VATICAN CITY — You live in a slum in Manila, penniless and with a family to feed. Near your home, a small group of people set up a stall offering a few thousand dollars in exchange for one of your kidneys or part of your liver. You’re told the operation would not be life threatening but would give you some much-needed financial stability. Would you refuse?

Such exploitation is called organ trafficking, or organ tourism. And it’s a scourge that’s growing as demand for organs increases worldwide. Kidneys, liver sections and lung lobes are all needed in this expanding market, and increasingly they are found among people living in poor countries where such organs can be obtained cheaply.

According to the World Health Organization, donors are approached by brokers who will pay them as little as $5,000 for an organ. These brokers will then sell them to wealthy patients for anything from $100,000 to $200,000. The most lucrative markets are in Saudi Arabia and Israel.

“In the slums, they have nothing at all, so it’s not a matter of choice anymore; their poverty compels them to do things they’re not going to necessarily want to do,” said Francis Delmonico, a Harvard professor of surgery and leading campaigner against organ trafficking. “This is a despicable practice, all about money, big business and exploitation that neither the Church nor any responsible government should accede to.”

The majority of governments, including Brazil and India, which used to be the largest supplier of donors, have banned the practice. Even China, which recorded 11,000 cases of “transplant tourism” last year, is said to be working on ending the trade. (Last year, it admitted to using organs from executed prisoners for transplants since 1984.)

The exception is the Philippines. The government there “has no problem with this happening,” says Delmonico, and will even allow poor Filipino donors to be sent to have transplant operations in Riyadh or Tel Aviv.

Delmonico wants to see the Church, both in the Philippines and in Rome, doing more to end this practice. He recently spent a few days at the Vatican, visiting various departments and “pleading” with officials to take action. He has also written to Vatican Secretary of State Cardinal Tarcisio Bertone. “I need the Church to speak out against this,” he said.

He got his wish. From the top.

Pope John Paul II himself, in his 2004 Lenten Message, called the practice “obscene.”

The issue remains “certainly of concern” to the Holy See, but more time is needed to learn about what is a very shady practice and hard to pin down. According to Msgr. Maurizio Calipari, spokesman at the Pontifical Academy for Life, the Vatican will make public a number of initiatives in 2008 to draw attention to the issue.

“At the moment, we are in a study phase, reflecting internally, gathering data and consulting with other dicasteries,” he said Oct. 9. “It’s too premature to comment further.”

Msgr. Anthony Frontiero, an official at the Pontifical Council for Justice and Peace, said the problem, like all others related to human trafficking, is of “grave concern” to the Church, but until Delmonico came to the Vatican, they weren’t aware of the extent of it.

“We need to highlight this particular issue more,” Msgr. Frontiero said. “Organ donation is a noble and worthy gesture where there is a need, but when it’s done for profit, that’s when it becomes a problem for us.”

Msgr. Frontiero condemned not only government approval of “organ tourism,” but also the complicity of the medical community (in Manila, at least five hospitals allow the practice, with permission allegedly coming from the most senior staff). “They contribute to the devaluation of the dignity of the human person, objectifying them and reducing them to a commodity that can be bought, sold and used,” he said.

Also of concern to the Holy See is that these victims are not guaranteed medical care afterwards. According to the Coalition for Organ-Failure Solutions, which is also campaigning against this trade, 48% to 86% of kidney donors in the Philippines, Egypt, Iran and India reported a deterioration in their health, such as fatigue and the inability to carry heavy loads. Their financial compensation for being donors is also often so small that it provides no long-term benefit, and least of all adequate healthcare.

Regarding the situation in the Philippines, in comments to the Register Oct. 12, Msgr. Pedro Quitorio, media director of the Philippine bishops’ conference, said the bishops have been very vocal against the problems of the government, and “not a few” bishops and priests have preached against the practice. But he admitted “there has not yet been any concrete action taken by the Church on this matter except to denounce this practice as immoral.”

He said denouncements were the key to lessening this crime that, he believes, is here to stay for as long as rich clients can afford to buy organs and the business is lucrative. Explaining the bishops’ priorities, he said the problem is a big one, but there is the “gigantic issue” of government corruption and election fraud.

Delmonico sees three ways to tackle or minimize this scourge: Maximize legitimate donations within patients’ native populations, provide state benefits for donors, such as medical insurance and after-care assistance, and not allow patients to obtain visas to travel to countries such as the Philippines if buying such organs is illegal in their own country.

Delmonico hopes the practice will be made illegal worldwide.

Even if China stops the practice, Delmonico asks, “where are the people going to get those organs now? They’ll be on their way to Manila.”

Edward Pentin writes

from Rome.