business man , dressed up to kill in 
a Giogio Armani suit, sat down next to him and bought him a few 
drinks. Well, the guy finally passed out cold and the next day the 
police discovered him still unconscious in a dumpster. He was O.K. 
but he had a very fine little incision on his stomach, like it was 
done by professionals, you know."

	One could even link the Latin American "baby parts" story 
with rumors in the U.S. of UFO alien abduction for sexual abuse and 
organ/reproductive stealing ["aliens have no genitals!" ], as 
reported by Luise White (1994) and by perceived abduction victims in 
therapy in my own community, Berkeley, California (Richard Offshey, 
personal communication). I encountered a version of this story in 
Spanish-speaking northern New Mexico a few years ago. Local farmers 
and ranchers there had spread a rumor of ritualized animal 
mutilations that was attributed to extraterrestrials. A livestock 
inspector I interviewed in Taos County verified instances of 
ritualized slaughter of livestock with mutilations and did not 
discount the possibility of Alien terrorists.


Impact of the Rumors:

	The rumors have had their effects. An article I published 
(originally in the LA Times (1990) but picked up by international 
news agencies, and republished in New Internationalist in which I 
linked the "organ theft" rumor and panic in Brazil to the shadowy 
practices of international adoption there helped to shut down the 
American evangelical Christian "orphanage" I had investigated in a 
suburb of Recife and to reduce significantly the number of 
international adoptions from that city and from rural Pernambuco. 
Elsewhere, accounts of the rumor --even in media stories attempting 
to disprove or discount it -- have backfired and generated an anti- 
international adoption climate in Central America, but especially in 
Guatemala, where foreign tourists, suspected of child theft for organ 
trafficking have been attacked. The Leventhall report for USIA notes 
the adverse effects of the organ stealing rumor on voluntary organ 
donation, citing a precipitous decline in donated cornea in Columbia 
following national broadcasts of child organ trafficking there.

Verifying the Rumor

	Verifying actual cases of children exported for organ 
transplants has lead to a predictable dead end. Allegations of "baby 
farms" and "fattening houses" in Guatemala, Honduras, Mexico, and 
Brazil, where newborns were said to be housed awaiting transport to 
the United States for use as organ donors , were investigated and 
found to be based on false accusations. The International Children's 
Right Monitor, published a report raising the obvious questions: 
Where would the operations take place? How could the murder of the 
child donors be concealed? Wouldn't the cost and difficulty of an 
illegal and criminal trade far surpass the difficulty of normal 
procedures? Patients
awaiting a transplant in US and every organ made available to them is 
strictly monitored by computer through the United Network for Organ 
Sharing. And organs must be matched to recipients to avoid rejection. 
Why, then, is it
that the 'baby parts story just won't die? (San Francisco Examiner, 
1990), despite the appointment of a full-time disinformation 
specialist , Todd Leventhall, for the U.S. Information Agency in 
Washington who has led a long
campaign to kill it?

	What does it mean when a lot of people around the world begin 
to tell variants of the same bizarre and unlikely story? In other 
words, how does one interpret the social imaginary of poor and third 
world peoples? According to one interptretive strain the rumors 
indicate a kind of global mass hysteria reflecting characteristic fin 
de siecle anxieties and post modern malaise, a misplaced new age 
spirituality focusing on the body and the sanctity of organs in the 
face of everyday threats to personal security in the forms of urban 
violence, anarchy, theft and loss, fragmentation. ( The world's 
cities, after all have never been so dangerous, so violent.)

	Less dramatically, the world rumors have been interpreted by 
some oral historians and folklorists ( see Dundes 1991; 
Campion-Vincent 1990, White 1993,1994) as constituting a genre, an 
oral literary form, the "urban legend". The stories are circulated 
and repeated because they are "good to think" and "good to tell", 
they entertain by fright , write Luise White, just like good old 
fashioned ghost stories 1 .

	 Todd Leventhall, disinformation officer for the US 
Information Agency, has adopted this language in his report "The 
Child Organ Trafficking Rumor: a Modern Urban Legend" (December 
1994). Citing the writings of eminent folklorists ( like 
Campion-Vincent 1990) who interpret the organ theft stories as the 
literary inventions of semi-literate people who do not possess the 
skills to sort out the credible and realistic from the incredible and 
the fantastic, Leventhall unequivocally states that the rumors are 
"groundless", "pernicious" , and "harmful". His position is that the 
rumors must be exposed, refuted, and killed.

	Here I will frame my remarks as a response to Mr. 
Leventhall's conclusions that "no government, international body, 
NGO, or investigative journalist has ever produced any credible 
evidence to substantiate the rumor ....[which constitutes] a false 
story that is commonly believed because it encapsulates... widespread 
anxieties about modern life" ( 1994:i). Among these are "fear of and 
resentment at wealthy foreigners...fear of wrongful mutilation and 
death, subconsciously stimulated by the dramatic advances during the 
past ten to fifteen years in the field of organ transplantaton" 
(1994:2).

	 The USIA Leventhal report equates third world organ theft 
stories with US rumors about pets exploding in dangerous microwave 
ovens, and with the popularity of the American novel and film, Coma, 
that portrayed unsuspecting people rendered comatose state so that 
their organs could be removed for transplant in others. Organ theft 
rumors in South America and the Hollywood film are equated under the 
rubric of unsophisticated peoples' anxieties about modern 
technologies that have proceeded too far and too fast.

	Leventhall's report relies on peoples' stories and narratives 
(just like the rumors he is trying to dispel), although among his 
sources are police, public officials and military officers, rather 
than the common people who often feel threatened by these. Lacking is 
any familiarity with the everyday, lived experiences of the very poor 
who circulate and believe the baby parts and organ stealing stories. 
Here, the ethnographer, working in small locations over time and 
skilled in the tasks of gathering and interpreting "local knowledge" 
by means of multi-layered "thick descriptions" of everyday life can 
perhaps throw new light on the fantastic rumors.

	In Northeast Brazil where my research focused on the causes 
of infant and childhood death -- later of the deaths of the 
"disappeared" adolescents and young men of the shantytown of Alto do 
Cruzeiro. I began with the "official " statistics, but finding them 
wholly inadequate, [ Child deaths, for example, are routinely 
under-reported by more than 50% in rural NE Brazil (see 
Scheper-Hughes 1992,1995, in press; Nations and Amaral 1991)], I soon 
left the civil registry office to walk the length and breath of the 
poor barrios, hillside slums, and outlaying hamlets in order to 
observe and document the experiences of the sick and dying, and to 
hand count, as it were, the the dead, and the disappeared. My "rule 
of method" was simple -- follow the bodies!  Into the public clinics, 
into hospitals , even into surgery amphitheaters. It meant attending 
infant and child wakes, following "angel" processions and burials, 
trailing "street children" on their rounds of the city and tracking 
them down in the local jails that illegal detained them. It meant 
tracking bodies in the local hospital morgue, and accompanying 
relatives of the "disappeared" to the the Medical-Legal Institute in 
Recife. It meant visits to the municipal graveyard to examine old, 
new and reused gravesites, and the remains of the "unknown" or the 
"unclaimed " that were removed prematurely from competitive 
gravesites and tossed into the deposito de osos  (the collective 
paupers' deep well ) in the cemetery.

	Collecting peoples' narratives is important, but one needs to 
listen to popular voices as well as the "official story". In Brazil 
this meant collecting the stories of the "folk demographers" of the 
rural community: the
priests and nuns who attend deaths, the pharmacists, hospital 
orderlies, the local carpenters who fashion pauper coffins of 
plywood, cardboard, and crepe paper, the local seamstresses who sew 
the shrouds, the "praying women" who prepare the bodies of the poor 
and despised for burial, and the venders in the local market who sell 
all the ritual paraphernalia used at wakes. What these people did not 
know the combi- taxi drivers who carry the sick and
dying to and from clinics and hospitals might know. What they didn't 
know the local grave-digger was sure to know. The all too often 
"rejected knowledge" of these "specialists" can provide the missing 
social context within which
strange events occur and even stranger rumors circulate to account for them.

	Based on this kind of anthropological "thick description" -- 
both in Brazil and in South Africa -- I have drawn rather difficult 
conclusions about the organ stealing rumors, suggesting that the 
stories are repeated and circulated because there is some truth to 
them (see Scheper-Hughes 1992, chapter 6).

	 Most anthropologists ( as opposed to folklorists) who have 
encountered these rumors in one form or another will suggest that the 
stories are , like the Scriptures, at the very least metaphorically 
true, operating by means of symbolic substitutions. Blood sucking 
rumors in Africa and organ theft and fat stealing rumors in South 
America are cogent metaphors expressing the often grotesque nature of 
colonialist and neo-colonialist economic, social relations and labor 
practices. (See Comarff 1985; Taussig 191987,1990; Nash 1977; Niehaus 
1993 ). The root metaphor concerns the radical commodification of the 
body and of body parts in work and in new medical practices.

	 In its strongest and plainest version, the body parts rumors 
may be taken as factually true. The business of organ transplants is 
conducted in a transnational space. Elements of both legal and 
illegal trade in blood and solid organs exist in some parts of the 
world. Between 1983-1988, 131 patients from three renal units in the 
United Arab Emirates and Oman traveled to Bombay, India where they 
purchased, through local brokers, kidneys from living donors. The 
donors were from urban shantytowns outside Bombay who were 
compensated between $2,000 and $3,000 for a kidney. This ghoulish 
trade was widely publicized in an Indian news weekly, but treated as 
well in a Lancet article analyzing the high mortality among the Arab 
recipients of purchased Indian kidneys (Salahudeen et al. 1990). 
Where there is a legal market in the sale of blood or organs, one can 
be almost certain of an illegal blackmarket replete with human rights 
abuses.

In my research on AIDS in Brazil (Scheper-Hughes 1994), for example, 
I found that 1 of every 5 cases of reported AIDS in Rio de Janeiro 
was linked to contaminated blood. Although it is unconstitutional to 
traffic in blood in Brazil, the new laws have not been enforced by 
public health authorities. In Rio, Mafia style "numbers" game 
bookmakers (bicheiros ) traffic openly in blood and blood products 
just as they do in illegal drugs.

	 Meanwhile, in Cape Town, South Africa today cornea, heart 
valve, liver, and skin graft "donations" are harvested and 
distributed to the appropriate surgical and medical units for use in 
transplantation without soliciting family members' consent. The 
'donor' bodies, most of them township Blacks and 'Coloureds' who were 
the unfortuante victims of violence and other traumas, are handled by 
state pathologists attached to public mortuaries still controlled by 
the police. (see NIM 1996: 37-38). There is strong disagreement among 
pathologists today about the current mortuary-to-surgery practices 
which are not in strict conformity with South African laws. There is 
no "presumed" consent for cadaveric organ procurement. Instead, 
doctors and hospitals are "presumed" to operate with explicit consent 
of organ donors or their families, a presumption that is not 
completely warrented.

	 Fear of potential medical exploitation of the dead is strong 
enough in South Africa at present that the second section of the now 
hopefully final draft Bill of Rights , dealing with the security of 
the person, includes
wording meant to protect the human rights of potential organ donors. 
The ANC favored wording of the section on the right to bodily 
integrity to specify " the right to make decisions about reproduction 
and their bodies free from
coercion, descrimination and violence. Speaking for the ANC, Willie 
Hofmeyer explained the inclusion of the words 'and their bodies' with 
reference to the case of organ transplantation in South Africa.

	 It should come as no surprise, then, that in the 
impoverished Black townships outside of Cape Town, a stone's throw 
from the city's famous Groote Schurr teaching hospital ( where 
Christian Barnard pioneered heart
transplants), people express hostile and negative attitudes toward 
organ donation. 2  Politically astute township youths referred to the 
directionality of the exchanges: organs were being "harvested" from 
poor and black bodies -- representing the majority of the population 
of South Africa and accounting for a grossly disproportionate number 
of violent and accidental deaths -- for transplantation into wealthy, 
white bodies. Sophisticated, high tech medicine is the perogative, 
still, of South Afican whites. Negative attitudes toward organ 
removal also derive from older and "traditional" practices of "muti" 
murder in which organs are removed for magical practices. A case, 
verified by doctors at Groote Schurr Hospital, occurred in Nyanga, a 
black suburb of Cape Town this past year (Cameron 1995).

	Here I will argue that the organ stealing stories are told, 
remembered, and circulated because they are true at that 
indeterminate level between metaphor and fact. The poor people of 
urban shantytowns world wide are "on to something" ; the stories 
express an intuitive sense that something is gravely amiss.

Timing of the Rumors: Political Disappearances / State of Emergency

	It is important to note the geo-political mapping and the 
timing of the organ stealing rumors. While rumors of blood libel and 
body snatching appear and disappear periodically, the current spate 
of organ and child stealing rumors arose and spread in the late 
1980s. In Brazil, Argentina, Guatemala El Salvador, and South Africa 
the organ stealing rumors have arisen within a specific political 
context and following a recent history of military
regimes, police states, civil wars, and " dirty wars" in which 
abductions, "disappearances", mutilations, and deaths were 
commonplace.

	 During the Argentine "Dirty War" of the late 1970s and early 
1980s, children were stolen, students were captured, interrogated, 
tortured and killed. Their bodies were abused and mutilated, and 
physicians often
collaborated as interrogator- torturers ( as they did in El Salvador 
, Argentina, and in South Africa) with the military state. 
Anthropologist Marcelo Suarez Orozco (1987) described in lurid detail 
the abuse of children
during the "Dirty War". Babies and small children were kidnapped and 
given to military families; older children were abducted by security 
officers, brutalized in detention, and then returned "transformed" to 
relatives. Some
of these were used as "bait" to entrap other "subversives". Other 
children were tortured in front of their parents and some died in 
captivity. An official truth commissions, established in the mid 
1980s (CONADEP 1984 ),
initiated the task of documenting after the fact the kinds of 
atrocities that had terrorized large segments of the population 
there. Nonetheless, Dr. Felix Cantarovitch, reporting from the 
Ministry of Health in Buenos Aires in 1990, contributed an article to 
Transplantation Proceedings (1990) in which he states:

	"In Argentina between 1984 and 1987 a persistent rumor 
circulated about child kidnapping. The rumor was extremely 
troublesome because of its persistence sustained by the exaggerated 
press that has always been a powerful tool to attract attention of 
people about the matter. In November 1987 the Secretary of Health 
gathered the most important authorities of justice, police, medical 
associations and also members of Parliament with the purpose of 
determining the truth. As a result it was stated that all the rumors 
and comments made by the press were spurious."

	Similarly, Mayan Indian villages in Guatemala sustained 
military attacks that were nothing less than genocidal over the past 
decade. The counterinsurgency war, which reached its height between 
1978 and 1984, left
over 100,000 people dead, another one million internally displaced, 
and caused thousands to flee across the Mexican border. Over 440 
rural Indian villages in the highlands were destroyed. (see Falla 
1982, 1992; Green 1995). Women were widowed and children were 
displaced, lost, and orphaned in the tens of thousands. These 
displaced children became the focus of international (especially 
North American) adoption, contributing to villagers mounting sense of 
panic, terror, and disaster. The consequent hysterical attacks of 
American tourists, especially those seeking to adopt Indian babies, 
has to be understood within this recent history. That Leventhal cites 
interviews with Guatemala's military officials in refuting the 
over-detemined child and organ stealing rumors there, is a bit like 
asking the proverbial fox to guard the hen house.

	Similarly, in Brazil many vestiges of the military state 
remain. In the shantytowns this presence is still felt in the 
late-at-night knock on the door, the appearance of masked men in 
police uniform, and in the scuffle
abduction of one's husband or teenage son. Several young men of the 
Alto do Cruzeiro , each black, young and in trouble with the law for 
petty crimes, were seized from their homes just after Christians in 
1987 by masked men in uniform. Two of the bodies, slashed, mutilated, 
and duped between rows of sugarcane, turned up a few weeks later. The 
police arrived with graphic photos: "How do you expect me to 
recognize meu homen (my man) in these
pictures? Dona Elena screamed. Finally, the men came one night for 
the teenage son of Black Irene, the boy that everyone on the Alto 
knew affectionately as "Nego De". The existence of local paramilitary 
death squads is suspected, but on this topic shantytown people are 
silent, speaking, when at all, in a complicated form of sign 
language. No one else wants to be marked. Meanwhile, violent attacks 
and the murder of unwanted street children
in Brazilian cities continues unabated to this day (see Dimenstein 
1992; Scheper-Hughes and Hoffman 1994).

	One could "read" the organ stealing and baby parts rumor and 
panic as a response to the nervous, unstable democracies just now 
emerging in parts of South and Central America. In Argentina, Brazil, 
Guatemala, the rumors surfaced or soon after the democratization 
process was initiated and in the wake of the reports by " truth 
commission" such as Nunca Mas in Argentina and  Brazil Nunca Mas. The 
rumors appeared, then, during a time when people finally became aware 
of the magnitude of the atrocities practiced by the state and its 
henchmen. Insofar as the poor of urban shantytowns are rarely called 
upon to speak before official Truth Commissions, body theft rumors 
may be seen as a surrogate form of political witnessing. The rumors 
participate in the spirit of the various official Truth Commissions 
by testifying to human suffering on the margins of the official story.

	The rumors also signify a sense of alarm, warning others in 
the community that their bodies, their lives, and those of their 
children are or have been in danger. The rumor expresses, obliquely 
and covertly, the abnormality of the "normal" and the chronic "state 
of emergency" in which poor people live (Taussig 19992, citing 
Benjamin). The rumors express the subjectivity of subalterns living 
in a "negative zone" of existence where lives and bodies are 
experienced as a constant crisis of presence (hunger, sickness, 
injury) on the one hand, and as a crisis of absence and disappearance 
on the other.

Misplaced Bodies: Clinics and Hospitals

	 There are even more mundane sources of the organ theft 
rumors as well. In Brazil the rumors allude to the way that poor 
peoples' bodies are usually dis-regarded in medical encounters. In 
public clinics and hospitals of the rural Northeast indifferent 
doctors in the employ of the state or the municipio  are willing to 
over-medicate the poor, to tranquilize hungry bodies, and to order 
unnecessary amputations and surgical removals for treatable 
conditions. I think of the municipal dental clinic in Bom Jesus where 
poor peoples' teeth were extracted for minor toothaches. Dr. 
"Tiradentes" agreed, saying with a shrug of his shoulders:

	 " Yes, this clinic is scandal,truly, and people worse off 
coming here than treating themselves. This is no way to run a clinic. 
... What do you see here -- just a chair!

All I do is pull teeth. People come in with a healthy set of teeth, 
but with a pain they can't bear. All they need is a filling. But they 
can't afford a private dentist in town. So, against my conscience I 
pull the tooth. If I sent them all home, I'd soon be out of a job.

  My job is not only to extract teeth from the poor, but to extract 
their votes for the mayor as well."

	And at the municipal clinic Dr. Joao took a cursory look at 
Seu Antonio, a cane cutter who had suffered a series of strokes that 
had left his eye damaged and his vision impaired, and said: " That 
eye of yours isn't worth
anything; let's have it removed." The frequent accident victims among 
the sugarcane cutters and sugar mill workers on the plantations 
return home from hospital with grotesque scars and badly set bones 
that leave them permanently disfigured or disabled. Meanwhile, the 
the middle classes and the wealthy of rural Brazil indulge themselves 
in the very latest and most sophisticated forms of body sculpting and 
plastic surgery. "So many of the rich are having plastic surgery and 
organ transplants, "offered an older woman of the shantytown of O 
Cruzeiro, that we really don't know whose body we are talking to 
anymore".

	In all, the organ stealing rumor has its basis in poor 
peoples' perceptions, grounded in a social and bio- medical reality , 
that their bodies and those of their children might be worth more 
dead than alive to the rich and the powerful. They can all too easily 
imagine that their bodies , and the bodies of their young children, 
may be eyed longingly by those with money. As they envision it , 
organ exchange proceeds from the bodies of the young, the poor
and the beautiful to the bodies of the old, the rich, and the ugly , 
and from the poor in the South to the rich in the North: Americans , 
Germans, Italians, Japanese and Israelis in particular.

	Obviously, there are many existential and ethical dilemmas 
concerning modern biomedical technology that are being imaginatively 
addressed by shantytown residents in the pre-literate form of "wild" 
rumors. For these reasons shantytown residents fear hospitalization 
and avoid dying in public hospitals where they imagine that autopsies 
are done to harvest usable organs from charity patients as a way of 
canceling their medical debts. "Little people like ourselves", I was 
often told, "can have anything done to them". Stories like the 
following, told by an elderly washerwoman from Recife confirms some 
of these suspicions:

	"When I was working in Recife," she began, "I became the 
lover of a man who had a huge, ugly ulcer on his leg. I felt sorry 
for him and so I would go to his house and wash his clothes for him, 
and he would visit my house from time to time. We were going along 
like this as lovers for several years when all of a sudden and 
without warning, he died. The city sent for his body. I decided to 
follow him to make sure that his body wouldn't be lost. He didn't 
have a single document, so I was going to serve as his witness and as 
his identification papers. But by the time I got to the public morgue 
they had already sent his body to the medical school for the students 
to practice on.
So I followed him there and what I saw happening at the school I 
could not allow. They had his body hung up and they were already 
cutting off little pieces of him. I demanded the body back, and after 
a lot of arguing they let me take it home with me. It's true, he was 
only a beggar, a 'tirador de esmolas,' who sometimes did magic tricks 
on the bridge in Recife to amuse people. But I was the one who washed 
his clothes and took care of his wound, and so you could say that I 
was the owner of his body."

	 When Biu's little girl Mercea, who had been sick for a very 
long time, finally died in late February of 1988 just as they arrived 
at the emergency room of the local hospital, Biu wisked the child's 
body away despite the
protest of the clinic staff. She and her sister buried Mercea 
hurriedly that same day. I accompanied Biu to the registry office 
where she recorded the child as having died at home that morning. "We 
were afraid of the state", Biu
said, "I didn't want an autopsy or Mercea's body tampered with. She 
is my  child and I will be the guardian of  her little body."

  	 But Mercea, like most of the more than 300 children who die 
in Bom Jesus each year, was buried in an unmarked grave although in 
her own little coffin, purchased on credit. Within less than six 
months her grave was cleared to make room for another "little angel" 
and her remains were tossed in the deep well that is called the bone 
depository, the "depósito de ossos". And so, Mercea's older sister, 
Xoxa, (who was away working on a plantation at the time of her baby 
sister's death) could not, on her return home, locate the little 
grave. This made it difficult for Xoxa to offer her sister the pretty 
white stockings that Mercea told Xoxa in a dream that she wanted. 
"Your vision was a true one", Biu told her eldest daughter. "In our 
rush to bury Mercea we had to put her into the ground barefoot."
	 [ slide of Xoxa with Stockings]

Unequal Exchange

	It was just this perceived injustice of unfair and unequal 
exchange of organs and body parts that kept Dona Carminha in search 
of medical assistance for her only living son, Tomas, who was blinded 
at the age of seven following the medical maltreatment of a serious 
eye infection. Secondary scar tissue had grown over the cornea of 
both eyes and the boy , now l3, was living in a world of impenetrable 
darkness. Carminha was certain her son's condition could be reversed 
by a cornea transplant. The only obstacle , as she saw it, was that 
the "eye banks" were reserved -- like everything else in the world -- 
for those with money. She had taken the boy to Recife, and then by 
bus to Rio where she pursued one impossible lead after another., 
going from hospital to hospital. Through all she persisted in her 
belief that somewhere she would find " a sainted doctor" , a doctor 
of conscience who would be willing to help. "Don't they give new eyes 
to the rich"? And, wasn't her own son "equal before the eyes of 
God?"she asked.

		 Finally, the child and organ stealing rumor reflects 
unscrupulous practices of international adoption. In the shantytowns 
of Brazil I encountered several cases of coerced adoption and (in 
1990 alone) two cases of child stealing by wealthy "patrons" 3 . Each 
year nearly 1,500 children leave Brazil, legally, to live with 
adoptive parents in Europe, the United States, and Israel. But if one 
adds the clandestine traffic in babies that relies on false documents 
and bureaucratic corruption in Brazil and abroad, exploiting the 
ignorance and the powerlessness of poor women , the number of 
children leaving Brazil has been estimated at 3,000 a year, or 
roughly 50 babies a week 4 .

	The lively market in "spare babies" for international 
adoption is often confused with the lively market in "spare parts" 
for international transplant surgery. As poor people in shantytowns 
see it, the ring of organ exchange proceeds from the bodies of the 
young, the poor, and the beautiful to the bodies of the old, the 
rich, and the ugly, and from poor nations in the South to rich 
nations in the North. In the midst of the black market for organs and 
babies, poor people can hardly be blamed for thinking that their 
babies are wanted as much dead and for their organs as or their lives.

	My investigations in 1989 (previously reported) led me to a 
small beach-front hotel in Recife, Pernambuco where I encountered 
several couples from Europe and the United States awaiting the final 
steps in adopting a Brazilian child. Most were working through 
adoption agencies in their native countries that had put them in 
touch with "Casa Alegre", a children's home in a secluded hillside 
suburb run by an elderly Protest missionary from the American 
Midwest. The couples had scheduled their arrivals to coincide with 
the appointment of a sympathetic children's judge who supported 
international adoptions.

	Adoption cost the couples about $3,000 excluding air fares 
and living expenses in Brazil, considerably less than the $l0,000 it 
cost in the U.S. $1,000 went directly to the Children's Home, and 
another thousand to the
local "adoption lawyer", and the remainder paid for various legal 
"processing fees" and for a court translator. The couples, working 
through intermediaries, knew little about the birth parents, but they 
all believed that the birth mothers had voluntarily surrendered their 
children.

	 At Casa Alegre in Recife I found a dozen babies lying in 
cribs. Above each head was a name and , in some cases, the name of an 
adoptive parent and their phone number. Some of the babies were 
awaiting the adoption proceedings, others had just arrived. Several 
babies looked ill and malnourished. The director explained that she 
did the best she could to match the babies according to the adoptive 
parents' specifications. Most wanted pretty,
healthy babies, light-skinned and with white features. Girls were preferred.

	 When I asked, directly , about the Brazilian "traffic in 
babies", the director admitted that aspects of the adoption process 
were murky. Sometimes, she had to fight with mothers to release their 
children. Some birth mothers resisted signing the adoption papers 
even when they know it would be best for their child. As I left Casa 
Alegre I thought of the tortured ambivalence of Dona Maria of the 
Alto do Cruzeiro and of the loss and humiliation suffered by her 
husband. "When I am very angry", she once said, "I think to myself, 
'Why doesn't that rich American woman who stole my little blood 
(galega ) come back and rescue the rest of us as well.'"

Conclusions:

	Organ transplantation takes place within a specific 
historical, social, and political context. It depends, as 
Cantarovitch (1990) suggests, on a social contract and a social 
trust. The procedures cannot exit without the protest and defiance 
which the organ stealing rumors register, unless the grounds for 
social trust are explicit. This requires national and international 
laws protecting the rights of both organ donors and organ recipients.

	At a very rudimentary level, the practice of organ 
transplantation requires a reasonably fair and equitable health care 
system. The Ministry of Health in Gauteng, South Africa was correct , 
I think, in proposing a temporary moratorium earlier this year on 
organ transplants, until the majority of South African blacks in the 
province could be assured access to adequate primary health care. 
Despite protests from the organ donor foundations, some organs ( 
corneas in particular, according to my sources) are taken without 
consent. It seems like stating the obvious to suggest that organ 
donation requires a transparent process of informed consent .

  	The social ethics of transplantation requires a reasonably 
democratic state in which basic human rights are protected and 
guaranteed. Organ transplantation occurring, even in elite medical 
centers by the most
conscientious of physicians, within the milieux of a police or 
military state where political "disappearances ( Brazil, South Africa 
), "dirty wars" ( Argentina) , ethnic cleansing (Bosnia) or genocide 
(Ruanda, Guatemala) are
practiced or where routine police torture and injury and deaths in 
detention are common ( the 'old' South Africa) , can only represent 
an abomination, another form of violence. Under such compromised 
circumstance the most
vulnerable people will fight back with the only resources they have 
-- gossip and rumors which convey, albeit obliquely, the reality of 
the "situation of emergency" that exists for them.

	Following from the above, other requirements are a legal 
system concerned with the protection of women's reproductive rights, 
so that poor women are free from coerced sterilization and coerced 
adoption, both of which exist in parts of the world. Similarly, where 
vestiges of forced labor exist especially in "debt peonage" systems 
which unfairly bind workers to their "bosses", unfair exchanges -- 
including trade in children -- for survival fuels the panic 
underlying rumors of organ and child stealing.

	 Finally, the US government needs to accept far more 
responsibility for reinforcing political and economic circumstances 
that engender the bodily, ontological insecurity registered in the 
organ stealing rumors. The USIA document is tone deaf to the very 
real suffering expressed in the rumors, a suffering based on economic 
imbalances and political collusions in which the US has played no 
insignificant part.

	 	Acknowledgements

	Parts of this paper was presented and discussed at the 
Conference on "Securing Bodily Integrity for the Socially 
Disadvantaged: Strategies for Controlling the Traffic in Organs for 
Transplantation", Bellagio, Italy,
September 24 -28, 1995. That Tsuyoshi Awaya, Bernard Cohen, Abdallah 
Daar, Sergei Dzemeshkevich, Chun Jean Lee, Robin Monro, Hernan Reyes, 
Sheila Rothman, Eric Rose, Kenneth Schoen, Zaki Shapira, and Heiner 
Smit and myself were able to spend four intensive days together 
debating the philosophical, medical, and human rights dimensions, 
meanings and consequences of the global trade in human organs 
testifies either to the incredible skills of David Rothman as 
moderator and 'founder of the feast ' or to the calming effects of 
Lake Como. Probably both.

	 Notes

1.This is how White (1993, 1995) explains Central and East African 
blood sucking and organ stealing stories, especially favored by poor 
women who are sex workers. The women tell stories of urban brothels 
where unsuspecting men are lured and then drugged as they sit on 
chairs covering a trap door which drops the unconscious client to a 
basement where he is "operated on", that is, his blood is drained, 
skin is removed, and organs are taken. Poor women, so often abused by 
their male clients, took great delight in telling stories of male 
"johns" rendered unconscious, passive, mute, and physically gutted.

2. I cite my own field research in Chris Hani squatter camp as well 
as professors of medicine at the University of Cape Town ( Lerer, 
Benataur, personal communication).

Nonetheless, a survey of "public attitudes to organ donation in South 
Africa", published in SAMJ in Feb. 1993 remarkably reported generally 
positive and supportive attitudes across ethnic lines, with the 
exception of
communities closest to Groote Schurr Hospital where most 
transplantations in the country have taken place (see Pike, Odell, 
and Kahn 1993).

3. When Maria Lourdes, the mother of five sickly and malnourished 
children living in a miserable hovel on the Alto do Cruzeiro was 
asked by her wealthy boss ) if she could "borrow" Maria's 
four-year-old, Maria readily agreed. The woman, for whom Maria washed 
clothes, said she wanted the little "blond" (galega)  just for her 
amusement. Maria sent her daughter off just as she was: untidy, 
barefoot, and without a change of clothing. The patroa promised
to return the child the following morning. Two nights passed and when 
still her daughter was not returned, Maria became worried but she did 
not want to anger her boss by appearing mistrustful. When Maria's 
husband returned home from his work on a distant plantation and he 
discovered his favorite daughter was missing, he shoved Maria up 
against the wall of their hut. "Stupid woman!", he yelled when Maria 
told him what had happened. The husband went off in frantic search. 
At the house of the patroa he learned that the child had already been 
given to a missionary who directed a "children's home" that 
specialized in overseas adoption. "Your daughter is in good hands," 
insisted the home's local sponsor and benefactor. "Leave her where 
she is and soon she will be on her way to America to become the 
daughter of a rich family. Don't be selfish; give her a chance." Had 
Maria and Manoel lodged a complaint with the police? I asked. "Do you 
think the police would take a complaint from us?" Maria said. She was 
angry at having been tricked but she came to accept what had 
happened. Surely her daughter was better off now.

4. Israel: About l50 Brazilian children live with their legal 
adoptive parents in Israel. Between 1985-1990 about 2,000 children 
have entered Israel from Brazil in a questionable manner. Italy: Most 
adoptive babies who go to
Italy are from the state of Bahia which has a heavy concentration of 
Afro-Brazilians. Some of these adoptions have been investigated by 
the Italian courts. Germany: The clandestine adoptions of Brazilian 
babies to Germany can be traced to the Northeast Brazilian city of 
Fortaleza.

United States: About 200 babies leave Brazil each year legally 
through the help of private adoption agencies, many of them 
affiliated with fundamentalist and evangelical Christian Churches.

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Monica Narula
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