The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers [Paperback]

I first heard about The Red Market after reading an intriguing Publisher's Weekly interview [...] with author/journo/anthropologist Scott Carney. Based on an investigative journalism series for Mother Jones during 2009 and 2010, Carney delves into the black market trade of the human body - both living and deceased, whole and in part - following a set of circumstances that left him in the guardianship of the corpse of an American student overseas.

This is where most reviews would say something like "not for the faint of heart" or something like that and it's true. Carney has taken a very frank (and graphic) look inside the human body trade but he does so without coming off as a sensationalist. Much of his work revolves around India and China - places where poverty and overpopulation have contributed to the profiteering and exploitation of international adoption, kidney/other organ donations and fertility methods (egg harvesting/surrogacy).

I expected to be more shocked by accounts like those of an entire village of indigent women in India who saw kidney donation as their only way out of poverty (Note: it never is!) by agreeing to a small amount of money up front only to be swindled out of the additional money they were promised afterwards AND left without post-operative care. I was less shocked by these deceitful methods of procurement than I was by the attitude of the organ donation recipients: I don't care where it comes from or what it costs, just get it.

Carney has compiled his work into a quick read that poses excellent moral and ethical questions - and I believe sheds some much-needed light on a grim traffic that few here in the U.S. know or think about. I look forward to more interviews with the author about this work in the coming months.

How can I sell thee? Let me count the ways. Actually, I don't need to. In The Red Market investigative journalist Scott Carney seems to have taken care of that. He covers the wealth of ways in which business people in the people business sell parts of people to other people. He covers the selling of bones, kidneys, human ova, personal gestation services, blood, and more. Geographically, most of Carney's work is in India, where he lived for several years, but he forays out to Cyprus, Spain and the USA for personal investigations.

The impact of what he reveals here is global. It appears that the West (primarily) has found new sources of third-world raw materials to exploit. And as with prior versions of such practices, the locals do not fare very well from the transaction. In addition, it appears that third-worlders are being employed to do some work that gives the term "labor-saving" new weight. Carney's focus is on the supply side of the equation, in particular its impact on the suppliers in this international meat market.

The material here is the stuff of horror films, reminiscent at times of the X-files or Sweeney Todd, although the consumption involved is not savory. Carney was teaching in India when a young woman in his program died. It was through his experience seeing that her remains were returned to the USA that he became aware of the way that once a person has passed on, pressure builds for their remains to be passed along.

He begins by digging into the business of grave-robbing in India, an enterprise that has supplied high-quality, sparkling product, intended largely for Western medical training. When the police arrived to investigate in early 2007, they could smell the stench of rotting flesh from nearly a mile away. Sections of spine strung together with twine dangled from the rafters, an officer told me. Hundreds of bones were scattered on the floor in some sort of ordering system. Carney offers a professional's description of how the preparers transform a body into a sack of bones. (Included at the end of this review, for the ghoulishly curious) He writes, in addition, about the history of grave-robbing, particularly in the West. That is engrossing stuff.

One of the unanticipated aftermaths of the great tsunami of 2004 was the creation, via a large population of displaced and impoverished people, of a ready source of kidneys. Desperate people sell one of their two kidneys in order to get enough cash to keep their families going just a little longer. On the grounds of a dairy farm shanghaied transients are hooked up to tubes and their blood is siphoned off multiple times a week until they are near death. When their utility as milk-able blood-cows is about to expire they are put on a bus and sent out of town for someone else to deal with. Corneas are taken from barely living or just killed prisoners in Chinese prisons. In Cyprus, mostly Eastern-European women are given large doses of hormones to encourage the production of multiple ova, which are then implanted in Western customers. In India, women serving as surrogates live for months under conditions of virtual imprisonment until their product is C-Sectioned out of them. Carney paints a bleak picture. The only part of the Red Market that seems to work well is the donation and marketing of human hair.

Brokers for blood products, particularly, reminded me of how Wall Street fused hordes of junk financial products into one gigantic stinking pile of finance and sold it in a way that no buyer could discern the actual source of the underlying stench. When it comes to blood there are major brokers who collect blood from sources as solid as 9.5% APR mortgages. The quality of that blood is, to be generous, not reliable.

In addition to the reality on the ground, Carney looks at underlying issues, the role of anonymity in organ donation, the relationship between the free market and voluntarism, how changes in law affect such trade. He looks at the likelihood that new scientific developments might mitigate worldwide demand and examines the nature of fluctuating demand. Carney points out the very definite class difference in who benefits the most from this trade

Sometimes Carney shows a bit of naiveté, such as in the following Obscuring the source of raw materials for any market is almost always a bad idea. We would never allow an oil company to hide the locations of its oil rigs, or not to disclose its environmental policies. And when an oil rig fails and leaks millions of barrels of petroleum into the ocean we demand accountability. Transparency is capitalism's most basic safety feature. Perhaps he has not noticed that corporations are quite successful at minimizing transparency. In doing this he ignores his own evidence of under-the-table payments to law enforcement personnel in India, a decidedly capitalist nation.

The grainy black-and-white images that appear throughout the book seem well-suited to the material. Carney writes in a first person voice that gives the reader a you-are-there feel. He is very readable, and that eases the discomfort of absorbing his subject matter.

In The Red Market, Scott Carney has done an outstanding job of shining a bright light into one of the darker dungeons of human commerce. While I thought that his solutions were a bit fuzzy, the upside here is that The Red Market offers a significant contribution to our base of knowledge about some serious public health, and human rights concerns.

While some parts of the book have been previously published in magazines, (Carney has been writing for many well-known publications for years) this is his first book. It is a stunning debut and promises to be the beginning of a long, productive and valuable career.

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Carney's blog[...] is well worth a look. There is much material there that supplements this book, including links to related articles, as well as material on other projects.

The book itself contains a wonderful bibliography for anyone interested in looking a bit deeper into specific areas.

While reading The Red Market I was reminded of several other books that touched on related subjects.

Little Princes, by Conor Grennan re stealing children for fun and profit
Larry's Kidney by Daniel Asa ROse re traveling abroad to pick up hard-to-find parts and services
Long for This World by Jonathan Weiner re our quest for immortality
The Immortal life of Henrietta Lacks by Rebecca Skloot for the deep respect research science has for test subjects or "donors"

Dirty Pretty Things is the only film addressing issues raised here that popped to mind. But I am sure there are more.

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Not a High School Science Project - the ff is quoted from the book
First the corpses are wrapped in netting and anchored in the river, where bacteria and fish reduce them to loose piles of bones and mush in a week or so. The crew then scrubs them and boils them in a cauldron of water and caustic soda to dissolve any remaining flesh. That leaves the calcium surfaces with a yellow tint. To bring them up to medical white, bones are then left in sunlight for a week before being soaked in hydrochloric acid. This means you, Norm.

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UPDATE - June 16, 2011
A very nice review by Michiko Kakutani appeared in today's New York Times

This is a book that i really wanted to love. It started out extremely well, with some fascinating stories about the trade in human body parts. It covers many different aspects of the "red market", ranging from skeletons to kidneys, eggs, surrogate parenting, blood and even the gigantic business of collecting and selling human hair.

There are many stories that are chilling, and you can feel and understand the author's passion, as he takes you on a tour of some unexplored or purposefully ignored areas of this trade.

On the other hand, the book also suffers from what I would call righteous indignation. Yes, many of the stories are disturbing, some extremely so. And although the author raises some very interesting and valid points about the implications of anonymity in the marketplace, and the exploitation by the middle men, there is a point, somewhere towards the middle of the book, during which it goes beyond to have more blanket criticisms of both the free market economy and medical research.

The book would have been stronger, perhaps, by presenting some potential solutions to some of the issues rather than outright condemnation, and by having more focus on the facts and a bit less editorializing. Likewise, I would have preferred more science and less ethics.