Chapter One: Preliminaries
Since David Kilgour and David Matas wrote Bloody Harvest and Ethan Gutmann wrote The Slaughter, we three have remained active in writing, researching, investigating and speaking on organ transplant abuse in China. We have a joint website – endtransplantabuse.org – which posts our work as we do it. David Kilgour also has a website – www.david‑kilgour.com – which keeps up to date on this issue, also posting the work of all three of us.
We encourage readers, before they start this work, to read our previous works on transplant abuse in China. It is difficult, if not impossible, to appreciate an update without awareness of what is being updated. The information we have provided previously is not repeated here. Nonetheless, to make this text user-friendly we provide a brief recapitulation of our previous work here.
Bloody Harvest came out in three versions, first in July 2006, second in January 2007 and third, in book form, in August 2009. The first report was prompted by a request David Kilgour and David Matas received from an NGO to investigate a statement that a woman (given the pseudonym “Annie”) had made. Annie told the newspaper the Epoch Times in a story published in its March 17, 2006 issue: “One of my family members was involved in the operation to harvest Falun Gong practitioners’ organs.” The requesting NGO was the Coalition to Investigate the Persecution of Falun Gong. (This NGO is similar in name to the World Organization to Investigate the Persecution of Falun Gong, but is a different organization.)
Falun Gong, also known as Falun Dafa, began in May 1992 with the teachings of Li Hongzhi. The two Davids have described Falun Gong as a set of exercises with a spiritual and ethical foundation. Ethan Gutmann in The Slaughter states: “Falun Gong, simply put, is a Buddhist revival movement.”
In 1999 the Communist Party of China decided to repress the spiritual practice and its practitioners. Those who did the exercises after the repression campaign was launched were arrested and asked to denounce the practice. Those who did so were released. Those who did not were tortured. Those who still refused to recant after torture disappeared into the Chinese gulag – China’s network of labour camps, detention centres, psychiatric hospitals, prisons, and black jails, sometimes referred to as the “Laogai System.”
Chapter one of the book Bloody Harvest set out the methods David Kilgour and David Matas used to do their research. Amongst the methodological principles used were an insistence on looking at all evidence and a refusal to jump to conclusions based on only some of the evidence; a refusal to rely on hearsay or rumour or third party evidence; and an insistence that any evidence which the two Davids saw independent researchers could see on their own to form their own conclusions.
Chapter two set out contextual information, the general repression of Falun Gong. Whatever one concludes about the killing of Falun Gong for their organs, the vilification and brutalization of practitioners of Falun Gong in China is incontestable.
Chapters three and four provided some Falun Gong witness/victim statements. These statements showed, in chapter three, that many detained Falun Gong practitioners refused to identify themselves to the authorities. The non‑self‑identified were more numerous than the self‑identified and with rare exceptions, were never released.
These statements also showed, in chapter four, that Falun Gong practitioners in detention were systematically blood tested and organ examined. Non‑Falun Gong detainees did not experience similar tests and examinations.
Chapter five set out statements of patients who went to China for transplants. These statements showed that organs were available on short notice, in secrecy, with a heavy involvement of military personnel and institutions.
Chapter six looked at Chinese transplant hospitals. Many of these hospitals on their websites actively promoted transplant tourism, advertising easy, quick availability of organs, at high prices.
Chapter seven detailed calls investigators made to hospitals. The callers pretended to be relatives of patients who needed transplants and asked for organs of practitioners of Falun Gong. The reason for the requests was that the exercises of practitioners meant the organs would be healthy. Hospitals throughout China told the callers, in calls which were taped, transcribed and translated, that they had organs of Falun Gong practitioners for sale.
Chapter eight attempted to estimate the sourcing of organs based on Chinese government statements of transplant volumes. The estimate was that, from 2000 to 2005, at a transplant volume of the official figure of ten thousand a year, approximately 41,500 organs during those six years came from practitioners of Falun Gong.
Chapter nine looked at Sujiatun hospital, where Annie’s husband worked. Some investigators went to the hospital several weeks after Annie’s statement and found nothing. The chapter pointed out that this sort of investigation had little probative value.
Chapter ten set out work from other researchers on the subject. All the researchers corroborated the results of the two Davids.
Chapter eleven provided the responses of the Government of China to the evidence of the killing of practitioners of Falun Gong for their organs. The responses have been harassment, bullying, spying, disinformation, and anti‑Falun Gong propaganda.
Chapter twelve went through foreign laws on transplant tourism and Chinese laws on transplant abuse. The conclusion was that the laws which should have been in place to prevent the killing of Falun Gong for their organs and selling the organs to transplant tourists were not in place.
Chapter thirteen examined ethical codes of conduct of transplant professionals on transplant tourism and relationships with Chinese transplant professionals. The chapter noted that there had been substantial development in these codes since the first report of the two Davids, but that there was still much to do.
Chapter fourteen asked the question “How does one best combat human rights violations in China?” The answer given was to go after the worst violations first ‑ in this instance, the killing of Falun Gong practitioners for their organs.
Chapter fifteen addressed the Chinese Communist Party claim that human rights values are Western. The argument of the chapter is that human rights values are universal.
Chapter sixteen addresses the question “How do we end organ transplant abuse in China?” The chapter made a number of recommendations, one of which is the need for an institutionally‑based independent investigation into organ transplant abuse in China.
* * *
Ethan Gutmann devised a test to either confirm or reject the basic conclusions of Bloody Harvest: instead of relying on Chinese official transplant numbers, investigative phone calls, and other evidence that had previously come to light, the investigation would start with a blank page and attempt to fill the space with field research and witnesses who had never been spoken to. This created an environment where the goals of the investigation could be hidden from the subjects as well. Gutmann and his researchers Leeshai Lemish and Jaya Gibson ended up travelling across four continents, interviewing well over one hundred individuals over a six‑year period.
After his first ten interviews with Falun Gong refugees, Gutmann began to suspect that the conclusions of Bloody Harvest were true, and possibly even understated. However, Gutmann also wondered if evidence that only focused on the central question – “Are the allegations true?” – would fully persuade critical readers in the West. For example, it is simple common sense that murder requires a motive. Yet China is a complex culture; establishing a motive cannot always be reduced to a soundbite. Instead, Gutmann decided that, given a comprehensive history of the conflict between the Chinese Communist Party and Falun Gong, the readers themselves would be capable of answering certain basic questions: “Why did the Party attack Falun Gong? How did a relatively routine Party crackdown degenerate into mass murder?”
Critical readers might also want to understand how forced organ harvesting of prisoners of conscience began. So a new line of investigation was created focusing on the following questions: “Was Falun Gong the first victim group to be harvested? If not, how did the organ harvesting of prisoners of conscience begin? Was organ harvesting created as a “final solution” for Falun Gong or was it an improvised solution?
In August 2014, Prometheus Books published The Slaughter: Mass Killings Organ Harvesting, and China’s Secret Solution to Its Dissident Problem. Chapter one established that the first known cases of live organ harvesting – in essence, a surgeon extracting the organs from a living human being so that the surgeon becomes the executioner ‑ were performed in 1995 on the execution grounds of the Xinjiang Autonomous Region in Northwest China. For example, a Uyghur surgeon, Enver Tohti, recounted extracting the kidneys and a liver from a prisoner who had been shot in the chest with the objective not to kill the prisoner but to send the prisoner’s body into shock (and this update confirms that live organ harvesting using medical methods would actually become a routine procedure a few years later). The chapter also established that the first forced organ harvesting of prisoners of conscience – in this case, Uyghur Muslim activists – were administered in Urumqi, the capital of the Xinjiang Autonomous Region, in 1997. Another medical witness described being forced to administer blood tests of Uyghur political prisoners on behalf of a handful of aging, high‑ranking, Chinese Communist Party officials who needed tissue‑matched organs. Because the officials had travelled to Urumqi specifically for the operations, this can be seen as one of the first cases of “organ tourism,” albeit within China’s borders, while also underscoring that the Party was explicitly involved in the forced organ harvesting of political and religious prisoners from the very beginning.
It was during this period that the Chinese Communist Party began construction of the world’s largest labour camp in the Tarim Desert, where approximately 50,000 Uyghurs and hardened criminals (and ultimately Falun Gong) would be detained. Yet there was no guarantee in 1997 that organ harvesting would become the Party’s preferred method of eliminating prisoners of conscience, so the research question then turns from the “how?” to the “why?”
Chapter two is the first of six chapters that examines how the conflict between the Chinese State and Falun Gong evolved over time. Beginning in 1992, the chapter tracks various Falun Gong practitioners – a university student, a professor, a small business owner, and a female pensioner – to illustrate how the practice could spread so quickly throughout Chinese society and even into the upper echelons of the Chinese Communist Party. The chapter also reveals the testimony of a finance minister who is told to cooperate in the secret surveillance and repression of Falun Gong in 1996, demonstrating that the Party had already decided to eliminate Falun Gong and any remaining debate was largely over tactics. The author identifies three main factors in the Party’s decision to eliminate Falun Gong: its size (at least 70 million, and therefore slightly larger than the membership of the Party), its cross‑appeal (particularly in the upper echelons of the Party), and its values of truth, compassion, and forbearance (the nationalist wing of the Party believed these values harkened back to a period of Chinese weakness and thus were in conflict with China becoming globally dominant). The chapter ends in early 1999, shortly before the repression of Falun Gong became officially stated policy.
Chapter three traces the history of the Falun Gong crackdown from the spring of 1999 to the end of the year, when the repression was fully operational. The key points are that Falun Gong walked into several carefully laid‑out traps as the Chinese Communist Party prepared a massive public crackdown. The author also makes the controversial case that the crackdown was not the work of one man, President Jiang Zemin, but a systematic campaign with the tacit support of the majority within the politburo. It is germane to the development of forced organ harvesting in China that both the Falun Gong resistance and the lethal use of torture by state authorities had taken shape before the end of December 1999.
Chapters four, five, six, and seven follow individuals on opposite sides of the fence: an officer of the secret police, a prison camp director, and a series of Falun Gong practitioners demonstrating, printing leaflets, and hijacking television signals. The narrative of pursuit, arrest, torture, and, in several cases, execution, illustrates that Falun Gong was putting up an increasingly effective resistance ‑ even as the state’s structure of persecution was spinning out of control, and shedding any remaining inhibitions surrounding the mass exploitation of Falun Gong for their organs. The “self‑immolation” of Falun Gong practitioners on Tiananmen Square is also examined in detail, with the conclusion that it was not only a set‑up but a masterstroke of state propaganda.
Chapter eight takes a ground‑up approach to forced organ harvesting, focusing on Falun Gong practitioners who were given suspicious “retail organs only” physical examinations while they were in the Laogai System. What emerges is a picture of an organ harvesting regime that began giving discreet physical examinations of select Falun Gong practitioners in late 2000/early 2001, expanding into mass examinations (including Tibetan prisoners of conscience and the House Christian group “Eastern Lightning”) by 2003, and an organ harvesting regime wasn’t even being kept fully secret within the Laogai System by 2005. These findings are amplified by an extensive interview with an investigator (given the pseudonym “Crystal”) from the World Organization to Investigate the Persecution of Falun Gong, and an extended comparison with the findings of Bloody Harvest.
Chapter nine employs a top‑down approach to the evidence of forced organ harvesting beginning with the testimony of Dr. Ko Wen‑je, a Taiwanese surgeon who was offered Falun Gong organs from a Mainland hospital in 2005. (Dr. Ko subsequently ran for mayor of Taipei and during a heated campaign attempted to distance himself from his interview; the actual email correspondence between the author and Dr. Ko confirming his testimony is available for download at ethan‑gutmann.com). The evolution of Falun Gong harvesting after the Beijing Olympics is briefly explored, and there is also a detailed discussion of how organ harvesting played into the Chinese leadership crisis of 2012, specifically the revelation of how Wang Lijun (the right hand man to Communist Party leader Bo Xilai) experimented with mass organ harvesting in Liaoning Province.
Chapter ten explores the relationship between the growth of the plastination industry concordant with the acceleration of forced organ harvesting of prisoners of conscience in Liaoning province. Some of the evidence from that chapter will be referenced in this report.
Finally, an appendix estimates the number of Falun Gong killed for their organs between 2000 to 2008, based on in‑depth interviews of a sample of approximately fifty refugees from the Laogai System. Because the intention was to fill in the full history of the Falun Gong persecution, the author was not actively seeking out Falun Gong practitioners who had experienced an unusual physical examination in detention. The author also rejected accounts of “retail physical examinations” if the subject gave too little detail, had been on hunger strike at the time, was clearly influenced by talking points, or had experienced too much trauma.
So the author’s confidence was high that he had a genuinely conservative sample. However, the author’s confidence in his final estimate: a range of 9000 to 120,000 Falun Gong were killed for their organs from 2000 to 2008 was not as high, as the size of the range implicitly acknowledges. Nonetheless, the mid‑range number that Gutmann chose as his best guess ‑ 65,000 Falun Gong killed for their organs ‑ has been widely accepted in the press. The reason for this has less to do with the author touting the accuracy of the figure, and more to do with a deep human need to contextualize tragedy with a specific number or benchmark.
The need for an update
We felt the need to produce an update to what we have done, for several reasons, seven in all. One is the need to make our own assessment of transplant volumes.
In looking at the sources for organ transplants in China, we have, in the past, taken Chinese government official statements of overall transplant volumes at face value and focused on attempting to identify the sources for those asserted volumes. However, Chinese government statistics for transplant volumes are not necessarily reliable. One effort which needed to be made and which we finally have made is to determine on our own what Chinese transplant volumes are.
We did that by looking at and accumulating the data from the individual hospitals where transplants occur. Some hospitals state their transplant volumes. For those who do not, we can, from their bed counts, personnel strength, potential patient groups, rate of growth, technological development, academic publications, and media reports, come to a conclusion on their transplant volumes.
A second task, flowing from the first, was the need to address cover-up. Cover-up is a standard reaction to wrongdoing. Chinese Communist Party coverup is not a new story. But, because we are dealing new data, we consequently have to address cover up anew, attempts to hide individual hospital transplant figures.
Deception in the data limits the yield of research from that data. Because of the Chinese corruption of the data with which we are working, we cannot make specific numerical conclusions with complete certainty. Accordingly, our estimates of Chinese transplant volumes are not expressed in single integers but in a numerical range.
Despite the cover up and corruption of data, despite our inability to produce an exact figure, we are convinced that transplant volume is substantially higher than the official figure. The high volume led us into a third component of this update, to explore the driving factors behind these volumes.
Once we started looking at what is generating the volume, we had to look at the extent to which the Chinese Communist Party is in the driver’s seat, the structure the regime has built around organ harvesting, and the culpability of some individual Party members. The update accordingly addresses that topic as well.
Fifth, we analyze the Party’s claims of recent transplant reform. The Chinese regime announces changes regularly on organ transplant sourcing, some of which are real, while some are not. Because the Party has moved since our last published works, we too have to move, to assess their claims of change and attempt to determine how real those claims are.
A sixth new feature of this work is incorporation of whistleblower evidence. In the past, we have tended to avoid reproducing that evidence, even though we had it. We have to protect the identities of whistleblowers. That protection, while understandable, means that an independent researcher cannot identify and question the whistleblowers him or herself. Whistleblower evidence nonetheless deserves to be presented publicly, albeit with the identities of the whistleblowers disguised, if for no other reason than to encourage other whistleblowers to come forward. So it is presented here.
Finally, this update addresses plastination, in addition to organ sourcing, a subject we have mostly not addressed before. In the past, we have shied away from addressing plastination, because plastination is different from our focus, organ transplantation. Nonetheless, there is compelling evidence that practitioners of Falun Gong are killed for both plastination and organ sourcing. The evidence supporting each abuse is also evidence in support of the other abuse.
No one in the West has witnessed organ transplant abuse in China; yet a large number have seen plastinated bodies from China on display. Furthermore, plastinated body parts from China have been sold to medical schools and universities throughout the Western world. Plastination gives an immediate, widespread, publicly visible reality to the abuse that the killing of innocents for their organs cannot.
A Note on Methods Used
We have had the benefit of work by a group of Chinese‑language researchers to whom we express our profound appreciation. The researchers:
- reviewed data from telephone surveys, hospital websites, and medical journals for the 865 hospitals in China which perform organ transplants (about 13% of all hospitals);
- tracked 712 liver and kidney transplant centres and collected and analyzed information about them from media reports, public and government websites, current and archived hospital websites, and medical journals;
- examined individually 165 hospitals approved by the Government of China to conduct transplantation and set down their features, qualifications, revenue, potential patient groups, bed counts, personnel, transplant capacity and volume, research projects, relationships with other hospitals and parties, funding, patents, and awards;
- made phone calls to a number of the hospitals to verify their current organ transplant status and to cross check information about the hospitals the searchers had previously obtained; and
- summarized the policies and regulations of the Government on organ transplants, reviewed the history of the industry in China, and provided information on the state military and civilian institutions which enable the industrialization.
This update has to be read forward but understood backwards. The ultimate conclusion is that the Chinese Communist Party has engaged the State in the mass killings of innocents, primarily practitioners of the spiritually‑based set of exercises, Falun Gong, but also Uyghurs, Tibetans, and select House Christians, in order to obtain organs for transplants.
Even with the volumes of transplants the Chinese government has asserted in the past, there is a substantial discrepancy between the number of transplants and the number of sources which the Government of China has identified – prisoners sentenced to death and voluntary donors. This discrepancy is one reason, among several, that had led us in the past to the conclusion that the above groups have been the source of many, and indeed most, organs for transplants.
The fact that the evidence we have now examined shows much larger volumes of transplants than the Government of China has asserted points to a larger discrepancy between transplant volumes and Government of China‑identified sources than we had previously thought existed. That increased discrepancy leads us to conclude that there has been a far larger slaughter of practitioners of Falun Gong for their organs than we had originally estimated.
The update begins, in chapter two, by introducing the examination of individual hospitals. It addresses the volume of evidence, the feature of the evidence and the numbers and classifications of transplant centres.
Chapter three focuses on national approved military transplant centres. Chapter four considers national approved civilian transplant centres. In chapter five, we turn our attention to regional approved transplant centres. Chapter six concludes this examination of individual hospitals by looking at non-approved transplant hospitals and cornea transplant centres.
Chapter seven looks at indicators of total volumes of transplants in China besides the figures which come from looking at particular hospitals. These other indicators and the examination of individual hospitals tell us that the total volume of transplants in China is a substantial multiple of the official figures.
Chapter eight canvasses the various forms that cover up of transplant data takes and considers how that impacts on our own analysis. We address deletion of data, falsification of figures, underreporting and restriction of access to data as well as various pretenses used.
Chapter nine then looks at what is generating this volume. In this chapter, we address the Communist Party and the Government as volume drivers, but not the criminality of the Party /State.
Chapter ten calculate a range of possibilities for the total number of transplants performed in China since 2000. This chapter approaches the range calculation from a variety of directions in order to cross check the totals reached.
Chapter eleven sets out evidence that organ sourcing in China is criminal, that innocents are being killed for their organs. In this chapter, we focus on the evidence of the fact of a crime, without attribution to a particular set of criminals.
In chapter twelve, we address finally who is committing this crime -the Chinese Communist Party – and why. This chapter, in effect, explains all that has been presented before.
We have tried to avoid acronyms and technical terminology. Nonetheless, when dealing with a specialized medical field, such as organ transplantation, it is impossible to avoid all technical terms. We have, accordingly, provided a glossary.
We acknowledge that to begin the substance of a report with an accumulation of information drawn from the websites of particular hospitals and the biographies of particular doctors may not be gripping reading. Many of the phrases are translated directly from Chinese reports and websites; the language, however leaden, is preserved for accuracy.
Decontextualized, the presentation of this information may be mystifying. We ask the reader to keep in mind our purpose in presenting this material: to explore the scale and velocity of state‑sanctioned mass murder.
* * *
We understand the desire for a precise number ‑ particularly among the journalism community ‑ but we have collectively decided not to make such an estimate in this update; there are too many variables to make any new estimates other than annual volume of transplants and even that is expressed in a range. We are not in a position to come up with a specific figure of prisoners of conscience who have been murdered through organ harvesting.
Nor can we determine how many organs are extracted, on average, from each transplant source, although the evidence suggests that we are dealing with only one organ extracted from each donor source in many cases. China did not have any form of national organ distribution until 2013. The organ distribution system in place since 2013 is, according to Chinese officials, limited to organs donated voluntarily.
What we can say is that the evidence in this update suggests that our original estimates were far too low. And we can say that the end of this crime against humanity is not yet in sight.