Transplant patients often wait for years for a donor organ to become available. In China, where the black market for human organs is rife, desperate patients can get organ transplants at short notice. Credit:Getty Images

Normal text size Larger text size Very large text size One day in November, 2006, Jintao Liu, a 26-year-old chemical engineering student at the China University of Petroleum in Beijing, got a phone call from his lecturer, asking if he could come to the chemistry lab for a quick chat. It was about noon and Jintao was about to start lunch, but the lecturer was an important man, so Jintao did as he was told. “I thought he wanted to talk to me about work,” says Jintao. When he entered the lab, however, he saw his lecturer, together with two policemen and four plain-clothed members of the 610 Office, an extra-judicial body set up by the Communist Party with the sole purpose of eradicating Falun Gong, a spiritual movement the Chinese government regards as an evil cult and a challenge to its authority. Jintao, who practised Falun Gong, had recently downloaded some material – music mainly – onto his desktop computer in the lab. When the policemen examined the computer, they found the Falun Gong material and arrested him. “I asked them if they had a search warrant or an arrest order and they scribbled on a piece of paper, chucked it at me and said, ‘That’s your warrant.’ ” Jintao, who has anglicised his name to Tony, lives in a 1970s red-brick home in Epping, a quiet, leafy suburb in Sydney’s north-west. He and his wife, Tina, fled China in 2013, coming to Australia where they were granted protection visas. (They are now Australian citizens.) At 39, Tony has broad-set eyes, a cautious smile and a pronounced liking for black tea, which Tina supplies in prodigious quantities throughout our conversation. He still adheres to Falun Gong, which he credits with far-reaching mental and physical benefits. In a country like China, where organised religion has been repressed, Falun Gong gave Tony what he calls “a deeper sense of meaning”. Following his arrest, Tony underwent four months of brainwashing in the Beijing Changping Detention Centre, where he was forced to watch videos and read newspapers detailing Falun Gong’s alleged crimes. When he refused to denounce the movement, he was put in a cell with eight drug addicts who were induced by the guards to regularly beat him. “One day, they were beating me around the back and waist when a guard ran in and told them, ‘Don’t damage his organs!’ ” In May 2007, Tony was moved to Beijing Tuanhe Re-education Through Labour Camp, where the abuse worsened. Tony claims he was starved for three days, then force-fed through a tube, into which another prisoner urinated. “Some of the prisoners didn’t want to beat me, so the guards moved them and brought in really cruel ones.” The prisoners stripped him and forced the handle of a toilet brush into his anus; they burnt his back on a heating unit, yanked on his testicles, and shoved metal under his nails. “All the time they wanted me to sign statements saying I would give up Falun Gong.” In late 2007, he and other Falun Gong prisoners received a series of medical tests. They had their height and weight measured, had their blood taken and were X-rayed. “They X-rayed all of my torso,” Tony says. “A year later, they gave me another X-ray, and took more blood.” None of the prisoners were told what the tests were for, and they never received the results. But given his treatment, Tony doubted they were out of concern for his health.


In 2009, Tony finally signed the statements renouncing Falun Gong. After lobbying by his family, he was released. He married in 2012 and got a job in Beijing as an engineer. But he was still required to file regular “thought reports” to the authorities, who continued to monitor him closely. Fearing re-arrest, he and Tina decided to leave, seeking asylum in Australia. In the years following, he often thought back on the X-rays and blood tests. He thought about when the prisoners were instructed by the guards not to injure his organs. Though he had heard whispers of prisoners being killed for their organs, he had always found it hard to believe. Then he remembered one particular day, in 2007. He had been in his cell when a senior guard, named Li Wei, came to see him privately. “He bent down so we were almost face to face, and said, ‘Nothing is impossible!’ ” Arrested in China for being a member of Falun Gong, Jintao “Tony” Liu was forced to undergo medical tests. Credit:Wolter Peeters In December 2018, Tony gave evidence via phone to the China Tribunal, an independent inquiry held in London into the murder in China of prisoners of conscience for their organs. (Despite medical advances, the demand for organs worldwide still outstrips supply, causing an increase in transplant tourism, especially to countries like China, where the black market for body parts is rife, and where desperate patients from around the globe can find organs at short notice.) The tribunal was headed by a seven-person panel and chaired by Sir Geoffrey Nice QC, a hawkish-looking British barrister and part-time judge at the Old Bailey, who worked at the International Criminal Court for the former Yugoslavia from 1998 to 2006, and led the prosecution of Serbia’s former president, Slobodan Miloševic. The tribunal, which was initiated by a global not-for-profit group called the International Coalition to End Transplant Abuse in China (ETAC), was a world first. Other inquiries, such as those by the US House Committee on Foreign Affairs in 2012 and the European Parliament in 2013, have found credible evidence of systematic organ harvesting in China. But none explored specifically whether such allegations constituted international criminal offences, including genocide and crimes against humanity, as defined by the Geneva Convention and the Rome Statute of the International Criminal Court. Accordingly, the tribunal adopted a single criminal standard: proof beyond reasonable doubt. “ETAC provided the bulk of the material, just as any prosecuting authority would do,” says Nice, talking on the phone from London. “And we were no different to a judge or jury, filtering information to make objective judgments.” The tribunal had a huge task. Over a period of 12 months it examined thousands of pages of submissions, including previous investigations and academic papers, internal Chinese medical records, and reports from Amnesty International, independent watchdog group Freedom House and the United Nations Committee Against Torture. It reviewed undercover video footage taken inside Chinese hospitals, covert telephone recordings with Chinese transplant surgeons, and heard from 50 witnesses, some of whom appeared in person and others via video link, from France, Canada, the US, Japan, Australia, Turkey and Korea.


The public hearings were held at the Grand Connaught Rooms, an ornate, heritage-listed building in Covent Garden. Witnesses included Enver Tothi, a former surgeon from the western Chinese region of Xinjiang, now living in London, who claimed to have removed the kidneys from a still-living prisoner, and a Chinese man who, as a medical intern at Shenyang Army General Hospital, had been involved in harvesting livers, kidneys and corneas from “incompletely executed” prisoners. Huige Li, a professor of pharmacology at the University Medical Centre of Mainz, Germany, who also gave evidence at the tribunal, claimed “incomplete execution”, often via a gunshot to the right side of the chest, is not uncommon, the purpose being to maintain blood circulation to the organs. Witnesses often identified their torturers by name, rank and police number; they could remember each camp they were held in, when, and for how long. They recounted how they had been told by guards that they would be killed for their organs; how guards referred to Falun Gong prisoners as “merchandise”; and that they were “being kept as spare goods”. The tribunal heard multiple accounts of medical testing, including regular X-rays and CT scans; witnesses also claimed they had been forced to provide urine and blood samples. Only Falun Gong prisoners were subject to such tests, the selective and systematic nature of which was, in the view of the tribunal’s medical experts, highly suggestive of methods used to assess organ function. (The Chinese government was invited to take part in the tribunal but declined to do so.) The tribunal relied in part on a 2016 report called Bloody Harvest/The Slaughter by David Matas, a Canadian expert in refugee and human rights law, David Kilgour, a former Canadian secretary of state, and American investigative journalist Ethan Gutmann. Bloody Harvest/The Slaughter is 678 pages long and includes 2367 footnotes. (Earlier research by Matas and Kilgour on organ harvesting saw them nominated for the 2010 Nobel Peace Prize.) The tribunal also listened to dozens of phone calls made by Falun Gong practitioners in Europe, the US and Australia to hospital officials and transplant surgeons within China. The calls, which were independently verified, included Chinese surgeons and medical staff admitting to, and in some cases boasting about, taking organs from prisoners of conscience. How could this happen?’ It’s just so outlandish. But look at Cambodia. Look at people hacking each other to death in Rwanda. Human experience shows us again and again that there is nothing too outlandish to be true. Geoffrey Nice, head of the China Tribunal The tribunal wound up in April. The final judgment, a 60-page summary of which was released in June, found that official transplant statistics in China are routinely falsified, and that instead of performing 10,000 operations as claimed, the real figure is between 60,000 and 90,000 a year. It found that the main source of these organs were Falun Gong, but that Uighurs, a mostly Muslim minority – up to 1.5 million of whom are incarcerated in China – were at risk of becoming the next “organ bank”.


It also found that illicit organ transplants had become a lucrative industry in China, directed by the state and enabled by the military. Geoffrey Nice and the panel effectively accused the People’s Republic of China of having committed mass murder, and warned that governments or any other bodies that engaged with it in any substantial way “should now recognise that they are interacting with a criminal state”. China has in the past admitted to using the organs of executed criminals. (It claims the practice ended in 2015.) But it denies harvesting organs from prisoners of conscience. Dr Huang Jiefu, China’s former vice minister of health and one of the country’s leading transplant surgeons, has described such claims as “nonsense”. Dr Haibo Wang, director of the Organ Transplant Response System Research Centre, at the Ministry of Health, says the tribunal’s findings were “clearly based on falsified information”. In an email to Good Weekend, Wang says reports of prisoners being X-rayed were “non-factual”. An Australian physician, Professor Jeremy Chapman, former head of the global peak body, the Transplantation Society, and one of the world’s foremost experts on kidney transplantation, has likewise cast doubt on claims that China is engaged in systematic organ harvesting from groups such as the Falun Gong, describing the allegations as “pure imagination”. According to Nice, a certain degree of scepticism is natural. “People didn’t at first believe that the Holocaust was happening, either,” he says. “If you’ve been brought up in a gentle suburb of Melbourne or London, you’d think, ‘How could this happen?’ It’s just so outlandish. But look at Cambodia. Look at people hacking each other to death in Rwanda. Human experience shows us again and again that there is nothing too outlandish to be true.” Organ transplants in China have, almost from the beginning, been inextricably linked to politics. One of the earliest recorded accounts is that of Zhong Haiyuan, a young schoolteacher who was executed in Jiangxi Province on April 30, 1978 for being an “active counter-revolutionary element”. According to one of the executioners, who later spoke to Chinese journalist Hu Ping, Zhong was shot in the head and her kidneys removed in the back of an army truck. They were then transplanted into an airforce officer named Shi Yunfeng, the son of a retired deputy commander of the Nanjing Military Region. (Three years later, Zhong was exonerated of all charges and posthumously pardoned.) In 1984, China introduced regulations allowing the use of organs from executed prisoners, with the operations to be kept strictly confidential. By the mid-1990s, army surgeons were removing livers, kidneys and corneas for use by Communist Party high-ups. A Chinese Army doctor named Wang Guoqi later told a United States Congressional Committee how he had removed not just internal organs, but skin for eventual transplant to burn victims. (China’s then Foreign Ministry spokeswoman described Wang’s testimony as “sensational lies” and “vicious slander”.) From the year 2000, the Chinese transplant industry began a period of extraordinary growth. The government prioritised organ transplantation, incorporating it into its Five Year Plans. Thousands of transplant beds, specialist surgeons and personnel were added to the system in a matter of years. Between 2000 and 2006, the number of hospitals that performed organ transplants went from 91 to 1000, their numbers multiplying, as one official put it, “like bamboo after the rain”. Operations also skyrocketed: according to an internal speech by then vice-minister of health, Huang Jiefu, China conducted 34,726 organ transplants between 2000 and 2004 – including an 18-time increase for livers, and 24.5-time increase for lungs. Then, in March 2006, two sensational stories came to light. The first was from a man calling himself Peter, who claimed that Falun Gong practitioners were being held in a secret concentration camp located in Sujiatun, in north-eastern China. According to Peter, the camp had on-site doctors to remove the inmates’ internal organs, and a crematorium to dispose of the bodies. The organs were sold, he said.


Just days afterward, a woman calling herself Annie, who was then living in Washington, DC, claimed that between 2003 and 2005 her ex-husband, a surgeon, had harvested thousands of corneas from Falun Gong practitioners in the same camp. The Falun Gong were killed during the harvesting, and their bodies cremated. The surreal nature of the allegations, together with the fact that the stories appeared in The Epoch Times, a Falun Gong-affiliated newspaper, undercut their credibility. The accounts were also attacked by Harry Wu, a Chinese-American human rights activist and an expert on China’s detention facilities. Yet it piqued the interest of David Matas and fellow Canadian David Kilgour, both long-time human rights activists. In May 2006, at the request of a pressure group called the Coalition to Investigate the Persecution of Falun Gong in China (CIPFG), the two men began investigating Peter and Annie’s claims, pro bono. In 2006, the Chinese government claimed to be conducting 10,000 organ transplants a year. But Matas and Kilgour were sceptical of this figure. “There is so much secrecy and official propaganda,” says Matas. He and Kilgour then set about calculating the real number of transplants in China by, among other things, examining its transplant infrastructure: bed counts, surgeon numbers, hospital capacity and volumes, transplant waiting times, current and archived hospital websites, hospital revenues and research facilities, and so on. They also collected media reports and interviews with health officials. (Many of these reports have since been taken down.) They found that the official claim of 10,000 operations a year was easily accounted for by just a few hospitals, and that the real figure was closer to 60,000. As new hospitals came online, that figure kept rising. In 2010, the First Affiliated Hospital of Sun Yat-Sen University in Guangzhou admitted it had performed “tens of thousands of transplants”. In 2013, Zhu Jiye, director of the Organ Transplantation Institute at Peking University, told the China Economic Weekly magazine that they had conducted 4000 liver and kidney transplants in one year. Huang Jiefu told Guangzhou Daily newspaper that he alone had done 500 kidney and liver transplants in 2012. The source of these organs remained unclear. China’s voluntary organ donation system did not become operational until 2013. (Chinese people have a cultural aversion to organ donation, owing to a traditional belief that the body must be buried intact.) In Shanghai, the first donation from a deceased organ donor happened on August 21, 2013. Yet there were 11 transplant centres in Shanghai approved by the Ministry of Health. In 2015, the Red Cross in Beijing confirmed that it didn’t even have a donation office, and hadn’t arranged a single case of organ donation. Yet there were 20 state-approved transplant centres in the city, many of them with the capacity to carry out thousands of transplants a year. “There seemed to be an endless supply of organs,” says Matas. “The numbers just didn’t add up.” Professor Maria Fiatarone Singh, a University of Sydney geriatrician. Credit:Joshua Morris One of the most unusual aspects of China’s organ transplant system is the extraordinarily short waiting times. “In most countries with voluntary donation systems, patients wait long periods for organs,” says Professor Maria Fiatarone Singh, a geriatrician at the University of Sydney, who is also a member of global pressure group Doctors Against Forced Organ Harvesting. In the UK, the average waiting time for a liver transplant is 135 days. In Australia, people needing a kidney can wait between five and seven years. Waiting times in China, meanwhile, can be as little as two weeks. On the Chinese website haodf.com, or “Good Doctor”, an online chatboard where patients swap reviews of their surgeons, people talk of receiving organs in a matter of days.

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