“Black transplantologists” operate in Ukraine. Black transplantologists - The most interesting things in blogs How long do people wait for a suitable organ?
Cyprus police detained Israeli citizen Moshe Harel, who is suspected of involvement in illegal surgical operations and trafficking in human internal organs. The victims of “black transplantologists” were residents of Eastern Europe, including Russians.
The detainee Moshe Harel has been on the international wanted list for the last eight years. Now he faces extradition to the Republic of Kosovo. The authorities of this state have already sent a corresponding request to Cyprus, writes The Washington Post.
It was possible to get on the trail of an international gang of “black transplantologists” by accident 10 years ago. In November 2008, a Turkish man named Yilmaz Altun collapsed on the floor at Pristina airport. The 23-year-old man collapsed while waiting for a flight home. While checking the condition of the air passenger, representatives of the Kosovo authorities discovered a large, fresh wound on his stomach. It turned out that the Turkish citizen had his left kidney cut out, InoPressa reports.
Altun told the police that he became a kidney donor at the Medicus clinic, located on the outskirts of Pristina. An intermediary in Istanbul promised the man a large sum of money for the operation.
During further investigation, it was possible to identify other victims who were persuaded to sell their internal organs on the international black market. Most donors were citizens of Turkey and states that emerged in the post-Soviet space. The victims agreed to sell their organs because they suffered from poverty and needed money.
Buyers included, in particular, citizens of Israel, Canada, Germany and Poland. They were willing to pay up to 100 thousand euros for kidneys. However, most of this money was received by intermediaries and “black transplantologists”. Donors were typically paid no more than $10,000 per kidney removed. In addition, at least two victims did not receive any money at all.
In 2013, Jonathan Reitel, the prosecutor investigating the EU law enforcement mission in Kosovo, called the criminals' actions "exploitation of the poor and needy" who were being used as expendable material.
The Washington Post notes that Moshe Harel, who was caught in Cyprus, was an intermediary who was looking for potential donors. Harel was first arrested back in 2008. Then he was released, and the suspect fled from the investigation.
Since 2010, Harel had been wanted by Interpol on charges of human trafficking and intentionally causing grievous bodily harm. Moreover, one of the requests for the search for Harel came from Russia.
According to press reports, the Medicus clinic was run by the famous Kosovar urologist Lutfi Dervishi and his son Arban. The operations in the clinics were allegedly carried out by Turkish surgeon Yusuf Ersin Sonmez, who received the nickname Doctor Vulture in his homeland.
In 2013, father and son Dervishes were found guilty of the crimes. They were sentenced to eight and seven years in prison. However, the convicts escaped. In 2016, Lutfi was arrested, but his son is still wanted. Doctor Vulture is also missing.
The chief anesthesiologist at the Medicus clinic, where at least 23 illegal organ harvesting operations were carried out over eight months, was sentenced to three years in prison. Two more employees received one year suspended sentences each.
Medicus was part of a whole network of clinics where “black transplantologists” worked. Other hospitals where people's organs were illegally removed are located, in particular, in Azerbaijan and South Africa, investigators believe.
The case of the Kosovo transplant surgeons turned out to be closely connected with another high-profile scandal that erupted in 2008 after the release of the book “The Hunt: Me and the War Criminals” by former Hague Tribunal prosecutor Carla del Ponte. The book told the story of the abduction in 1999 of about 300 Kosovo Serbs, Roma and citizens of other countries: all of them were forcibly taken to Albania, where their kidneys and other organs were removed.
Carla del Ponte reported that the crimes were committed with the knowledge and active participation of senior and mid-level Kosovo Liberation Army (KLA) officers. As is known, one of the KLA commanders was Hashim Thaci, who became an influential politician. From 2008 to 2014, he served as Prime Minister of Kosovo, and is currently the President of the Republic.
We also add that in the fall of 2016, a citizen of Russia and Israel, Boris Volfman, was arrested in the Albanian capital Tirana. He was wanted for trafficking in donor organs to the authorities of Costa Rica, Turkey, Ukraine, Kosovo and other countries. According to investigators, Wolfman has been involved in criminal business since 2008.
According to Kommersant, a decision by the European Court of Human Rights in the case of Alina Sablina, whose relatives complained that they were not notified of the posthumous removal of organs, is expected in the near future. In June, the Moscow City Court will consider a complaint in a similar case. Alexey Pinchuk, head of the scientific department of kidney and pancreas transplantation at the Sklifosovsky Research Institute of Emergency Medicine, told Kommersant correspondent Valeria Mishina how in Russia one can express consent or disagreement to posthumous donation, how the system of distribution of donor organs works and how long patients have to wait for an organ for transplantation .
Russian officials talk about a growing number of organ transplants. At the same time, the courts are receiving lawsuits from relatives of those killed in road accidents and who became posthumous donors: families complain about the removal of organs without notification. What is happening in Russian transplantology?
Unfortunately, we have not observed any fundamentally significant changes in our industry over the past ten years. There are some successes. For example, we began to more actively introduce those types of transplantations that were practically not performed in the country before: heart and liver transplants (in some centers they even became routine), lung transplants, pancreas transplants... 10–15 years ago these were rare , isolated cases. Now such operations, one might say, have been put on stream, but, unfortunately, not throughout the country, but only in the leading, largest transplant clinics.
- What kind of clinics are these? And what happened ten years ago that these operations became routine?
Nothing big has happened, we’ve probably already reached the point where we understand that without conforming to global trends, without keeping pace with global medicine, we find ourselves on the periphery. Therefore, we began to more actively master these methods and try to introduce them into everyday clinical practice. There are not many clinics in our country that work with all types of organ transplants; we can single out about five leading ones in this regard, no more. These are primarily the Shumakov National Transplant Center and the Sklifosovsky Institute, which is the largest urban transplant clinic in the capital. All the others are still inferior in scale - the regional hospital named after Ochapovsky in Krasnodar, MONIKI named after Vladimirsky in the Moscow region, regional transplantation centers in Rostov, Novosibirsk... But, unfortunately, in the country as a whole, the pace of development of the industry leaves much to be desired. Leading clinics are still primarily concentrated in Moscow.
If we look at the map of transplantations for the country as a whole, we will see that about half of all transplants are performed in just two institutes - Shumakov and Sklifosovsky.
There are more heart transplants at the Shumakov Institute, and until recently we performed more kidney transplants. In Sklif, more liver transplants are performed from cadaveric donors, and from relatives - in the Shumakov center. We annually perform almost 200 kidney transplants and 100 liver transplants, about 10 heart and lung transplants. In other clinics, transplants are performed an order of magnitude less. But these round figures do not entirely correctly reflect the current state of affairs, because from year to year the number of organ donors nationwide remains at a very low level.
- How many people need organ transplants in Russia?
So many. We perform 200 kidney transplants a year - this is a decent figure for one clinic. Nevertheless, we always have about 500 people on the waiting list, and these are only Muscovites - residents of a region where, compared to others, this situation is not so acute.
On a national scale, the picture is sadder. We, as a Moscow healthcare structure, unfortunately, cannot provide assistance to regional patients. This is done in federal clinics - the Shumakov Center, the Russian Scientific Center for Surgery, and the Research Institute of Urology. All these institutions are also located in the capital. Therefore, those who were able to get to Moscow have some chance.
- How to get to Moscow for a transfer?
So far, through a system of federal quotas for the provision of high-tech medical care. They are distributed by the Ministry of Health. This year the quota system remains in place. But if financing is carried out through the compulsory health insurance fund, then I don’t think that the situation can change dramatically. In the end, it doesn’t matter where exactly we get funding from, in any case, the available donor organs do not go to waste. All suitable ones that can save a life will be transplanted. In any region. Here the question is not about funding, but about the available quantity - we are able to perform not 200, but also 400 and 600 kidney transplants per year. This quantity corresponds to our level, both surgical and medical in general, but we do not yet have such a number of organs.
- Approximately how long do people wait for a suitable organ?
On average, in our clinic, if we talk about a kidney, then one and a half to two years. There are a number of patients who have to wait longer because they have certain medical difficulties with the selection of an organ.
“It is not an organ that is “searched for”, but the most suitable recipient from the waiting list that is selected for the organ.”
- How is an organ found for a patient?
It is very important to note: it is not an organ that is “searched for,” but an already existing, removed donor organ, with a certain set of medical characteristics, that the most suitable recipient is selected from the entire list of those in need - from the so-called waiting list. The selection of a recipient, in addition to many medical indicators, is also made taking into account the waiting time. When in the intensive care unit, unfortunately, it is not possible to save a patient with a stroke or severe head injury, and if neither he himself nor his relatives actively spoke out against the possible removal of organs, after death is declared, they can be used for transplantation. Organ donor service specialists remove organs and preserve them for a short time. For an existing organ, recipients are selected from a waiting list for whom this organ is best suited. And from this shortened list - the one who waits the longest for surgery.
- What should match, besides, for example, blood type?
There are about 20 factors that must be taken into account in order for a patient's donor kidney to work, work well, and last a long time. The most important are blood type, age, initial state of the organ, immunological compatibility.
Also, if the donor has suffered from hypertension for a long time, it is very important that the recipient’s own blood pressure is not low. The kidney will work efficiently in the conditions to which it is “accustomed” and in which it worked during the last years of the donor’s life.
And, believe me, there are many such nuances in transplantation.
- How long will the organ work if all the parameters match?
Ideally, we strive for the patient to live happily to a ripe old age and die due to age with a normally functioning graft. Unfortunately, life makes its own adjustments, but there are survival rates that can be called record-breaking. The maximum time a transplanted kidney has worked is 42 years. Heart transplant - 36 years old. There is no doubt that with the correct selection of organ and recipient, impeccable surgery and competent management of the patient after transplantation, the donor organ can work for several decades.
Organ transplant patients need to take immunosuppressants to prevent the organ from being rejected. How do they affect health?
The arsenal of immunosuppressive drugs is constantly expanding. In fact, the problem of rejection - something that our predecessors and teachers constantly faced - is not as relevant now as it used to be. That is, in principle, deceiving the body and making it “believe” that the donor organ is its own is possible in most cases. On the other hand, we must admit that even the most modern immunosuppressive drugs have a number of side effects that still do not add to the health of the recipient. But these undesirable phenomena have been well studied, we know how to prevent them, how to prevent their development and how to deal with them if they have already appeared.
For example, we often have to deal with the development of diabetes mellitus. Or, against the background of immunosuppression, blood pressure may increase. The risk of developing infectious diseases increases, not only ordinary ones such as pneumonia and influenza, but also specific ones associated specifically with suppressed immunity. For example, cytomegalovirus and herpes. They are not dangerous for the average person. But in conditions of immunosuppression they can pose a threat to the health and even life of the patient.
- Some patients cannot have an organ transplant. What is the reason and what kind of patients are these?
There are fewer and fewer such patients every year. We now have a very liberal attitude, for example, to the age factor. Until relatively recently, patients over 60 years of age were practically not considered as candidates for transplantation. Today we successfully operate on patients much older than 70 years. If a patient can endure anesthesia and major surgery, if he can potentially live at least five years after transplantation, we try to help him. The same applies to patients with autoimmune pathology - when the body itself “devours” its organs. Previously, such patients were almost never operated on - after all, just as the immune system damaged its own kidneys, it also dealt with the transplanted one in the shortest possible time. And now we have the ability to successfully prevent such situations. For example, a patient with diabetes mellitus undergoes a kidney and pancreas transplant at the same time. Kidney failure is eliminated, and diabetes is virtually cured and does not further damage the transplanted kidney.
- Where in Russia are organs available for transplantation taken into account?
Separately in each organ donation center. So far, there is no full-fledged register, as well as a so-called organ bank. After all, donor organs acceptable for transplantation have a very short “life span.” It is impossible, for example, to freeze an organ and then take the one you need off the shelf, defrost it and transplant it.
A kidney transplant, for example, remains suitable for transplantation for a maximum of 24 hours. Subject to special preservation, of course. For other organs, this period is much shorter: heart up to 9–10 hours, liver up to 16 hours, pancreas up to 15 hours, lungs up to 7–9 hours.
Therefore, the selection of a recipient, his call and preparation are carried out in parallel with the work of the donor service. Both donor and transplant teams work around the clock, on holidays and weekends. This is a widespread, worldwide practice.
The entire process is organized by the coordinating donor center. Its functions include notifying teams, preliminary discussion of suitable recipients with the centers where they are awaiting transplantation. They try to take into account all the nuances at the initial stage, when they are just starting to seize.
Thus, the entire system of organ distribution is limited to the region or neighboring ones, since otherwise there are difficulties in successfully delivering the organ.
The kidney can be delivered to other regions in time, and in some cases to both the liver and the heart. But why? Each region should have an established organ donation process, and each region should have specialists and clinics that can transplant organs to patients living there. There is no need to organize the delivery of organs on an ongoing basis throughout our vast country - such a need can arise only in exceptional cases. Although we, for example, have experience in transplanting kidneys that were removed even in Krasnoyarsk. Our colleagues did not have a suitable recipient on the waiting list (he had a rare blood type), they contacted us, we calculated the logistics of delivery and met it within an acceptable time frame, everything went well. But this is a rare, isolated case. Ideally, organ allocation should remain within the region, with potential recipients available within 1–2 hours. Again, I repeat, this is a widespread, worldwide practice.
- What are the chances that the transplanted organ will take root?
Organ survival rate is now very high for any organ and on average exceeds 95%: 98% for kidney transplantation, and above 90% for liver, heart and lung transplantation.
- In kidney and liver transplants, how much is cadaveric donation and how much is related?
Up to 20% may come from related donations in different clinics. In other cases, patients await transplantation from a posthumous donor. Related transplantation of a kidney or part of a liver, primarily for organ deficiency. With a sufficient level of development of organ donation, related transplantation will move into the realm of rare cases that are difficult in terms of medical selection. And the active development of related donation programs occurs due to unresolved problems and difficulties in organizing posthumous donation.
“Donors can be those dead people who could not be helped”
- If we compare with other countries, what level are we at in terms of posthumous donation?
Unfortunately, we are among the laggards. We are somewhere in the third ten in the world.
- In other countries, the system is built specifically on cadaveric donation?
This largely depends on the length of wait for an organ transplant from a posthumous donor. For example, our colleagues in Belarus have virtually no waiting period for a transplant, because based on the level of development of organ donation, they provide the required number of transplants for all citizens of the country. That is, if a patient appears who needs a kidney, heart, or liver transplant, the operation is performed within a month, maximum two. Because the level of organization of the organ donation system, the level of administration, made it possible to build a system in which all possible patients whom doctors could not save will be considered as organ donors.
- How then is the situation in Russia different? We have the same presumption of consent.
Our weak point is in the system of administrative decisions, in the interaction of the donor service with those hospitals where they try to save the lives of patients, but this is not always possible. For example, in case of a head injury incompatible with life or severe brain damage as a result of a stroke or circulatory disorder. When all such cases are brought to the attention of the donor service, believe me, our level of organ donation will increase significantly. Again, Moscow is a vivid example of this. The average level of organ donation in Moscow also leaves much to be desired, but at least this local example shows that with the proper approach, primarily through administrative and organizational efforts, it is possible to achieve a level five times higher than in the country as a whole .
Currently, the overall donation rate does not exceed 4 organ donors per 1 million population. And in the capital it is above 17. The acceptable level to strive for is 28–32 donors per 1 million people.
And it is quite achievable when the entire pool of potential donors is covered by the donor service.
But Moscow now cannot provide for everyone in need throughout the country; this requires the development of donor services in the regions. And we see that there are areas in which this development is happening very successfully: Novosibirsk, Krasnodar, Rostov, Yekaterinburg, Tyumen.
- Large federal centers?
In principle, this is a worldwide trend. It is inappropriate to develop a service such as organ donation and organ transplantation at the level of central district hospitals. It requires flow. In a small hospital, even at the highest coverage, 5–10 transplants per year will be performed. And the specialists there will never accumulate the necessary experience and level so that all these operations end well for them, without problems and complications. It is better to assign patients to federal and large regional centers. But nevertheless, taking into account the scale of our country, in every region, in large cities with a serious level of medicine and surgery, this is also possible. But not all regions have this yet.
- Are the indicators you mentioned, 28–32 donors per 1 million people, possible now?
Possible even now. These are the dead people who, despite the titanic efforts of doctors (who are actually trying to save patients, but doctors are not gods), could not be helped.
“As a rule, we have the opinion that doctors killed”
In Russia, there is a presumption of consent to the removal of organs - if the patient and his relatives have not indicated that they do not want the removal, according to the law they have the right to take the organs. Doctors are not obliged to ask the opinions of relatives. How ethical do you think this is?
Two systems have developed and are developing in parallel in the world. The first is when the default is that if a refusal has not been declared, then in the event of the patient's death, if his organs can be removed, they will be removed for transplantation. This is the so-called presumption of consent, which is practiced in our country. The presumption of disagreement, or presumption of consent sought, on the contrary, states that if the will of a person is not known, then by default it is assumed that the person was categorically against it. And in this case, you need to either find out the patient’s opinion while this is still possible, or enter some documents that, during life and full health, will register his consent. And here we can still talk about registers... Or we need to ask for the consent of relatives if the patient, due to the severity of his condition, can no longer say this. In fact, both models have pros and cons. And there are ethical disputes between their supporters.
- Where do which models operate?
In North America, Canada, the USA, consent is sought, in Europe it is 50/50: for example, Spain is consent sought, the UK is a presumption of consent. In some countries, these models smoothly flow into one another: at first they worked according to one model, then reoriented to another. It seems to me that if we choose a model of requested consent, when we require people to record their opinion in a register, to put a mark on their rights, then in this case success comes only to those countries that have a high degree of public trust in medicine in general. Unfortunately, we in Russia cannot boast of such a situation. As a rule, we have the opinion that “the doctors killed you, the doctors treated you negligently, you didn’t pay the doctors any money - that’s why no one will come to you.” This is regularly heard in the media, from the pages of newspapers, from the TV screen, the Internet is full of similar reviews, regardless of whether we are talking about transplantation or treatment of a runny nose. And this all speaks about the degree of public trust in doctors and in medicine as a system as a whole. Of course, when people hear all this, even if they do not have a clearly formed negative opinion, then under the influence of all this information noise, if they are presented with a choice for or against, the person will say “no” just in case, without bothering to understand the issue in detail . The existing legislative framework in our country is absolutely adequate to the social situation. But at the same time, any person has the absolute right and opportunity to register in advance their disagreement with posthumous organ removal.
- How to fix it?
In practice, this is not applied, but according to the law, when hospitalized in a hospital for any reason, a person can tell the attending physician that in the event of death, sudden, accidental, unpredictable or expected, he categorically refuses to be an organ donor. The donor service will not work with this patient by default, due to the refusal of the patient himself. The same applies to relatives: when the patient was brought to the hospital in a severe agonal state, or something happened, and he ends up in the intensive care unit and cannot express his will, the relatives just need to tell the attending physician that they are categorically against it: “If you it will not be possible to save him, we ask, we demand that he not be considered for the possibility of posthumous donation.” All. The organ donation service will not be called to this patient, and even if they have already arrived and the condition leaves no doubt that death is inevitable, the team will simply turn around and leave. Believe me, you don’t need to fill out any paperwork for this, you don’t need any signatures, you don’t need petitions, you just need to tell the attending physician, the head of the intensive care unit. This will be quite enough.
“No one will come to him, sit, rub their hands and think about what is about to be cut out...”
- When do doctors begin to realize that there is a potential donor in front of them?
Based on forecasts. If there is any significant percentage of probability that we will not be able to save the patient in his current condition. An experienced resuscitator can assess the situation and say that a fatal outcome is probably expected in a day or two, and call the organ donation service for a preliminary assessment so that they can take a look at it. If they arrive or ask over the phone how this patient is doing, and they are told that he is on the mend, there is a positive trend, the patient is removed from observation. No one will come to him, sit, rub their hands and think about what they are about to cut out... This will not happen. Doctors work here. Some more, some less, but they are all very highly moral people.
But a doctor who is treating a patient and, unfortunately, cannot cure him, has two options - either inform the organ donation center, or not inform. He understands that in one case one of the relatives can then file a claim with the prosecutor's office, and in another he will sleep peacefully.
And this is the peculiarity of the Belarusian model: for them, failure to report such a case, about a potential donor, is equated to failure to provide medical care. Those patients whom this doctor does not see, who are in transplant waiting centers and for whom the organs of this deceased (or currently dying) person can help. In our case, someone died - a doctor will not be punished for this (if there were no serious errors in treatment), and many colleagues will also approve: “Well done, otherwise, God forbid, in six months a lawsuit will come and you will be dragged through the prosecutor’s offices and investigative committees.” I know from the inside how the system works, I am absolutely sure that when organs are removed, everything is done ethically and within the law. Neither transplantologists nor donor service specialists are involved in any way in ascertaining death. But in the event of a claim from relatives, both the resuscitator and the head of the intensive care unit will be put under pressure, they will be put under pressure, they will face many sleepless nights, thoughts about the family, all this moral burden. And then the person will say: “Why do I need all this? Yes, it would be better if I didn’t tell anyone, I would sleep peacefully and with a clear conscience. As for other people - those who need organs - I haven’t seen them, I don’t know them, I can’t help everyone in the world.”
In the USA, as in Belarus, if a resuscitator does not inform the donor center about a potential donor with minimal chances or about a patient in the process of ascertaining death, or it has already been confirmed, he faces penalties (up to and including deprivation of his license), censure from colleagues, administrative collections and so on. We have neither carrot nor stick for this. Not all doctors, unfortunately, and perhaps fortunately, can work for this idea. It’s one thing to make every effort to save a patient who is in your hands, for whom you are responsible, and another thing is that somewhere there is someone in a transplant center, and this is even another hospital...
- That is, propaganda is needed not only among the population, but also among doctors?
Among doctors too. And not just among doctors, but from school, from student days. Departments of transplantology are slowly beginning to appear in the regions. There are two operating in Moscow now. And for any medical student, it is necessary to make sure that transplantation and organ donation are a normal, civilized part of the work, especially for a doctor who works at the intersection of life and death, in intensive care, in emergency medicine. Everyone should have an understanding.
“In moments like these, every minute counts.”
Currently, the government is still working on a bill on organ transplantation, which has been in preparation for several years. It effectively provides for the consent sought. What is happening to the document now? And what are the positive or negative aspects of it, in your opinion?
The only positive thing I see in it is that it proposes the same mechanism that exists now, but in practice no one knows how to implement it. This is when a person is concerned with the problem of how to make sure that in the event of death, his organs are under no circumstances removed and used for transplantation. Now, hypothetically, a person can go to any medical institution, say that he is against it, even write it by hand, but there is no official form. Put the stamp of the institution on the piece of paper, fold it, put it in your passport and walk around with this piece of paper. And the bill introduces the possibility of electronic registration of one’s expression of will. The path is clearly laid out on how you can get into a single register for the whole country and express your will. The law proposes to create such a register, and this is perhaps the only thing we lack in the current situation from a legislative point of view. After all, if we simply, without changing the law, create a register of people who are categorically against the use of their organs in the event of death, this will solve a maximum of problems: a patient dies, he is checked against this database. If they do not find it, it is automatically considered that he agrees. Or they see that he is against it. And this removes the ethical point we are talking about.
On the other hand, given the peculiarities of our mentality, I doubt that more than 5% of the country’s adult population will register in this registry. By the way, both against and for. There is always a superstition: “I’m alive and well, I’ll go register a posthumous disagreement, what if higher powers do something to push me towards this. It’s better to let everything go as it goes.”
The law, in addition to creating registers of those for and against, proposes to give relatives after the death of a person who has not decided, two hours so that they remember that organs can be removed, call or come to the department and say that they are against . But even according to this law, doctors are not obliged to actively find out the opinions of relatives.
- Is two hours a long time?
Of course. In fact, at such moments every minute counts - not all donors manage to maintain blood circulation, lung ventilation, that is, gas exchange, after death, in a state sufficient to prevent critical organ damage. Therefore, I advocate simplifying this point as much as possible: let there be only two registers - for those who do not mind, and for those who cannot “neither eat nor sleep” because their disagreement is not registered anywhere. Please, here is an online mechanism for expressing your will, refuse - no problem.
When I came to transplantation, we talked with representatives of the media about how our society was not ready to accept the requested consent for posthumous donation. 20 years have passed since then, the situation has changed significantly, but we continue to say that society is not ready. So when will our society finally be ready? And what have we done during this time to ensure that it is ready? But we, doctors, and specifically transplantologists, have always been a closed community and remain so. Until we ourselves take a step forward, until we open up, until we show people, the security forces that supervise the rule of law in this country, it will be difficult to convince people that we have no abuses, no corruption, no organ market, no black transplantologists. Although believe me, they actually don’t exist.
- How can this be proven?
We need to open up, take the first step towards society in this regard. Firstly, there are no random people in transplantation: only enthusiastic doctors get there and survive. Those who went into medical practice, the art of medicine, with a highly moral position - and as a result of their development reached transplantation, which is now an advanced field of medicine. I personally know most of them - they are ambitious, they protect the “honor of the uniform”, and it is impossible to shut their mouths if they saw any serious abuses in this industry.
- Besides ethical aspects, what else says about the impossibility of black transplantation?
Second: the number of people involved in the process of organ donation, organ distribution, and transplantation is very large.
It is impossible to perform a transplant in some semi-underground organization, because this requires a developed donor service and an immunological laboratory to determine compatibility.
An operating room where highly qualified surgeons and nurses and anesthesiologists must work. Transplantation is the result of the work of a large number of people, each of whom must be a professional who has reached the top of his profession. And they don’t work at the same time in one place: surgeons can’t just agree to sew something on someone. The donor service does one thing, the immunological laboratory does another.
After a transplant has been performed, high-quality intensive care is needed for a long time. And it can’t just be any one resuscitator, even a brilliant one. Depending on the situation after the transplant, intensive care is needed for 6, 8, 12 hours, and sometimes it takes a week, 10 days... And all this time the patient receives a huge amount of intensive therapy, correction of all organs and systems. Doctors must change, resuscitation nurses must change, the resuscitator on duty must change. Often large quantities of blood transfusions, certain specific drugs, and determination of the concentration of these drugs in the blood are required - that is, another laboratory, no longer immunological. We need a transfusiology center that prepares and distributes blood and plasma for this patient. We need specialists in hemocorrection, hemodialysis, and oxygenation. We need drivers who transport organs in special vehicles; We need nurses who prepare operating rooms. A lot of people work in the system - they see everything, know everything and will not remain silent when there are violations. To achieve this in a handicraft way somewhere “in garages”, to rent premises from veterinarians - it’s so funny for us to hear. We, the doctors, sometimes get unsatisfactory results, despite the concerted efforts of a large number of people caring for each patient around the clock. Therefore, for anyone who has worked at least a little in practical transplantology, fairy tales about black transplantologists bring a sad smile.
Illegal trade in human organs is a global problem that has not spared Ukraine.
In case of severe chronic diseases of vital internal organs - heart, liver, kidneys and others - the only way for a person to regain lost health is transplantation. According to the World Health Organization, every year more and more people around the world are seeking organ transplants, but this need is met on average by only 10% per year. As a result, the illegal trade in organs has increased significantly in recent years - to such an extent that even the WHO cannot estimate the size of the transplant “market”.
"Black" organ bank on a global scale
According to the director of the global organization Organs Watch, Nancy Scheper-Hughes, according to the results of a study conducted by experts from the University of Berkeley (California, USA), at least 15 thousand human kidneys are sold “under the counter” every year in the world.
The main countries where organ trafficking is rampant, according to OrgansWatch, include Israel, Egypt, Brazil, South Africa, Indonesia, India and Iraq.
In these countries, this kind of activity is illegal, but this does not stop “black transplantologists.” The seller of a part of his own body often receives $2-$6 thousand for a kidney, $5 thousand for a cornea. A human liver on the “black market for spare parts” is estimated at $5-$55 thousand, bone marrow at $40 thousand, and a heart at $250 thousand.
Those who allow themselves to be dismantled into “spare parts” for money are often unaware of the risk of remaining weak and bedridden for the rest of their lives after kidney removal or unsuccessful eye surgery.
The dealers of this market have a whole range of psychological techniques - for example, they talk colorfully about themselves or “those guys” who, they say, made good money and live comfortably after selling their organs.
Moreover, under the pressure of hopeless poverty, driven by the desire to help their families, some “donors” decide to give their lives for money and sell organs such as hearts, livers or bone marrow.
Many black transplant companies do not hesitate to kidnap and kill people, including children, in order to provide their clients with healthy and not worn-out vital organs. Let us note that the clients of “black transplantologists” are people who are desperate to wait their turn for a transplant. After several years of waiting and daily struggle for life, they are ready to do anything to save themselves or a loved one.
Other countries, other customs
As Lawrence Cohen, a professor of anthropology at the University of Berkeley who conducted the study with Organs Watch, points out, in countries like India and Bangladesh, people use their organs as “collateral” when they borrow money. These organs are then shipped to wealthy clients in Sri Lanka, the Gulf countries, the UK and the US.
According to Cohen, even though people sell their kidneys to pay off all their debts, they very quickly acquire new debt obligations. When Cohen asked “contract donors” about their plans for the future, many of them answered that if necessary, they would again sell their organs, because the need to support their family will not go away.
In Egypt, which the WHO has recognized as a hot spot for organ trafficking, a very similar situation is observed. For example, all residents of poor neighborhoods in Cairo know that to quickly solve financial problems, you can donate a kidney and get $2 thousand. Intermediaries who buy organs can be easily found in any cheap cafe in the “slum” areas. Many of them are foreigners and work in underground laboratories that select donors individually for each client and help with finding a doctor who would perform the operation without asking unnecessary questions.
For example, in Brazil, cases of exploitation of people by employers were recorded. In particular, many domestic workers (maids, housekeepers) gave up their organs in exchange for a guarantee of long-term employment or payment for housing. As Nancy Scheper-Hughes discovered, in many countries, authorities and officials know about organ trafficking, but do nothing, so it is a “public secret.”
In the United States, where it was believed that there could be no black transplant surgeons, a scandal recently erupted.
In July of this year, police arrested 44 people in New Jersey, including the mayors of Oboken, Sicaucus and Ridgefield, as well as Jewish rabbis. They were charged with accepting bribes, money laundering and trafficking in human organs.
One of the rabbis, Levi Yitzchak Rosenbaum, is accused of speculating in the organ trafficking “industry” for many years. In particular, Rosenbaum convinced people from vulnerable groups to sell a kidney for $10 thousand, and then he himself sold the organ for $160 thousand.
Black transplantology in Ukrainian
In Ukraine, organ trafficking is associated with the recent scandal in Kyiv and Donetsk clinics.
In 2007, the Israeli police, as a result of checking information about organ trafficking and a detailed investigation, followed a trail that led law enforcement officers to a Kyiv clinic, as well as to the Donetsk kidney transplant center.
It was there, as the Israeli police suspected, that “purchase and sale” operations of organs were carried out and the kidneys were transferred to their new owners, who paid a tidy sum.
At the same time, a certain Michael Zis, an Israeli surgeon who provided “brotherly assistance” to surgeons at the Donetsk Kidney Transplant Center, was put on the international wanted list. According to the press service of the Ministry of Internal Affairs, “ In the fall of 2007, the Voroshilovsky court of Donetsk detained Michael Zis and kept him in pre-trial detention center No. 5 of Donetsk. In order to verify the facts of Zis M.’s involvement in committing crimes related to illegal transplantation on the territory of Ukraine, Donetsk law enforcement officers carried out a set of operational measures, as a result of which a number of facts were established of the recruitment of citizens for the purpose of their exploitation. Based on this fact, in October 2007, the Investigative Directorate of the Main Directorate of the Ministry of Internal Affairs of Ukraine in the Donetsk region opened a criminal case under Article 149 Part 2 (trafficking in persons or other illegal agreement in relation to a person) of the Criminal Code of Ukraine" Let us note that this article provides for punishment in the form of imprisonment for up to 12 years.
Zis's colleagues at the Donetsk kidney transplant center completely refuted the accusations, and at the end of August 2008 the court found Michael Zis not guilty "for lack of evidence of a crime." However, soon the decision to release the surgeon from custody was canceled, and in March 2009 the Court of Appeal overturned the acquittal.
At the end of July this year, it became known that the prosecutor's office of the Donetsk region changed the charges against Michael Zis. Now the surgeon is accused under Article 143 Part 1. (“violation of the procedure established by law for transplantation of human organs or tissues”). If his guilt is proven, the surgeon faces a fine of 850 hryvnia.
“I’m selling a kidney...I lead a healthy lifestyle”
According to the Ministry of Health of Ukraine, about 2 thousand people need a kidney transplant in our country every year. True, only one lucky person out of 20 has the opportunity to start a new life with a new organ: in 2007, 117 kidney transplants were performed, in 2008 - only 103.
Bagnet correspondents, for the sake of an experiment, decided to enter the words “will buy a kidney” and “sell a kidney” into an Internet search - and were horrified. Notice boards are full of offers for the sale of organs of the type “A young guy of 19 years old without bad habits will sell a kidney for 20 thousand euros, part of a liver for 10 thousand euros or bone marrow for 20 thousand euros. Blood group 1-. Phone 8(0……..).” Most “donors for money” are women 30-35 years old or young men under 25 years old.
On moderated message boards, in response to the request “I’ll buy a kidney,” the site kindly issues several dozen offers of organ donation - with photographs and detailed prices.
Anna Valevskaya
In contact with
In June, the Verkhovna Rada of Ukraine adopted changes to the legislation on organ transplantation. It is called a “breakthrough” and even “the beginning of the era of transplantology” in Ukraine. But in reality, the “era of transplantology” began in our country much earlier - Ukraine is one of the ten countries leading in the number of donors for illegal organ transplants. “Vesti” looked into why the new law will not solve the problems of the black market for organs, how much a part of a liver, kidney, cornea or bone marrow costs, and also why none of the black transplantologists were ever imprisoned.
The Internet is full of stories about how living people are dismantled for spare parts - and each is worse than the other. But there are not many people willing to testify or tell stories from their own experience.
Igor does not hide the fact that he received a fee of 8.5 thousand dollars for his kidney.
- Was it scary to take such a step? It is often said that other organs can be taken away from a person during an operation...
- There is always a risk. It's risky to walk on the streets. But to be honest, many of our fellow citizens are quietly trying to improve their own financial situation with the help of their organs. Living without one kidney does not mean disability.
Igor throws up his hands - he has no work. It is very difficult to find a job in the small regional center of Zhashkiv, Cherkasy region. For the last six months he lived on his mother's pension.
"I even thought about suicide. Who needs me like this - no money, no housing, not handsome", says our interlocutor.
In little Zhashkov, several more of Igor’s acquaintances tried to disassemble themselves for organs. His close friend was the first to decide to take such a step. On the Internet, he found the number of a “recruiter” who was looking for volunteers in the Ukrainian outback. The guy was taken to Turkey and a few weeks later he was already home. He started renovations on a grand scale. Igor simply followed his example.
I wrote a letter to a verified mailbox on the Internet. Soon a woman came to him - Elena. Igor admits that it was creepy and funny at the same time.
"It turned out that much about organ theft was simply made up. Elena explained to me that there is such a thing as immunity. This means that the foreign organ will be rejected by the body. Therefore, doctors try to find a donor for transplantation whose body is close in all respects to the recipient’s body. And if, say, a kidney is suitable, then the liver or spleen most likely is not. We're not relatives. But cutting out an organ and then looking for someone to transplant it to is also a problem. After all, a kidney can be stored separately from the body for only 48 hours. Other organs are even smaller. ByIt is unlikely that anyone will disassemble the organs of a living person. But there is always a risk", says Igor.
In his opinion, operations abroad are even safer than in Ukraine. There, this matter is put on stream - experienced specialists, the transplant takes place directly in the clinic, the operation is performed quickly. Igor was taken to Turkey for two weeks, to a small town. Igor never saw the person who would live with his kidney. This is prohibited by all rules.
"In fact, underground transplantation and donation existed back in Soviet times., - notes Igor. - My mother was in the hospital in 1975 after bladder surgery. She noticed that other women with the same diagnosis and, accordingly, the operation were back on their feet within a few days. A week later they were discharged. Mother was always young and healthy. I worked a lot physically. And after the operation I could not get out of bed for several weeks. One of the nurses took pity on her and told the truth. A spinal cord puncture was taken from her during the operation. This liquid was then poured into the wife of a local party leader.".
“The pain was terrible for eight months.”
Volodya sold his kidney in March last year for 13 thousand dollars. " I was not looking for a buyer, but an intermediary. I found a woman on social networks. She herself once sold a kidney. This woman immediately suggested that I get tested - initially in Ukraine, and then in Turkey. I paid for these tests and the flight to Turkey. I wasn’t flying alone - another woman from Ukraine was flying with me, also for a kidney transplant. We flew to Istanbul, to a government clinic. Tests were carried out there for another two weeks. I donated a kidney to a 12-year-old Arab boy who had kidney failure. The only catch was that before the special commission, this boy and I had to pretend that we were relatives. The commission was told that our grandfathers were siblings. The Turkish doctor is in charge of everything. Before the operation, he said that he would pay 13 thousand dollars. He said that you can earn more, but the operation will be performed not in a clinic, but at home. Then the cost of a kidney is 50 thousand dollars. But I was afraid that the devil would take me somewhere, not only would they take away my kidney, but they would even allow me to use my organs. But this is a government clinic after all, it’s not so scary"- said Vladimir.
A few days later, Vladimir received the money and flew home - he transferred some to his wife’s card, and brought some in cash. " The pain was terrible for 8 months. After all, during this time the remaining bud increases in size, becomes like two kidneys and occupies the void. It's more tolerable now", Vladimir shared.
Pyramid of organs
For some reason, politicians who speak out about the new “transplant” law constantly mix up two different stories. For example, they say that the new law will put an end to the Ukrainian black transplant market. In reality, this law will have no impact on organ trafficking. The reason is that we mainly employ recruiters - operations are carried out abroad. Ukrainian transplantologists do not transplant a kidney “after working in a garage,” and it is problematic to carry out an illegal operation in clinics, if only because of the large number of doctors who will be involved in it.
"Nowadays you can often find fables on social networks that transplantologists are the ones who kill children at bus stops, remove their organs and sell them abroad. In fact, there is no black transplantology in Ukraine. Even with all the technical capabilities, a clinic and a large support team, it is not always possible to carry out the operation. Transplantology is a very high-tech branch of medicine. It is impossible to do it underground, in a private clinic, in the kitchen or in the garage. The organ that is removed from the human body lives outside the body for 3-4 hours, and the number of people involved in the transplant ranges from 30 to 50. This includes the laboratory, intensive care, anesthesiology, perfusionology, surgery, and junior medical staff. Being a surgeon, I can't imagine how this could be done illegally and secretly", says Vesti Director of the Heart Institute, cardiac surgeon, Doctor of Medical Sciences Boris Todurov.
It is known about a number of high-profile cases in past years against Ukrainian transplantologists who were suspected of illegal organ transplants. For example, surgeons from the Shalimov Institute came under suspicion. For example, they tried to make surgeon Vladislav Zakordonets a “black transplantologist” - in fact, he probably performed organ transplants between relatives (Ukrainian law allows this), who in fact were not relatives. " Doctors did not check the degree of relationship - our job was to operate", Zakordonets himself comments on this fact to Vesti. The doctors were acquitted by the court.
As for the recruiters, the situation here is as follows. In October 2015, the SBU, together with the police, detained members of a transnational criminal group. The attackers, having connections in medical institutions in Asian countries, recruited potential kidney donors from poor people from the provinces in Ukraine during 2013-2015. The donors were then transported abroad to participate in illegal organ transplant operations. In total, 25 donors were transported.
In April last year, the court arrested, with the alternative of posting bail totaling over 72 million hryvnia, “black transplantologists” from Turkey and Ukraine. To cover up their illegal business, the criminals “created a commercial structure that allegedly provided medical tourism services.”
After obtaining consent from the victims, the criminals sent them abroad for operations. Every month the suspects organized four or five such “tours” for Ukrainians. “Black transplantologists” paid donors from 13 to 15 thousand dollars, while they themselves received from 80 thousand to 100 thousand dollars from the organ buyer.
Last fall, law enforcement officers stopped the activities of a criminal group whose members were recruiting minors for illegal organ transplants in Russia. Reported then Prosecutor of the Kyiv region Dmitry Chibisov. The prosecutor's office identified four victims - three children aged 14, 15, 16 from normal families and a 32-year-old woman.
But with all this, it is unknown that the case of at least one such group actually came to court and a guilty verdict was passed on it. " I have not heard of such cases, although there are quite often reports in the press about the detention of entire groups of black transplant surgeons. Last year there was a rather high-profile arrest; as a result, the recruiters were released on bail of several tens of millions of hryvnias each. What is happening to them now is unknown. But I think that the money can be "recaptured" quite quickly", states former investigator of the Ministry of Internal Affairs of Ukraine Alexander Stasiuk.
In his opinion, thousands of stories similar to those with which our story began could be collected. The reason is that in Ukraine there is a real pyramid for honest and “almost voluntary” organ removal from the least affluent citizens. People agree to become donors without understanding all the consequences. Recruiters tell them only about the advantages of transplantation, but are silent about the fact that such operations never take place without irreparable harm to health.
"The scheme is quite simple - an existing intermediary is looking for a person, preferably a low-income one, and there are plenty of them now. Naturally, such a person “breaks through” - there should be no leakage of information. After all the procedures and organ removal, the donor himself ends up “in the scheme”, because the intermediary from above promises him a percentage for each new donor. Who would refuse to take a certain amount not for their own organ, but simply “for services” to acquaintances and friends? This is how a system or a pyramid arises, as you wish. There may be several intermediaries. The donor earns pennies for his own organ, and the intermediary's remuneration can range from $1,000 to infinity. Word of mouth plays a role here: “neighbor Ivan sold a kidney, received money, bought a car, and feels fine, but why am I worse?” Each lower-level intermediary must control “their” donors so that the scheme continues to work. That is, Ivan, who sold a kidney, receives his reward only if he can vouch for his acquaintances and neighbors. Moreover, people from the lower social classes are drawn into the scheme itself - the poor, socially disadvantaged, imprisoned people, residents of rural areas, etc. Often such people are poorly informed, do not know their rights, will not be able to “snitch” or report, and then simply do not know where to turn for protection. They try not to allow strangers into this system, since a lot of money is at stake"- said the investigator.
Lungs - 150 thousand euros, bone marrow - 20 thousand per gram
According to the World Health Organization, more than 10,000 transactions involving the sale of human organs take place on the black market each year. In general, the price of a healthy human body is about 45 million euros, but only if a person could sell every part of it - that is, go for the entire organs.
It has long been known that without any visible threat to life and health, you can sell the cornea, kidney, part of the liver, lungs and bone marrow. In particular, lungs can be bought for 80-150 thousand euros, a whole liver - for 150-550 thousand euros, part of a liver costs about 40 thousand euros. Prices vary. The cornea of the eye is sold for 4-15 thousand euros. A kidney costs up to 250 thousand euros in the world - it all depends on the urgency and need for the organ. Bone marrow is bought by the gram, one costs about 20 thousand dollars.
These numbers contain the answer to the question of how to stop black transplantation in Ukraine. The only remedy is to overcome poverty. If a person works, saves for his old age, and is not afraid to start a family, he will not even think about this type of income. Selling a kidney is only out of despair.
Technology "Monsters": trial ball End.
5. Alexander Olimpievich Bukhanovsky.
Chikatilo is an extremely naive person, slightly autistic, confused by all this “pipe” pioneering-komsomol, Bolshevism-communism, jumping over a fire, a strong hand and cool ksivs.
All witnesses note his extreme spinelessness, complete inability to conflict. He was pushed around by his own subordinates, his young son was rude and lightly beat him, and his wife constantly kicked him with a rolling pin.
There is nothing strange in the fact that Chikatilo got a job as a supplier in order to be able to go on business trips more often. Away from his wife, and from everyone who has already found the key to his rudeness and irrepressible assertiveness.
It is easy to break such a person. And it’s even easier, considering that Chikatilo was diagnosed with schizophrenia. And right up to the moment of execution, he remained in the illusion of his safety, inspired by someone.
Although it threw him from “everything is gone, boss” to euphoria and back more than once.
And when the Serbsky Institute declared him sane, and when the court sentenced him to death. And at the time of his arrest (considering that he himself apparently did not suspect any super-mega-hyper-maniac, but took upon himself the murders one at a time, according to the principle
“Oh, once, what’s that once, many, many more times!” and “seven troubles, one answer”, because the more episodes, the more reliable the legend of insanity),
it should have seemed that such a diagnosis was an impenetrable shield.
But bone-crushing investigator Kolesnikov would hardly have been able to persuade even the schizophrenic Chikatilo to make such a confession.
Here a different mind was needed - subtle and insinuating.
He was such a person Alexander Olimpievich Bukhanovsky.
A man, it seems to me, quite capable of inspiring Americans
(to whom he later lectured on this issue) to create the image of Dr. Hannibal Lecter. A prominent, in general, specialist in maniacs.
Bukhanovsky was investigated back in 1984.
Then a version appeared that a series of murders could belong to illegal transplantologists.
The corpses were missing eyes, genitals (both penises with scrotums and uteruses with appendages), and other parts of the body.
Experts claimed that the criminal had a medical background. We started looking for transplantologists and came to the Rostov Medical Institute
(now Rostov State Medical University, with research departments), including the RGMI clinic.
There, several groups of scientists were involved in illegal transplantology.
One of these scientists was a psychiatrist from the Rostov Medical Institute A. O. Bukhanovsky. Who was interrogated in this case. Well, here it is necessary to make a small biographical digression.
A. O. Bukhanovsky received his surname and patronymic from his stepfather - Olympia Maksimovich Bukhanovsky.
Alexander Olympievich's real father is American businessman Joseph Strassberg, President of Gold Cross Construction Company in New Jersey.
Alexander Olimpievich’s mother, Evelina Aramovna, is a dentist.
Grandfather, Aram Samuilovich Sarkisyants, is considered the creator of the health care system of the Chechen Autonomous Soviet Socialist Republic (Chechnya).
Yes, A. O. Bukhanovsky was born and raised in the mountains. Grozny.
Bukhanovsky, while still in the army (where he was drafted as a doctor), begins to study genetics schizophrenia.
The trail of semi-disgrace and dangerous closeness to eugenics (and thus to Nazism) remained behind genetics until perestroika (the taboo on genetics was only just lifted in 1963-65).
And Alexander Olympievich specialized in the genetics of schizophrenia while still in the army (a Lombrosian topic, frankly speaking!) and defended his Ph.D. thesis on it in 1977.
At the Russian State Medical Institute, where illegal transplantology has flourished no later than 1970
(when Bukhanovsky got a job there after the army as a nurse).
And there, at the RGMI, Bukhanovsky unexpectedly switched to the topic of transsexualism in 1980.
Moreover, he soon began to carry out criminally punishable gender reassignment operations (causing grievous bodily harm, Article 108 of the Criminal Code of the RSFSR, up to 15 years).
In total, 400 transsexuals contacted Bukhanovsky, of whom 150 were operated on. Most are from Soviet times.
For some reason, then the number of applicants fell sharply (perhaps the professional reoriented himself to foreign clients, who are mainly served by the private medical center "Phoenix" created by him in 1991).
But during operations, from time to time, deaths inevitably occur.
How could Bukhanovsky carry out such operations?
Why did the RGMI administration turn a blind eye to this?
Even if the Ministry of Health unofficially sanctioned such experiments, how could they be entrusted to a non-specialist, and even one under the KGB’s hood, as the son of an American capitalist?
There is only one answer to all questions.
The experiments of Bukhanovsky (possibly those of his colleagues) were carried out on the initiative of the KGB itself, or some other Soviet intelligence service.
For example, the GRU (in Rostov the military headquarters and several special GRU facilities, including a special forces brigade).
What interest could the generals who made decisions on this kind of experiment have? And how did they justify this decision in the leadership of the KGB (or GRU) and in the Central Committee?
Although it should be borne in mind that their task was facilitated by the transition of Yu. V. Andropov in 1982 to the position of first Secretary and then General Secretary of the Central Committee.
It was probably during this period that Bukhanovsky’s platonic interest in changing people’s gender was embodied in specific surgical operations.
From the moment of its inception (still as the Cheka and the GPU), the KGB had an unhealthy interest in parascience and mysticism. Especially related to human sexuality.
And also to the issue of sectarianism. Which, on the other hand, is quite understandable.
“Gender reassignment” is an operation that directly links science with sectarianism.
First of all, with such a persecuted sect both under the Tsars and under the General Secretaries, like the eunuchs
(a branch of Khlystyism).
It is believed that after the defeat of the Skoptchestvo in 1929, the remnants of the sect survived... in the North Caucasus.
At the same time, the sect transformed into the so-called. “spiritual contempt” (i.e. abstinence without surgical castration).
It is quite possible that the eunuchs were taken as one of the foundations in the Chekists’ modeling of future sects, such as the “White Brotherhood” of Maria Tsvigun or “Aum Senrikyo” of Shoko Asahara.
And “sex change” (fictitious, since it is impossible to truly change gender) could be considered as a promising development in this particular area.
On the other hand, as part of gender reassignment, experiments were carried out on the transplantation of erogenous zones, attempts were made to implant other people's genital organs
(from men to women and back).
The success of such operations promised fabulous profits and the introduction of the KGB into the circles of the Western elite. The prospects are endless.
You can, for example, transplant a powerful black penis into an old white billionaire...
On the other hand, there is some reason to believe that gender reassignment can help rejuvenate the body. From here there is a direct path to immortalism.
And the immunological problems solved along the way are directly related to the problem of life extension.
And who should do all this if not Bukhanovsky, with his access to the American father-businessman!
Soon after interrogating Bukhanovsky, he suddenly turns from a suspect into an expert on maniacs.
Although I had never dealt with maniacs before. This is not the first change of his interests. Alexander Olimpievich started, let me remind you, as a military doctor in Severomorsk
(where the GRU special forces regiment is stationed), then switched to the genetics of schizophrenia, then illegal sex reassignment, and now maniacs.
In 1984, Bukhanovsky, having gained access to the materials of the criminal case, compiled the first “prospective portrait” of a serial killer, on seven pages,
and two years later - the second, by more than a hundred.
In them, Bukhanovsky allegedly completely foresaw the appearance of Chikatilo. This is the key evidence in the case.
But what if we look at the question a little differently?
Perhaps, back in 1984, Bukhanovsky became preoccupied with searching for a “scapegoat”?
M. b. Was the portrait originally painted “from life”, like Chikatilo?
In any case, at that time, Bukhanovsky himself looked much more suspicious than Chikatilo. And his transfer from suspect to expert (with a range of scientific interests in the form of genetics and genital rupture) looks extremely strange.
One way or another, after his arrest on November 20, 1990, there is no evidence against Chikatilo.
The search in Chikatilo's house did not help either. The only find that the investigation tried to give a “suspicious” character was 23 kitchen and utility knives, in total, found in the house.
(on which no traces of blood or any evidence of their participation in at least one of the murders were found)
A fairly wide range of household items can be considered “suspicious”.
For example, in another house you can find a bottle of concentrated acid. Or a bag of quicklime.
And for some reason, in another house there are as many as a hundred jars of iodine stored. For some reason, in the third there are bags for construction waste, although no repairs are being carried out.
In the fourth, between the parquet floors you can find old stains of someone’s blood
(it does not matter if the blood type matches the blood group of the owners).
The fifth contains a collection of porn and horror films.
It’s strange, but the owner of Chikatilo’s VCR did not even have the “Nightmare on Elm Street” video recorder that was standard in those years for any video library. Let’s imagine what would have happened if the cops had found such a film from Chikatilo! This is where the “indisputable” proof is!
During a search of the database of serial killers, numerous evidence is discovered. Parts of human bodies, belongings of the victims, clothes of the killer with blood stains from the victims, etc.
Absolutely nothing was found in Chikatilo's house!
There were no fingerprints at the scenes of numerous crimes.
Which suggests that the real criminals worked with gloves, possibly rubber ones.
And the group of sperm found on some corpses was classified by several experts (different for different corpses) as group IV (blood).
“On condition,” added all the experts, “that the material belongs to one man.”
And Chikatilo had group II!
The results of the examination so clearly justified Chikatilo that even the anti-scientific theory of “paradoxical isolation” was invented.
The essence of the theory is in the supposedly existing exceptions, in which blood belongs to one group and sperm to another
(which, according to all experts, both domestic and foreign, is complete nonsense).
It was the ninth day of detention, and Chikatilo did not admit to anything.
Well, besides his platonic interest in high school girls, when he was a teacher at school, boarding school and vocational school.
On the tenth day, Chikatilo was supposed to be released, without a chance. again brought to trial on this charge (once again I ask the question: why not at least try to catch Chikatilo at the scene of the crime, for example, “with live bait”?).
And here Bukhanovsky appears on the stage. He talks about something with the suspect.
And lo and behold, Chikatilo calls the investigator and begins to take charge of murder after murder.
Initially, Chikatilo was very confused in his testimony and reported many incredible details that directly contradict the case materials.
But the new arrivals of the good Doctor Lecter solve problem after problem.
Chikatilo (who was described by witnesses as a person unable to retain in his memory the simplest information about work, up to the director’s instructions an hour after a meeting and with the help of a notebook with work notes)
describes crime scenes and the crimes themselves in detail.
Psychologically, Chikatilo's testimony is quite convincing.
How convincing is the testimony of the oligophrenic Kalenik and his friends, whom the investigation split over the same murders a couple of years earlier.
However, the persuasiveness of Chikatilo’s testimony is only for the average person or at the most superficial glance.
Firstly, during all interrogations, Chikatilo, for the most part, answers in monosyllables: “yes”, “no”, “as it is written there, that’s how it all happened.”
Secondly, the motives for the murders and the psychological mechanisms of such insanity remained vague.
In fact, Chikatilo and after him (or vice versa?) Bukhanovsky are stupidly retelling the traditional gopnik “I don’t know what came over me.”
But the worst thing is that Chikatilo’s interrogations did not shed any light on the disappearance of the bodies of those killed.
And this is third.
Chikatilo told the investigation only what the investigation knew without him, and not a single fact more!
Where and how could Chikatilo have disposed of the victims’ organs that he cut out (how if he did not have a medical education?)?
How could he not be covered in blood from head to toe?
How could he not attract the attention of random passers-by, mushroom pickers in the forest belt, etc.?
Well, one victim, well, two, three.
But Bukhanovsky (and after him Kolesnikov, Kostoev and Yandiev) does not ask such questions.
Bukhanovsky (possibly with the assistance of Kolesnikov) retroactively painted a portrait of Chikatilo (and replaced the original document with it), or he initially painted the portrait from life, as part of the first attempt to pin the case on a schizophrenic.
Perhaps he pointed it out to him, as a specialist in schizophrenics (wasn’t Andrei Romanovich treated at the RGMI clinic?).
The extreme diversity of the origins and social roles of A. O. Bukhanovsky causes amazement.
He is a military doctor, a geneticist, a psychiatrist, and a surgeon.
In the Chikatilo case, he is both a suspect, an expert, an unofficial investigator, and the employer of Chikatilo’s lawyer, Marat Zaidovich Khabibulin (now working for Bukhanovsky at Phoenix).
Inevitably, the suspicion creeps in that these are just masks, and Bukhanovsky’s true social role is somewhere at the junction.
A secret agent from the government, an intermediary between the government and American business, a guild worker and a killer doctor.
6. Chikatilo as a victim of the System.
But the facts indicating Chikatilo’s innocence are already known.
1. At the trial of Chikatilo, the prosecution did not present a single direct piece of evidence.
There were no murder weapons, no blood stains from the victims on the defendant’s belongings, no fingerprints at the crime scene (or fingerprints from the victims on Chikatilo’s belongings).
There was no “biological material” of Chikatilo at the crime scenes, on the corpses (on the contrary, the “material” available there completely justified Ch., which is why the anti-scientific theory of “paradoxical isolation” was invented).
There was not a single examination result that unambiguously pointed to Chikatilo. There was not a single witness, not only who escaped from the hands of the “maniac” or who saw him in action (as this quite often happens with a smaller number of victims), but who even confirmed Ch.’s presence directly at the crime scene.
The only exception is the clearly fantasizing witness in the case of Katya Zakotnova (in which a certain Kravchenko had already been shot), but it was in this episode (the only one out of 53) that the court considered Chikatilo’s guilt unproven!
2. The case is full of purely everyday oddities and direct procedural violations. Procedural norms were not invented out of nothing to do. They are needed precisely in order to eliminate errors, forgeries and falsifications.
When, in the absence of direct evidence, the investigation and prosecution use dubious reports, witnesses, experts, examinations, victims, this further strengthens mistrust.
Suffice it to say that several corpses changed gender during the investigation.
When corpses were discovered “close” to the places of residence of A. R. Chikatilo
(one is a hundred km from Chikatilo’s place of business), the investigation was looking for missing women around the days of Ch.’s stay there, and if there was no suitable woman, then at least the missing man.
The corpse “had” a place, but did not “have” time, and to link the corpse to Ch., the missing person was required on certain dates - and then the corpse changed gender.
And since Chikatilo, who worked as a supply worker, traveled around the country a lot, on hundreds of such trips he managed to drag several corpses to his ears.
3. The key participants in the Chikatilo expose gained tangible personal benefit from the case.
Investigator Issa Kostoev immediately became Yeltsin's representative in Ingushetia
(where in those years the topic of Chechen advice was discussed and the ground was prepared for the creation of an Economic Favorable Zone, which turned Ingushetia into an internal Russian offshore in 1994).
Vladimir Kolesnikov became the First Deputy Minister of Internal Affairs.
Alexander Bukhanovsky opened his own medical center, aimed at Russian-speaking residents of non-CIS countries (i.e., the nomenclature operatives who plundered the country), and went to give lectures at the FBI.
Even Chikatilo’s lawyer, who assured the court of his client’s guilt, received the cushy position of chief lawyer at the Bukhanovsky medical center.
4. Chikatilo’s testimony became, in fact, the only evidence against him.
Which directly contradicts the thesis about the special cunning of this alleged serial killer,
13 years of successfully evading responsibility.
Also, Chikatilo’s detailed testimony contradicts the fact noted by all witnesses that Alexander Romanovich has extremely poor memory. Chikatilo's first testimony for each episode contained many contradictions with established facts and was subsequently corrected several times (usually after conversations with Bukhanovsky).
Chikatilo himself, in numerous letters, statements and appeals, claimed that testimony was extracted from him, and investigative experiments were rehearsed for a long time in advance.
5. During personal searches and a search of the apartment, nothing was found to prove Chikatilo’s involvement in the crimes. Whereas in most cases of long-term elusiveness of the criminal, it was achieved by committing crimes at home and hiding evidence in the criminal’s house. Which led to excess evidence after the criminal was caught (i.e., the longer the criminal was not caught, the easier it was then to prove his guilt).
The most “suspicious” were the results of Chikatilo’s personal search, when in his briefcase (or backpack?), among many other items, a penknife, a piece of rope, pieces of ribbon (possibly cut by operatives from the folders in the briefcase) and a standard jar were found Vaseline
(despite the fact that Ch. was declared impotent, imitating sexual intercourse with the movements of an unfound knife).
Which items, given the traveling nature of Chikatilo’s work and the extreme paucity of assortment in Soviet stores of that period, do not look strange at all
(the same Vaseline was used for many things!).
Of course, this “evidence” is completely insufficient to prove guilt
T.b. that they are not directly tied to the corpses, neither by the testimony of witnesses, nor by evidence at crime scenes, nor by the results of examinations.
Chikatilo's pedophilia is much better substantiated, but it is not completely certain. Maybe at the level of platonic interest in sexually developed high school girls (high school students?), but nothing more.
Perhaps Chikatilo’s sexual fears (and the associated guilt complex) served as one of the levers that forced him to take upon himself the crimes of others.
Plus his son’s suspended sentence (for robbery, with the boys, of Vietnamese shuttles).
It didn’t cost the investigators anything to ruin his son’s life. This could prompt Ch. to admit pedophilia, and then - “the claw got stuck, the whole bird was lost.”
The lessons of the Ch. case for the Russian man in the street are that you need to constantly check your every step for suspicion from the viewpoint. circumstantial evidence of the commission of something. crimes, especially such as terrorism, extremism, pedophilia and serial murder.
Thus, the presence in your home video library of a large number of detective stories, thrillers, horror films, and also any films with scenes of sex and/or violence can become evidence of a criminal lifestyle.
But the absence of such films can serve as evidence of infantilism, which is one step away from pedophilia, etc. serial murders.
The absence of a video library at all is sure proof of abnormality.
Having developed a sufficient level of suspicion in yourself, you can begin to denounce others, and as a result, go to the cops and surrender yourself.
The humor is not good, but the herds of domestic self-proclaimed accusers think approximately in this spirit. For whom everything is suspicious and everyone deserves the most severe punishment.
A jar of Vaseline or potassium permanganate in a business traveler’s briefcase is a ticket straight to death row. A soldering iron among household tools is sure proof of banditry (what else can you do with it, with a soldering iron?).
Just like the iron found during the search.
There is one more trump fucking approach.
List all the terrible crimes of which the victim of the alleged slander is allegedly guilty (the entire line of argument regarding the possibility of slander in general and in this particular case in particular is completely ignored, as if it did not exist).
Accuse those who doubt the guilt of the sentenced person as “accomplices” and “enemies of the people.”
And to crown any attempts at discussion with the seal “he was convicted by the court, which means he is guilty.”
7. So who killed?
I will assume that several murders were committed by illegal transplantologists, including Bukhanovsky personally.
The activities of which were protected by the GRU and the Kurdish-Yazidi organized crime group that was affiliated to it.
By the way, Grandfather Hasan, in recent years, finally settled in Rostov.
Rostov is a port city, the ancient city of Azov has become a virtual suburb of it.
In Soviet times, he was known as “Rostov-papa”, in tandem with “Odessa-mama”.
These are the two leading Black Sea port cities (since the Sea of Azov is essentially a gulf of the Black Sea).
Through the Volgo-Don canal, Rostov also communicated with Volgograd and further with the Caspian Sea. And the Black Sea was the epicenter of the then Soviet “shadow economy”.
What was the meaning of the Soviet “shadow economy”?
It was a compensation system that cleaned up the flaws of the official planned economy and the official leveling system.
The first secretaries of regional committees needed a “carrot” to reward distinguished directors and their clienteles. Such a “carrot” was the unaccounted for.
And the popular “currency” was agricultural products. That is, goods produced in the south of Russia and Ukraine, and also imported from hot countries through the Black Sea ports.
In connection with this, the special role of the Caucasus and Novorossiya, incl. to the "Caucasus" Rostov region.
And since the centers of the shadow economy were the headquarters of military districts (leftists were driven by military trains to avoid inspections), Rostov was the most important center of the shadow economy also for this reason.
Naturally, the entire shadow economy was supervised by the Soviet intelligence services, and ultimately by party intelligence.
But the interests of the intelligence services extend much beyond economic incentives for frontline workers. And the most important interest is the collection of incriminating evidence. Or the creation of it.
Transplantology is good because it allows you to compromise the recipient of an illegal organ transplant.
The fact is that organs (except kidneys) take root rather poorly. The problem of tissue compatibility even now is very acute. The organ of a deceased person quickly degrades and becomes unsuitable for transplantation. And the circle of people whose organs are suitable for transplantation for a given recipient is narrow. They should be monitored for a long time, tests collected, etc. So that the donor is healthy.
And if it is possible, in the end, to take one kidney and leave the other to the donor, then with a liver, for example, this is impossible. And it is unlikely that a suitable donor would die at the right time. The only option remains: to take organs from a still living donor (followed by euthanasia).
An elite member who is dying himself, or who sees with pain how his children, parents or beloved woman die, is often ready to do this.
And even if he did not know that the organ was taken at the cost of murder, he is unlikely to be able to prove it later.
And compromising evidence still remains (for a politician, for example) lethal.
From this viewpoint. Transplantology is a super interesting topic for the intelligence services.
A lot of money (except for relatively cheap kidneys, organs are very expensive for the final purchaser) - this is true, a nice bonus for the performers. The stakes here are completely different.
You can recruit members of governments, stock market insiders, prominent scientists, military...
Another means of equally lethal compromise can be pedophilia.
It seems that both topics were being developed in parallel in Rostov.
cont.sl.ch2.
