Monir Moniruzzaman doesn't look like James Bond, or even George Smiley, but for 15 months he prowled through the dark and dangerous alleyways of Bangladesh, searching for what he calls "living cadavers." By the time he was finished, the anthropologist-turned-sleuth had found 33 persons who were so desperate for a little cash that they sold one of their kidneys through a broker in the booming international black market for human organs.
In an impoverished country where the typical worker earns less than $2 a day, a few hundred bucks must have sounded like a fortune. But in the end, they didn't even get that. Instead, they were left with deteriorating health, social isolation, more bills than money, and ugly scars up to 22 inches long.
"Most of them didn't even know what an organ is, or its function," Moniruzzaman said in a telephone interview.
Other researchers have documented the international trafficking in human organs, and the wealthy buyers who end up with them, but Moniruzzaman wanted to look at the other side of the story. He wanted to know what happened to the people who sold parts of their body for a few gold coins.
What he found was 33 human stories of deceit, desperation and corruption among some of the world's poorest people.
But this isn't just a story about Bangladesh. Most of those organs ended up transplanted into American citizens.
Moniruzzaman was a young doctoral candidate at the University of Toronto when he began his search for answers a decade ago. He is now an assistant professor of anthropology at Michigan State University in East Lansing, and he has just published his study in Medical Anthropology Quarterly, called "'Living Cadavers' in Bangladesh: Bioviolence in the Human Organ Bazaar."
It took 15 months to find enough victims who were willing to overcome their sense of shame and talk about their plight. The only way to find them, he realized, was through a broker, but getting someone to confess to violating international laws is not exactly a walk in the park, especially in Bangladesh.
He finally located a broker in "a really bad alley," who Moniruzzaman thought might cooperate, but he soon found himself surrounded by eight or 10 people.
"Right away, I felt I was in a bad place. So I told him I'm a researcher, born in Bangladesh, and I just wanted to know what happened to those people who sold their organs," he recalled.
"He said, 'Who told you I do those nasty things,' and I literally backed out right way."
He later found a cooperative broker, but he was hardly an altruist. He wanted Moniruzzaman to publish his photo in the United States, helping him "expand his business." The photo was never published, and the broker received nothing for his help. But by the time he realized he wasn't going to get rich off of an anthropologist, he had introduced Moniruzzaman to 30 men and three women who had sold kidneys to natives of Bangladesh who had taken up citizenship in other countries, in many cases in the United States.
The field research concluded in 2005, but over the years Moniruzzaman has kept in touch with those 33 persons. Most had expected to receive about $1,400 for a kidney, but few received anywhere near that. All but two ended up penniless.
The surgeries were performed in India, after the sellers were provided with false passports and false notarized claims that they were related to the buyers . Moniruzzaman has photos showing huge scars that look like they were made with a machete. For $200 more they could have had laparoscopic surgery that would have left scars less than four inches long.
Their health deteriorated after the surgery, partly because many could not afford an average of $22 for postoperative care.
"They experience numerous physical problems and went through severe psychological suffering," Moniruzzaman writes in his study.
"We are living cadavers," one seller told Moniruzzaman, weeping uncontrollably. "By selling our kidneys, our bodies are lighter but our chests are heavier than ever."
Some found themselves ostracized by their own families.
In the end, 27 of the 33 sellers received only a small fraction of what they had been promised. Most spent all of it on bills, many of them resulting from the surgery and its aftermath. Some spent it on television sets. Only two benefited economically; they invested in farms.
It is likely that none of them realized the danger involved in surgery and giving up one kidney. They were told they didn't need two, and the one they would keep would be better than the one they sold.
Moniruzzaman said he thinks the black market is even stronger today than it was when he did his field research. Some of the hospitals in India where the surgeries were performed have opened clinics in Bangladesh.
And the tragedy is, indeed, international.
More than 100,000 Americans are waiting for an organ, and several thousand more are added every year. Around 7,000 die each year while waiting for a suitable transplant.
And each year the number of donors decreases, according to a study published in the American Journal of Transplantation. It is illegal, as well as unethical, to sell a human organ in the United States. But that doesn't mean it never happens.
Last year an Israeli-American, Levy Yitzhak Rosenbaum, admitted in a federal court in New York that he brokered black-market transplants for a number of wealthy residents of New Jersey. He bragged in a surveillance transcript that he could deliver for a price of $160,000.
His attorneys argued that he was just providing a service for people in need.
So this isn't just a story about Bangladesh.