Nightmarish Nephrectomies: An Overview of Organ Harvesting in North Africa

HRW traced the Organ Harvesting Route in the Middle East
HRW traced the Organ Harvesting Route in the Middle East

While transnational organized crime is inherently filled with malicious vice, few crimes are as heinous as organ harvesting in North Africa. Approximately 2,000 irregular immigrants per month seek to escape oppressive regimes in Eritrea and Sudan – the source states, move with the assistance of smugglers through Eritrea, Sudan, and Egypt – the transit states, and seek to reach a more prosperous life with family in Egypt, or continue to cross the Sinai into Israel.[1] However, some smugglers take advantage of this movement, and turn the irregular immigration into human trafficking or organ harvesting in the Sinai Peninsula – the market region.[2] Thousands of irregular immigrants have perished from organ harvesting and torture from their captors.[3] This crime is transnational in its framework, and has a litany of legal remedies working to end this trade; however, the governments of North Africa are not doing enough to fight this crime and needs to change their strategy in the Sinai to mitigate the illicit sale of organs.

Legal Framework

Organ harvesting explicitly goes against three U.N. multilateral frameworks, a conglomerate declaration, and a law in Egypt. The first U.N. document that challenges organ harvesting is the “Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime,” which Egypt ratified in March 2004.[4] This document mentioned “the removal of organs” when defining “trafficking in persons” and “exploitation.”[5] Egypt, Eritrea, and Sudan signed another U.N. document, the “Optional protocols to the Convention on the Rights of the Child on the involvement of children in armed conflict and on the sale of children, child prostitution and child pornography.”[6] This protocol condemns the, “Transfer of organs of the child for profit.”[7] Egypt and Sudan also signed the “Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment,” in June 1986.[8] This convention defines torture as, “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person.”[9] Furthermore, Article 2 of this convention stresses state-signatory action in that “Each State Party shall take effective legislative, administrative, judicial or other measures to prevent acts of torture in any territory under its jurisdiction.”[10] The U.N. arranged a potent multilateral framework against organ harvesting and torture.

Additionally, the international private and public sectors spoke out against organ trafficking and transplant tourism with the Declaration of Istanbul. This summit had over “150 representatives of scientific and medical bodies from around the world, government officials, social scientists, and ethicists, was held in Istanbul from April 30 to May 2, 2008.”[11] The agenda, developed by the World Health Organization, the International Society of Nephrology, and Transplantation Society, recommended best practices on organ transplanting, lobbying governments against organ harvesting, and providing substantive definitions.[12] This declaration provided definitions of organ trafficking, transplant commercialism, and transplant tourism.[13] The Declaration of Istanbul also noted best practices for principles of organ transplanting, legal frameworks for combating organ trafficking, and care of living donors.[14] This summit was important for North Africa as government representatives included Omar Abboud from Sudan, Mohamed Abel Bakr from Egypt – who was also on the Steering Committee for the Declaration of Istanbul, and Ahmed Adel Hassan from Egypt.[15] Thus, the Declaration of Istanbul served as a nexus for the public and private sectors, and provided further guidance on combating organ harvesting.

The Egyptian government has unilaterally attempted to legislate on organ harvesting in February 2010 with the Law on Human Organ Transplantation in Egypt. This law “condemn[s] organ trafficking,” through law enforcement surveillance and interdiction of organ harvesting criminal networks.[16] Furthermore, this law legalized organ transplantation from deceased donors, which Egyptians had previously viewed as a social taboo.[17] While this law provides a legal basis in combating the Egyptian organ trade, it has struggled against competing priorities in the wake of Arab Spring, the lack of a process for the harvesting of deceased peoples’ organs, and the lack of a regional multilateral framework.[18] Furthermore, Sudan and Eritrea do not have explicit domestic legal provisions against organ harvesting. Legal measures provide a framework on prohibiting the organ harvesting trade.

The Crime of Organ Harvesting

There are several parties of perpetrators involved in the crime of organ harvesting because of the transnational movement of the irregular immigrants. The initial party for the irregular immigrants are the contacts for the smugglers. These contacts are often urban Eritreans who have connections with the military and the People’s Front for Democracy and Justice political party, or brokers within Sudanese refugee camps.[19] The refugees seek to leave the camps in Sudan, such as Shagarab, as quickly as possible, because they are precariously close to the Eritrean border and are known to be violent.[20] The contacts will then arrange for smugglers, most notably the Rashaida “nomad camel pastoralists” for the journey from Eritrea and Sudan through Egypt to Israel.[21] These herdsmen are economically marginalized, and are known to traffic in people, weapons, capital, and goods.[22] The Rashaida bribe border guards to facilitate the movement of the illicit goods and irregular immigrants.[23] Some of the Rashaida further extort the Sudanese and Eritrea refugees by demanding additional funding or the nomads would sell them to Bedouins.[24] If the refugees fail to pay the increased price, then sometimes the Rashaida hand the immigrants over to “rogue” members of the influential Sawarka Bedouin tribe in the Sinai.[25] The movement from Sudan and Eritrea brings culpability on the brokers for the smugglers, the Rashaida smugglers, and the Bedouin holders.

The Bedouins then facilitate the organ harvesting with Egyptian doctors as a last resort to make money off of the Sudanese and Eritrean refugees. The Bedouin captors use sadistic means to force the compliance of their prisoners, including, but not limited to:

[The] rape of women, including having plastic piping inserted into their anuses and vaginas; burning of women’s genitalia and breasts; stripping women naked and whipping their buttocks; rape of men with plastic piping; beating with a metal rod or sticks; whipping with rubber whips or plastic cables; dripping molten plastic or rubber onto skin; burning with cigarettes or cigarette lighters; hanging from ceilings to the point of deforming arms; giving electric shocks; beating the soles of feet; forced standing for long periods, sometimes days; threatening to kill them, remove their organs, or cut off fingers; burning with a hot iron rod or boiling water; sleep deprivation; and putting water on wounds and beating the wounds.[26]

While this torture is occurring, the Bedouins will have the victims call their family members, especially the wealthier ones among the diaspora, to fund their release.[27] The captors will ransom their prisoners from $20,000 to $60,000, and if the price is not met, the Bedouins sometimes will cut their losses and harvest the victims’ organs.[28] Doctors from Cairo contact the captors, and will buy organs, such as corneas, livers, and kidneys, from $1,000 to $20,000 dollars.[29] Hamdy Al-Azazy, leader of the New Generation Foundation, an Egyptian anti-organ trafficking NGO, noted the modus operandi of the doctors in mobile clinics as “They [the harvesting doctors] drug them [the immigrants] first and remove their organs, then leave them to die and dump them in a deep dry well along with hundreds of bodies.”[30] This vile trade has led some of the Bedouin traffickers to make profits up to $200,000 annually.[31] The organs are often then sold and surgically implanted into wealthy patrons from the Gulf States.[32] The harvesting of organs brings together networks of doctors from Cairo and Bedouins from the Sinai.

This crime negatively impacts the welfare of the victims – if they survive a single nephrectomy and torture – as well as the internal security of North African states. Victims often suffer “a deterioration of their health in addition to negative social, economic, and psychological consequences as a result of the experience.”[33] This deterioration becomes apparent as victims contend with reduced health, hunger, pain, continued unemployment, stigmatization, family disruption, and depression.[34] Furthermore this trade spurs other transnational crime, including money laundering using the hawala system, arms smuggling, marijuana smuggling, corruption of law enforcement, and forced labor of irregular immigrants by the trafficking Bedouins.[35] Thus, organ harvesting in North Africa, involves the moment of irregular immigrants from Sudan and Eritrea through Egypt in an attempt to arrive at Israel. Sometimes, this irregular immigration turns into human trafficking, and the various criminal parties extort money and organs from their victims. This trade weakens any survivors and destabilizes the rule of law in Egypt.

Fighting the Crime

The instability of the North African region is limiting the response of the state in combating the transnational crime of organ harvesting. Surprisingly, tribal leaders in the Sinai are leading the charge against organ harvesters in lieu of the state. Additionally, NGOs and IGOs are gathering and disseminating information on the vile trade. In a similar manner, U.S. and the European Union are extending moral support through publications. Israel, however, has sought to seal its border to limit the trade, which has worsened the plight of refugees. The current measures to fighting the crime are not effective as they could be because of the hesitance of the state to stamp out the trade while facing other contending priorities.

The states of Egypt, Sudan, and Eritrea are rife with conflict and competing priorities to combating the illicit organ trade. Arab Spring in Egypt led to the removal of President Hosni Mubarak and Present Mohammed Morsi.[36] Furthermore, Egypt and Israel have a history of sparring over control of the Sinai, leading to mutual distrust.[37] Additionally, the Egyptian government has treated the Bedouin minority “disproportionately harshly,” as limited infrastructure and opportunity has lead the herdsmen to turn to crime for profit.[38] The Coalition for Organ-Failure Solutions, an activist NGO, noted, “the period of instability in Egypt and through the region will allow all forms of human trafficking of all forms to flourish.”[39] Eritrea, in its border skirmishes with Ethiopia, is using armed non-state actors to destabilize the region.[40] Furthermore, Eritrean President Isaias Afworki is turning Eritrea into a police state by utilizing conscription with indefinite service terms and stringent border controls.[41] Furthermore, Eritrea has only one political party, the People’s Front for Democracy and Justice, which suppresses the dissent of the Eritrean population.[42] Sudan is struggling with two civil wars; the first against the residents of South Sudan and the second against the residents of Darfur.[43] These conflicts are further compounded with the genocidal policies of Arabization, leading to segments of the population to flee to the prospects of work and safety in Israel.[44] The states of North Africa have competing priorities that take precedence over the organ trade.

Expectedly, the North African states’ response to organ harvesting has been poor and negligent. Corrupt law enforcement officers continue to collaborate with the smugglers.[45] The judicial systems in Egypt and Sudan have rendered few prosecutions. Egypt has not yet tried any law enforcement officers for collaborating with the smugglers, and only one trafficker has been prosecuted.[46] Sudan has prosecuted four corrupt police officers and 14 smugglers.[47] Law enforcement in the Sinai continues to be a problem, as the few official that acknowledge the organ trade is occurring lack the information on the perpetrators for large scale action.[48] Human Rights Watch framed this inaction well: “Senior officials in Sinai and Cairo either deny the abuses happen, or say Egypt’s public prosecutor is powerless to investigate such crimes without receiving names and locations of the traffickers.”[49] Reports of organ harvesting slowed following Egyptian military intervention against jihadists in the Sinai in October 2013.[50] The response of law enforcement and courts have been poor; the military option yielded some gains in the fight against organ harvesting.

The most effective apparatus against the organ harvesters have been Bedouin tribal leaders. Sawarka Bedouin Sheikh Mohammad Abu Bilal has worked with other local community leaders in setting up sanctions against the traffickers, such as denying them the right to purchase goods at Bedouin stores and marriage rights, as they have publically deemed the organ harvesting trade to be un-Islamic.[51] In addition to this effort Shiekh Abu Bilal has opened recovery homes to facilitate the well-being of irregular immigrant escapees.[52] Another Bedouin Sheikh, Ibrahim al Manai, has publically deemed the trade to be against Bedouin values, and has contributed 200 men to fight the organ trade.[53] These grassroots sheikhs have mobilized the local populace against the organ harvests.

NGOs and IGOs have been instrumental in fact-finding on this malignant trade, giving policy makers concrete information. The Coalition for Organ-Failure Solutions (COFS) has provided surveys for victims of organ harvesting, given medical services to commercial living donors, organized support groups, facilitated legal advice, and collaborated with other NGOs to arrange jobs for the victims.[54] CNN released two news documentaries on organ trafficking in the Sinai, “Death in the Desert” and “Stand in the Sinai.”[55] Following the filing of “Death in the Desert,” Egyptian intelligence pressured the Bedouin smuggles to end the trade; for a brief time the price of ransom shrank and more irregular immigrants were released.[56] Egyptian NGOs such as the Egyptian Initiative for Personal Rights (EIPR) and the New Generation Foundation have gathered evidence on the atrocities of organ harvesting and have prescribed legal recommendations to the Egyptian government. Physicians for Human Rights, an Israeli NGO, and the U.N. High Commissioner for Refugees (UNHCR) have conducted systematic interviews of African refugees in Israel to gather information on their journey.[57] Yet the Egyptian government blunted the efforts of the UNHCR by denying the group access to the Sinai.[58] Additionally, when Egyptian law enforcement officers arrested North African irregular immigrants in the Sinai, they were “without access to the Office of the United Nations High Commissioner for Refugees, thereby denying them the right to make an asylum claim.”[59] The most current NGO report is Human Rights Watch’s “I Wanted to Lie Down and Die,” which contains a map of the irregular immigration routs (featured on the cover), testimony from irregular immigrants, photos of the mutilations Bedouin captors did to the irregular immigrants (some featured in the annex), the compilation of work by NGOs and IGOs, and striking statistics on the movement of people in the North African region.[60] NGOs and IGOs have gathered the information on organ harvesting, and have presented this information along with prescriptions to the general public and to the governments of North Africa.

The U.S. and the EU have served as a moral force behind ending the organ trade in the region. The European Parliament has stressed the values espoused in the 1948 Universal Declaration of Human Rights, the Charter of Fundamental Rights, and the Conference of the Euro-Mediterranean Human Rights Network to the North African states.[61] The European Parliament condemned the human trafficking in the Sinai, where people were held hostage, tortured, raped, had their organs harvested, and coerced into forced labor.[62] Furthermore, the EU called for a greater pro-active stance by Egyptian law enforcement to end the human trafficking and protect the vulnerable refuges.[63] Within the member states, German MP Annette Growth has called for putting organ harvesting in the Sinai on the German Parliament’s agenda.[64] Across the Atlantic, the U.S. Department of State listed Egypt as a Tier 2 country, while marking Eritrea and Sudan as Tier 3 countries in its annual “Trafficking in Persons” report.[65] This second tier ranking means that Egypt has strived to working towards compliance with the Trafficking Victims Protection Act (TVPA).[66] The third tier ranking of Eritrea and Sudan means they have not complied with the TVPA, and face American sanctions on non-humanitarian aid.[67] The EU and the U.S. have sought to mitigate organ harvesting through publications and the threat of American sanctions against non-compliant countries.

Israel has responded defensively to the irregular immigration. The irregular immigrants from North Africa tend to go to Israel because there are job prospects.[68] However, Israel has recently become more xenophobic, passing an amendment to the 1954 Prevention of Infiltration Law in January 2012, labeling irregular immigrants as “infiltrators.”[69] This designation makes no distinction between asylum seekers, refugees, or smugglers, and any “infiltrator” can be detained up to 3 years before being deported from Israel.[70] The Israeli government, seeking to emulate the U.S. government’s policies on its Mexican border, have erected a fence along the Israeli-Sinai border and established a new jail in the Negev, which can hold up to 10,000 prisoners.[71] Furthermore, Egyptian border guards have “a shoot-to-kill policy in place” to defend their territory from smuggler, escalating strained tensions.[72] These escalated measures have led smugglers along with their human cargo to attempt going west through Libya and via a precarious boat journey into the Europe.[73] Israel has turned to defensive policies to stem the tide of North African irregular immigration.

What Now Can Be Done to Mitigate Organ Harvesting?

The current efforts to mitigate organ smuggling are ineffective at the state level and only mildly effective at the grassroots and NGO/IGO level. The efficiency of the efforts have become stagnated due to other pressing security concerns and the turmoil of regime change. The appropriateness of the response seems to be poor. NGOs have offered strong prescriptions to further mitigate the trade; perhaps combined with structural reforms and a counterinsurgency campaign, these prescriptions could further mitigate the organ harvesting trade.

As mentioned previously, the state level has struggled to make an impact on this transnational organized crime. Few prosecutions, corrupt border officials, and the sidelining of the 2010 Law on Human Organ Transplantation in Egypt, have stalled judicial and law enforcement efforts in the Sinai. Furthermore, denials of the trade by senior law enforcement officials delegitimize any effort against the vile exchange. Yet the Egyptian military has proven to be effective as an institution and as a fighting force in the Sinai. When the army manifested to fight jihadists in the Sinai in late 2013, the reports of organ harvesting dropped. Thus, the problems from a law enforcement or judicial perspective seem not to be in control; however, the deployment of the army seems to be a viable option to restore control.

The grassroots level has sought to use identity unity, sanctions, and pursuit of the harvesters to mitigate the trade, mitigating the trade. Sheikh Mohammad Abu Bilal and Sheikh Ibrahim al Manai have made a difference in rallying the local population against the trade and in rehabilitating the survivors of torture in the Sinai. While these actions serve as a short term solution to mitigating the trade, only long term solutions with the government in Cairo can truly cripple the trade. While these two sheikhs have spoken against the trade, other Bedouins still try to cover up the grave business. Perhaps an exchange program of information on the traffickers for aid and development could be reached between the government of Egypt and the Bedouins. While the steps of the sheikhs are a good first step, long term solutions for socio-economic distress and for counterinsurgency intelligence between the Bedouins and the Egyptian government still need to be discussed and executed.

NGOs and IGOs have done a fair job on reporting the information on the organ harvesting trade. Some of the numbers regarding this heinous business have fluctuated because of its clandestine nature. Furthermore, the Sinai has become a denied area for some NGOs and IGOs, such as the UNHCR. Additionally, the NGOs and IGOs have failed to push the issue of organ harvesting on the legislative agenda of states, despite successes on the international level through the U.N. and summits. NGOs and IGOs have performed as well as they can, barring the restrains placed on them by Egypt.

Resources could be more efficiently and more appropriately by enacting the legislative reforms on organ transplantation, aiding the Bedouin grass root movements against the traffickers, and the employment of the military option to establish security, rather than striving for a solution using corrupt or ignorant law enforcement officials and a hesitant judiciary. The Law on Human Organ Transplantation in Egypt is inefficient because it lacks a regional framework and it lacks a process for the harvesting of organs of the deceased. This inefficiency could be corrected by having the Egyptian parliament call for a conference between the North African states or through the Arab League on this issue and setting a legal framework base line on this issue. Furthermore, Egypt could establish a donation framework like the American organ donation program with driver’s licenses, allowing for a continuous stream of organs to be used for the needy. This donation framework would increase the supply of organs for transplant, and lessen the need to use coercively gained or illicitly obtained organs through transnational organized crime. Furthermore, the Egyptian government could go further in working with the Bedouin tribes in combating organ harvesting by creating a deeper dialogue. This dialogue could take place by increasing the buy in of the Bedouins in the Egyptian state through aid and development projects or creating a Council of Regions within the Egyptian parliament. These democratic inspired solutions could yield improved efficiency and appropriateness. Another program that could yield great success would be a chieu hoi like program, where smugglers that surrendered could start to work for the Egyptian government by providing intelligence in exchange for monetary inducements. While this option would be effective, it would essential be spying and bribery to ending the organ smuggling trade. If this dialogue facilitated usable intelligence against the traffickers and if the Bedouins did not compel the traffickers to change their ways, the Egyptian military could launch a counterinsurgency campaign against the criminal networks, perhaps with the tactic approval of Israel. Much can be done to further expand on the appropriateness and efficiency of the current efforts on fighting organ harvesting in North Africa.

NGOs have prescribed several actions that would work in concert with legal reform and a counterinsurgency campaign. COFS used an economic model of organ harvesting arguing that, “With transplants as the preferred therapy for renal failure, demand for kidneys will continue to outpace supplies. Until nations can build transparent, reliable systems of organ donation through altruistic donations from healthy individuals and deceased donors, poor and vulnerable individuals are at risk for being targeted to supply organs to privileged patients.”[74] Thus, COFS suggested strengthening the Law on Human Organ Transplantation in Egypt and the development of laws against organ harvesting elsewhere. EIPR reiterated stricter legislation against organ harvesting and stressed Egyptians adopt “a culture of donation” of organs.[75] Human Rights Watch provided a comprehensive list of prescriptions to mitigate organ harvesting and torture in North Africa. Like the other NGOs, they stressed increasing the power and enacting the provisions of the legal framework against this transnational crime.[76] The NGO also stressed changing the approach to irregular immigrants from criminal based investigations to victim care approaches.[77] Human Rights Watch also advised the Egyptian and Sudanese bureaucracy to investigate claims of corruption and torture by law enforcement officials.[78] A key institution for this expanded fight against the harvesters would be Egypt’s National Coordinating Committee on Combating and Preventing Human Trafficking through increased clout and situational updates from the Sinai.[79] Thus, NGOs have recommended the enforcement of the 2010 Egyptian law through reformed police agencies.

Ultimately, the nightmarish nephrectomies in the Sinai will persist. Immigrants fleeing repressive regimes in Sudan and Eritrea will continue to be preyed upon by smugglers in Egypt on their journey to Israel. Yet, current actions emplace by Bedouins, NGOs, and IGOs have mitigated this trade. For the suppression of organ harvesting, the states of North Africa need to work together as a region and collaborate with local and non-governmental resources to end the socioeconomic roots of this vile trade. This end state could be accomplished through aid and development in the Sinai in combination with a counterinsurgency campaign along with following the prescriptions of NGOs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Warning: Images Are Graphic – Viewer Discretion Is Advised

Annex A:

Eritrean Victim of Torture in the Sinai, Photographed by Tome Dale of HRW

 

Annex B:

Body Recovered in the Sinai with Organs Missing, Recorded in CNN’s “Death in the Desert.”

 

 

 

 

 

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[1] European Parliament, “Human trafficking in Sinai, in particular the case of Solomon W.” P7_TA(2012)0092. March 15, 2012. Accessed January 20, 2014; Rachel Humphris, “Refugees and the Rashaida: Human Smuggling and Trafficking from Eritrea to Sudan and Egypt,” Research Paper No. 254. March 2013. UNHCR, 4.

[2] Debra Budiani-Saberi, “Human Trafficking for Organ Removal: Evidence from Egypt,” Rights Work. March 5, 2012. Accessed January 20, 2014.

[3] Ibid.

[4] United Nations, “Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime.” November 15, 2000. Accessed March 31, 2014.

[5] United Nations Office on Drugs and Crime, “Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime.” New York, 2004. Accessed April 24, 2014.

[6] United Nations, “Optional protocols to the Convention on the Rights of the Child on the involvement of children in armed conflict and on the sale of children, child prostitution and child pornography.” March 16, 2001. Accessed March 31, 2014.

[7] United Nations, “Optional protocols to the Convention on the Rights of the Child on the involvement of children in armed conflict and on the sale of children, child prostitution and child pornography.” March 16, 2001. Accessed April 24, 2014.

[8] United Nations, “Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.” December 10, 1984. Accessed April 24, 2014.

[9] United Nations Human Rights, “Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.” December 10, 1984. Accessed April 24, 2014.

[10] Ibid.

[11] International Summit on Transplant Tourism and Organ Trafficking, “The Declaration of Istanbul on Organ Trafficking and Transplant Tourism.” May 2, 2008. Accessed March 31, 2014, Preamble.

[12] Debra Budiani-Saberi and Amr Mostada, “Care for commercial living donors: the experience of an NGO’s outreach in Egypt,” Transplant International. February 28, 2011.

[13] International Summit on Transplant Tourism and Organ Trafficking, “The Declaration of Istanbul on Organ Trafficking and Transplant Tourism,” Definitions.

[14] Ibid., Principles and Proposals.

[15] Ibid., Participants of Istanbul Summit.

[16] Coalition for Organ Failure Solutions, “Sudanese Victims of Organ Trafficking in Egypt.” December 2011.

[17] Ibid.

[18] Coalition for Organ Failure Solutions, “Sudanese Victims of Organ Trafficking in Egypt.” December 2011.

[19] Rachel Humphris, “Refugees and the Rashaida,” 11-13.

[20] Ibid., 8

[21] Ibid., 9.

[22] Ibid.

[23] Yohannes Woldemariam, “Egypt: Human Trafficking in Sinai,” Think Africa Press. April 17, 2013. Accessed January 20, 2014.

[24] Rachel Humphris, “Refugees and the Rashaida,” 11-15.

[25] Fred Pleitgen and Mohamed Fadel Fahmy, “Refugees Face Organ Theft in the Sinai,” CNN Freedom Project. November 3, 2011. Accessed January 20, 2014.

[26] Human Rights Watch, “I Wanted to Lie Down and Die.” February 11, 2014. Accessed April 24, 2014, 28-29.

[27] CNN, “Death in the Desert,” The CNN Freedom Project. November 8, 2011. Accessed January 20, 2014.

[28] Jill Reilly, “Child torturers of the desert: Horrific footage reveals human traffickers are even targeting BABIES to get families to pay ransoms,” Daily Mail. September 20, 2012. Accessed January 20, 2014.

[29] Fred Pleitgen and Mohamed Fadel Fahmy, “Refugees Face Organ Theft in the Sinai.”

[30] Fred Pleitgen and Mohamed Fadel Fahmy, “Refugees Face Organ Theft in the Sinai.”

[31] Harriet Sherwood, “Hundreds of Eritreans Enslaved in Torture Camps in Sudan and Egypt,” The Guardian. February 11, 2014. Accessed April 24, 2014.

[32] Coalition for Organ Failure Solutions, “Sudanese Victims of Organ Trafficking in Egypt.”

[33] Debra Budiani-Saberi, “Human Trafficking for Organ Removal: Evidence from Egypt.”

[34] Coalition for Organ Failure Solutions, “Sudanese Victims of Organ Trafficking in Egypt.”

[35] CNN, “Death in the Desert.”; Human Rights Watch, “I Wanted to Lie Down and Die,” 25, 31.

[36] CIA World Factbook, “Egypt,” CIA. Accessed March 31, 2014.

[37] Ibid.

[38] Yohannes Woldemariam, “Egypt: Human Trafficking in Sinai.”

[39] Coalition for Organ Failure Solutions, “Sudanese Victims of Organ Trafficking in Egypt.”

[40] CIA World Factbook, “Eritrea,” CIA. Accessed January 20, 2014.

[41] Ibid.

[42] Ibid.

[43] CIA World Factbook, “Sudan,” CIA. Accessed March 31, 2014.

[44] Ibid.

[45] Harriet Sherwood, “Hundreds of Eritreans Enslaved in Torture Camps in Sudan and Egypt.”

[46] Ibid.

[47] Ibid.

[48] CNN, “Death in the Desert.”

[49] Human Rights Watch, “I Wanted to Lie Down and Die,” 10.

[50] Ibid.

[51] CNN, “Stand in the Sinai,” The CNN Freedom Project. September 26, 2012. Accessed January 20, 2014; Jill Reilly, “Child torturers of the desert: Horrific footage reveals human traffickers are even targeting BABIES to get families to pay ransoms.”

[52] Ibid.

[53] CNN, “Stand in the Sinai.”

[54] Debra Budiani-Saberi and Amr Mostada, “Care for commercial living donors: the experience of an NGO’s outreach in Egypt.”

[55] CNN, “Death in the Desert.”; CNN, “Stand in the Sinai.”

[56] CNN, “Stand in the Sinai.”

[57] Human Rights Watch, “I Wanted to Lie Down and Die,” 33-34.

[58] Ibid., 34.

[59] Human Rights Watch, World Report 2012: Egypt.” 2012. Accessed January 2014.

[60] Human Rights Watch, “I Wanted to Lie Down and Die,” Summary.

[61] European Parliament. “Human trafficking in Sinai, in particular the case of Solomon W.”

[62] Ibid.

[63] European Parliament. “Human trafficking in Sinai, in particular the case of Solomon W.”

[64] CNN, “Stand in the Sinai.”

[65] United States Department of State, “Trafficking in Persons Report.” June 2013. Accessed March 31, 2014, 56.

[66] Ibid., 44, 55.

[67] Ibid., 46-47, 55.

[68] Rachel Humphris, “Refugees and the Rashaida,” 4.

[69] Ibid.

[70] Ibid.

[71] Ibid., 4-5.

[72] Yohannes Woldemariam, “Egypt: Human Trafficking in Sinai.”

[73] Human Rights Watch, “I Wanted to Lie Down and Die,” 12.

[74] Debra Budiani-Saberi, “Human Trafficking for Organ Removal: Evidence from Egypt.”

[75] Egyptian Initiative for Personal Rights, “Organ Transplant Legislation: From Trade to Donation.” March 31, 2014. Accessed April 24, 2014.

[76] Human Rights Watch, “I Wanted to Lie Down and Die,” 14.

[77] Ibid.

[78] Ibid.

[79] Ibid., 17.

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