Vital Views

Joe Gaccione 0:08
Hello and welcome to Vital Views the podcast for the UNLV School of Nursing. I'm Joe Gaccione Communications Director for the School of Nursing. Nursing can positively impact lives beyond the bedside and not just in local communities but international ones as well. UNLV Nursing Associate Professor in Residence, Dr. Kathleen Thimsen is helping fight on the global frontlines against human trafficking, specifically forced organ harvesting, which is exactly how it sounds, people are forced to donate their organs without consent, for patients who need transplants. This is an ethical and health violation in need of more awareness and advocacy. Dr. Thimsen is well versed in the subject having not only presented before on this, but her expertise includes forensic nursing, clinical practice, and community health. She joins us in the booth today to share her insight into this prevalent problem. Dr. Thimsen, thanks for joining us. Thank you.
Can you explain how this type of trafficking works? Where does the research show this happens most frequently?
There are a lot of countries that are involved in forced organ harvesting. Probably the most pronounced and well publicized is in the country of China, where forced organ harvesting is an accepted and considered legal practice. That is, the mechanism of the action of forced organ harvesting occurs in that

Kathi 1:33
ordinary citizens who are typically religious followers of either Taoist, Buddhist, or the Falun Gong, among some other religious practices. Those practitioners are literally arrested off the street. And they don't even take their names. They take basically a swab of the inside of their cheek in their mouth for their DNA, and they are incarcerated in a Chinese prison. The Chinese government waits until someone who is seeking an organ that would match the tissue type of that individual to determine the fate of the incarcerated individual.

Kathi 2:14
Once the potential transplant recipient and donor is identified, the recipient is then beckoned to come to China for what is considered organ transplant tourism. It's a form of medical practice. The government in China endorses this and actually makes quite a bit of money off of it, because as I said, it is legal there and operates under sanction of the government.

Kathi 2:33
These prisoners are the victims, that are selected, again based on their DNA to be organ donors very much against their will.
And when did you first get attached to this issue? So, I've been working with human trafficking, primarily sex and labor trafficking for probably close to seven years now. And this aspect was something I was aware of back about 20 years ago when I lived in Philadelphia, and that a lot of homeless people were found dead or near to death, in one of the parks in Philadelphia city proper. Individuals were victims of being abducted because they were homeless. Their organs were sought for transplant, which obviously, was an illegal practice here in the United States. But these are disposable people. So, I knew that the practice was in existence. And then fast forward to 2020. During the past seven years, I worked with MidAmerica Transplant in the St. Louis market, where I used to live and we did not see organ trafficking because occasionally working in trafficking or anti trafficking, I would ask their opinion on did they see any kind of organ trafficking in the Midwest, and we didn't see it in the Midwest, or even in the United States. However, about a year ago, year and a half ago, now, I was asked to work with a group called Doctors Against Forced Organ Harvesting. They've been around since about 2005. They've been nominated for Nobel Peace Prize a couple of times as their work is international. They've never had any nursing input into the practice before. But because I'm part of the Academy of Forensic Nursing, which is an international nursing organization,

Kathi 4:34
we were consulted to help them to advance their cause and to help to expand the voice and the message about forced organ harvesting because today there are many US residents who seek organ transplant outside of the United States primarily in China.
Is it because it's more affordable because it's more convenient? They don't have to wait

Kathy 5:00
because they have already supply of organs to be donated in China in the prisons waiting to be called upon to have organs taken from them. The cost is really, low, a lot less than it costs in the United States. If you look at the cost of kidney transplant here in the United States averages, probably about $80,000, and maybe a two to three year wait. If you seek out via the internet, any consumer can do this, from China through their tourism program. You can get a kidney within two weeks, and the cost is between 10 to $20,000.

Joe
There obviously legal and criminal implications with this despite China considering it legal, you could one could argue this is silly, a criminal nature. Legislators trying to pass laws to force to stop forced harvesting Congress's Human Rights Commission as discussed that I believe most recently, this past spring, they had it on their website, where do nurses and for that matter, any health professional fit into this?

Kathi 6:13
It's a good question. And it's multiple part answer. I think awareness of the practice is the first step.

Kathy 6:25
that's something that we at the Academy of Forensic Nursing are really trying to advance. I think second is to educate our patients and our colleagues who are medical practitioners here in the United States, I mean, whether it be a physician who's taking care of a patient as a primary care provider, or nurse practitioner, for that matter, in their office, perhaps

Kathy 6:50
a patient who is a transplant recipient, or who's considering going abroad for transplantation of whatever organ they need, we need to educate patients about where those organs are coming from. And the fact that,

Kathi 7:06
you know, one of the mechanisms of action to retrieve these organs is that it's very much an inhumane and very unethical practice, just from the face of it. But when you get down into the details of it, these patients are going through extreme torture when they are taken to the operating room to have their organs harvested.

Kathi 7:32
There are two types of sedation that are given to patients undergoing any kind of surgical procedure. One is to paralyze the body and second is to give them a medication for awareness. So, they're not aware of what's happening. In the case of these victims of forced organ harvesting in China, where it's been publicized, and there has been a lot of medical practitioners from the US and across the world, who have actually witnessed these procedures, these patients are paralyzed, so they cannot move, but they are awake, they are not given any medication for awareness or sedation, from that respect, and as a result of that, they can see and know what's coming next. As your body undergoes a situation of preparing for flight or fight that causes a perfusion of your circulatory supply to your vital organs, your lungs, your heart, your brain. These organ donors are aware of what is going to happen to them and the fact that the organs that are taken have such a vast increase in the amount of blood flow, that they're healthier as a result of the that flight or fight syndrome and the increased amount of circulation to those organs. So ,the rejection rate potentially could be lower because of the high perfusion rate of the blood.

Kathi 9:11
You know, another aspect is that there's a lot of unknown

Kathi 9:16
use of any kind of organ or tissue procurement process. One example, I was recently at my dentist and we got into a conversation about her use of cadaver bone for dental use, whereby they pull a tooth typically and you need to regenerate bone grow so they'll sprinkle cadaver powder, bone powder into your mouth. And I said to her, where do you get your product from? She's like, well, the dental supply company. I said go get the package we had been talking about.

Kathy 10:00
She went and got a package of cadaver bone. There was no country of origin listed on the package. And I said to her, probably this was from the bones of one of the victims of organ harvesting, because that's what they do after they take the organ, the vital organs that they need. Then the second step of that is if the patient dies on the operating table, they'll take their bones, their corneum, their skin, whatever to be sold again, as this is another type of tissue harvesting, and used as illegal and unethical tissue transplant. My dentist had no idea of the practice of tissue procurement that may involve forced donations. I know other dentists across the country that I've had this same conversation with,
Kathi 10:49
unknowingly, they are using these kinds of products. How would you, if you receive it from a supply company, you wouldn't think twice necessarily, you would just assume it's from a reputable source, you would think. However, there are no import laws relative to the labeling, and the notification if a product is produced outside of the United States. We have certain manufacturing standards for drugs over the counter drugs, and even cosmetics. But products being brought in from outside of the US don't always have requirements

Kathy 11:28
to comply or be aligned with our US production guidelines. So, there's two sets of standards, one if you're a foreign made product, and two, if you are a product made in the US and the I speak from to that on several levels, I did some research probably 20 or 30 years ago now on gauze products that were manufactured in the Pacific Rim that have a whole different level of sterilization requirements put upon them.
Kathi 12:01
US based manufacturers of products for medical use are held to high standards for sterilization. Pacific Rim manufacturers are not held to those standards and have very low thresholds for sterilization. The same thing applies to gloves. It very different regulatory requirements.
I want to take a step back, kind of look more big picture forensic nursing for people that aren't aware of what forensic nursing is, can you talk about this, this specialty, and how it ties back into a subject like forced organ harvesting?
Sure. Forensic nursing is a relatively new specialty within nursing. It's about almost 30 years old, but it's it is still relatively new in terms of the numbers, there's probably about 12,000 Forensic Nurses,

Kathi 12:51 not just nationally, but internationally. We focus on working with persons who have had their lives impacted by some form of violence, whether that's interpersonal violence, whether it's by nature of a crime that's been perpetrated. And in this case of forced organ harvesting, you know, the patient is very much exploited. So, we deal with all sorts of

Kathi 13:19
conditions of the human spirits, so to speak, relative to however, their lives have been impacted by that aspect of what violence is in that realm. So that could be from anywhere across the lifespan. From a pediatric or a child perspective, all the way to the elderly. You have child abuse, you have child sexual assault, you have child trafficking, you have domestic violence, you have interpersonal violence, you have gunshot victims, stabbing victims. Strangulation is another area that in the last 10 years is really becoming a new sub-specialty. There's a lot of unknowns about strangulation because you can't see the injury.
Kathi 14:08
The use of alternative light sources which Forensic Nurses have really taken the lead on,
Kathi 14:16
really identifying and validating the importance of using alternate light to identify at the time a patient presents after being strangled. If, of course, if it was non-fatal strangulation, if it's a fatal strangulation, even corners are using alternate light source to identify the trauma that's occurred in people and then it includes a wide variety of other forms of violence and any kind of financial exploitation and elder abuse,
Kathi 14:50
disabled adult abuse, so it's a wide spectrum, even disaster management and emergency preparedness death investigation.
Joe 15:00
There's sub-specialties within forensic nursing. It's not just about the care and the treatment. It's also about the victimology and the offender, correct?
Correct. We have another faculty member here at UNLV, who's probably the grandfather of Forensic Nursing. His specialty is in gangs, and in childhood victimization, and perpetration and grooming into gangs. So, we really do look at,
Kathi 15:34
you know our patient population from not only what care we have to give, but what are preventative interventions we can put into place and then what are programs that we can put into place to improve and empower the persons to really recover and become resilient and thrive after being victimized.

Joe
Now, this October, you're set to speak on forced organ harvesting at a global nursing Summit. Can you talk a little bit about that?
Kathi
Sure. This is a collaboration between the Academy of Forensic Nursing and Doctors Against Forced Organ Harvesting. And, as I said earlier, nurses haven't historically been involved with Doctors Against Forced Organ Harvesting. And last year,

Kathi 16:23
another colleague of mine from Baltimore, and myself were the two nurses who were asked to present at the United Nations with Doctors Against Forced Organ Harvesting in a Global Medical Summit. This year, we're partnered the Academy and Doctors Against Forced Organ Harvesting, to do the first Global Summit for Nursing relative to forced organ harvesting. I'm one of the three program planners. And I'm very pleased to say we have everything covered from the epidemiology of and the data that supports the need for advocacy and policy related to forced organ harvesting. We also have speakers ranging from a survivor of being arrested, as she was a Falun Gong practitioner, and was incarcerated. For whatever reason though, she was let go. She sought asylum here in the US and with appropriate protections of her identity, she will tell her story.
Kathi 17:30
We'll also be talking about this human rights violation from ethical and legal perspectives.
Kathi 17:39
We will discuss prevention and education of consumers, as well as our healthcare colleagues in nursing and other medical specialties. Because this is really something that people haven't heard a lot about. But the problem is such an issue with China, in that they are going to be probably leading the globe in terms of the numbers of kidney transplants that are being done there that are forecasted to outpace what we're doing here in the United States. And that's a concern to the global transplant industry based on the legality yet, unrestrained human rights violations and the Chinese methods of
Kathi 18:30
procuring those organs. This is problematic as it could change the world’s ethics and the whole complexion of transplant medicine, even here in the United States.
Joe
And that must be challenging that because they consider it legal.
Joe 18:46
You can only do so much you can raise awareness, you can advocate against this practice, but you would need larger forces to help make an impact.
How do you suppose or how do you propose? Like how do you get leaders, world leaders, political leaders, as a community health community to help rectify this to change this?
Kathi 19:15
You know, that's an excellent question. If I had the answer to it I probably wouldn't be sitting here today. But we wouldn't be talking about the problem. But you know, forced organ harvesting is one human rights violation of many that occur. Given our work with the United Nations last year, we ended up having over 600,000 people attend. I think we had 400,000 people attend the Summit and then another 200,000 signed on to the archive sessions that we gave and those were eight hours it was an eight-hour seminar.
Kathi 19:53
You know, we've had conversations with a lot of countries who I can't even name. In those countries because of confidentiality, with those leaders, but
Kathi 20:06
the problem is that China has is a huge global economic force, and every country has some degree of
Kathi 20:18
relationship with them. I will say that in the conference last year, I met several faculty from a number of different academic institutions across the country. And I have to applaud several of them, because their schools, their universities have actually taken a stance against admitting students into surgical our nursing rotations from certain countries, ie: China, because they don't want to be involved in training the next generation of clinicians that are doing unethical things, because they have to.
Kathi 20:59
I have a colleague, I've known him for, I don't know, 10 years now, who is the head nurse of a very large Taiwanese hospital, and he runs the operating room there, and they do about 2000 surgeries a day. If you can imagine that. Most hospitals don't do that in a week. But they do it in a day. And I asked him if he would speak at the global conference in October. He has had experiences with post operative care of transplanted patients (who had received organs from un-consenting donors in China), but he could not put his family in jeopardy, because even though they're in Taiwan, there's still a lot of personal danger that you put yourself in, by speaking out about this practice that goes on in China.
Joe
Where can people find out more information about this? We mentioned before the Human Rights Commission, which it's, it's online, but what are some other resources people can use to do the research themselves.

Kathy
So putting, you know, doing a search, going to a library and getting a search. There's a lot written about it, but a lot that isn't written about it for a number of reasons, you can visit the Academy of Forensic nursing website, we will be putting some our position paper up about that. And that's GO afn.org. You can also visit doctors against forced organ harvesting.org, for additional information, and you can read the global declaration that we put together and was signed by hundreds of 1000s of people last year after the conference, because that was the first international conference. And being online, I think it got a lot more legs, so to speak, to have attendance be so proliferative. So those are a couple of sources. And hopefully, once I get more of the details, I have a wonderful marketing department here at UNLV School of Nursing. So I'm sure that when we get the date finalized, and the speaking agenda, organized, that we'll be posting something on our website about that. Sounds good. Is there any final message to give whether it's for up and coming nurses, healthcare professionals in general, or just the general audience about this issue? I think educating yourself

Kathy 23:30
as an individual first and speaking out for victims who don't have a voice, I mean, I can't even imagine I don't think any American could imagine walking down the street and just being pulled aside, handcuffed, have a swab taken in your mouth, being put into a police car and put in jail and you did nothing wrong, except practice your religion. I think that's the biggest thing is trying to understand that. And if you have the opportunity to have to state

Kathy 24:06
to send a letter to call your congressman or your senator.

Kathi 24:11
That would be what I would say to do you know, one of the things that we're going to be doing is trying to figure out a place for healthcare providers to call in and report these kinds of crimes to about our patients that come back from China,
Kathi 24:30
or who are considering going to China because we don't have good numbers of how many people go there and then they come back, and they must be cared for. You know, and maybe that's something the insurance industry has to really start to address along with Medicare and Medicaid to have some kind of a reporting mechanism because we all end up paying for this. But that's one way to get a handle on how many people it is impacting from our US soil.

Joe 25:00
That's all I have today Dr Thimsen, thank you so much for joining us thank you
Transcribed by https://otter.ai