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Analysis: Is North Korea moving toward a post-totalitarian regime?

By Philippe Pons

LE MONDE/Worldcrunch

Beyond the eye-catching anecdotal – Kim Jong-un and his wife linking arms while attending a Walt Disney show at the opening ceremony of a theme park – one may seriously begin to ask if North Korea is quietly shifting toward a post-totalitarian regime.


The answer to that question won’t come from Pyongyang: the propaganda media have just swept away all speculations over the country initiating “reforms”, referring to them as “hallucinations” – a statement that is not to be taken literally as the politically loaded word “reform” is prohibited in Democratic People’s Republic of Korea (DPRK). Since everything in the DPRK is “perfect”, those can only be called “adjustments.” Yet, it is undeniable that the country is changing. But to what extent?

Since Kim Jong-un’s ascent to power after his father’s death last December, the DPRK has been trying hard to polish its image. That was the goal of the PR operation organized last April to celebrate the 100th anniversary of the birth of the “eternal President” Kim Il-sung (1912-1994) and covered by hundreds of foreign journalists. But the regime is mostly concerned with internal affairs: economic recovery and social stability.

North Koreans were badly hit by the 1995-1997 famine (from 600,000 to one million deaths) and the economic collapse. The population is still experiencing shortages and the government can hardly push for any more sacrifices, especially since the new leader’s coming into office yields so much hope for Koreans.

Kim Jong-un’s obvious resemblance with his grand-father is no accident: for many North Koreans, the Kim-il Sung era, especially during the 1970s and 1980s, is still regarded as a Golden Age: people, including those who fled south of the border, still feel nostalgic about the modest yet decent life enjoyed by most at the time. In his first public speech last April, Kim Jong-un promised that North Koreans “will never have to tighten their belt again.”

According to the South Korean news website Daily NK, recent developments suggest that North Korea is changing: the country recently revised its law on foreign investment – as new projects like special economic zones with China are in progress – and announced “a new economic management system in our own style.”

Adjustments and reforms

This new management system, as it was with the July 2002 “adjustments” which granted more autonomy to state-run companies and initiated salary deregulations, claims to be neither based on the Chinese nor the Vietnamese model. It should have a big impact on agriculture and industry. In 2002, the DPRK ended up freezing “reforms” because of growing tensions with the United States, which only led to more isolation for North Korea and was marked by two nuclear tests in 2006 and 2009.

The current evolution seems to be confirmed by the rehabilitation of two of the main initiators of the 2002 measures – Roh Du-cheol, former vice prime minister and Pak Pong-ju, who served as director of the ministry of light industry. Economic affairs have been handed back to the cabinet, which had been replaced in its decision-making role by the army.

The recent sacking of Vice Marshal Ri Yong-ho as head of the Korean People’s Army illustrates the will the give more responsibilities to civilian institutions (the party and cabinet), a move he himself would have certainly opposed.

During Kim Jong-il’s era (1994-2001), the military enjoyed special treatment, as showed by the “Army First” slogan. With 1.2 million members, the army was seen as the legitimate heir of Kim il-Sung’s anti-Japanese guerrilla and maintained a considerable power. It has also been an economic stronghold. The army is financially independent and receives funding from factories, agricultural cooperatives and trade houses (which are in charge of arms and mining exports). The military benefited from the underground economy, which has developed this past ten years and now co-exists with the planned economy.

This de-facto “free-market” underground economy is difficult to measure but is believed to account for 50% of North Korea’s total supplies. It has led to deep and irreversible social changes. The rise in participants, the creation of a business class and the growth in corruption has made society more flexible and weakened the coercive system. As more Chinese goods enter North Korea, more information also flows in.

In 2002, the regime tried to get on top of this chaotic free market, created to meet the needs of the starving masses, by implementing reforms. Yet from 2005 onward, the government decided to fight the system but failed to eradicate the growing business activity. Even though the state has a very efficient repressive instrument (between 150,000 and 200,000 civilians are held captive in work camps), it cannot afford to tackle the underground economy without worsening the country’s situation.

A new economic system aimed at offering better living conditions and regulating the underground economy is likely to be implemented but North Korea has only just begun to improve its ties with the rest of the world.

Read the original story in French.

Photo- John Pavelka

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Dallas uses aerial attack to fight West Nile virus

The Texas Department of State Health Services said the aircraft covered 52,000 acres of Dallas County on Thursday night, opening a new front to stop the spread of West Nile Virus.


“Aerial spraying is a safe and very effective tool, but it doesn’t take the place of the basic precautions,” said David Lakey, the head of the health department.

“We are urging people to continue using insect repellent every time they go outside.”

Four more aircraft were to resume spraying later Friday, and residents were cautioned to avoid going outdoors, keep pets inside, cover ornamental fishponds and rinse off homegrown fruits and vegetables.

Throughout the state 465 people have been sickened since the start of the year, putting it on track to have the most cases since the disease first emerged a decade ago, the department said.

The county incorporating Dallas, the ninth-largest city in the United States, has been the hardest hit, prompting the mayor to declare a local state of disaster on Wednesday.

“The city of Dallas is experiencing a widespread outbreak of mosquito-borne West Nile virus that has caused, and appears likely to continue to cause, widespread and severe illness and loss of life,” Mayor Michael Rawlings said.

The virus has claimed ten lives in the county so far, local and state health authorities said.

First discovered in Uganda in 1937, the virus is carried by birds and spread to humans by mosquitoes.

Severe symptoms of the virus include high fever, vision loss and paralysis, while milder symptoms range from headaches to skin rashes.

At least 693 cases — both confirmed and probable — of the virus have been reported in the United States this year, including 26 deaths, according to the Centers for Disease Control and Prevention.

Texas tops the list in both total cases and fatalities.

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Prudish Vietnam makes its coming cut

A colorful affair (iboy.



By Bruno Philip

LE MONDE/Worldcrunch

BANGKOK – About a hundred cyclists streamed the streets of Hanoi on August 5 waving rainbow pennants and yelling “Support gay marriage!” Good Lord! Has prudish Vietnam initiated a sort of ‘social coming out,’ even before turning to democracy?

The fact is that the Socialist Republic of Vietnam, a tightly controlled single-party state still shaped by Confucian conservative values, has just experienced its “first gay pride.”

Despite lacking full official approval from authorities, the event went smoothly. Even if it failed to cause euphoria in the picturesque streets of Vietnam’s capital city, the event can be seen as a step forward towards openness, confirmed a week earlier by Justice Minister Ha Huong Cong’s statement: “I think, as far as human rights are concerned, it’s time for us to look at reality. The number of homosexuals has grown to hundreds of thousands. It’s not a small figure. They live together without registering marriage. They sometimes own property. We have to handle these issues legally.”

Experts have real doubts over Vietnam legalizing same-sex marriage in the near future. However, Vietnamese MPs are expected to debate next year over a bill that could grant a special legal status for same-sex couples. “In South East Asia, the issue of same-sex marriage has never been addressed, not even in Thailand. What is happening in Vietnam is a surprise for a lot of people,” says sociologist Le Quang Binh. Unlike Malaysia, Indonesia and the Philippines where Islam and Catholicism prevail, there is no major pressure group that could act as a barrier to gay rights in Vietnam, the researcher points out. Nevertheless, only a few dare to come out, as homosexuality is still regarded as deviant behavior in most Vietnamese families. “I’m sad I can’t tell my mother about who I really am,” said a twenty-year old lesbian while taking part in the parade with her partner.

The regime’s tolerance towards the issue may seem surprising in a country where political dissent is fiercely repressed. Yet as Phil Robertson, deputy director of Human Rights Watch’s Asia division points out, homosexuality is “a social reality which does not threaten government stability.” Similar gay marches recently took place in Singapore, Laos and Burma, three countries that can hardly be described as triumphant democracies.

In ultra-prudish Malaysia – where sodomy can result in up to 20 years in jail – gay pastor Ngeo Boon Lin even dared to hold a banquet in Kuala Lumpur on August 4 to celebrate his marriage with his partner Phineas Newborn. Yet the official ceremony had taken place in New York in September 2011.

Read more from Le Monde in French.

Photo –

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Clown had Steve Jobs’ stolen iPad

Kenneth Kahn, also known as Kenny the Clown, says he unwittingly received the stolen tablet from a friend who was later arrested for breaking into the Jobs residence in Palo Alto, the San Jose Mercury News reported on Friday.


“It would be like getting a football from Joe Montana that was stolen out of his house,” Kahn said. “If this thing weren’t so tragic, it would be comical.”

Kahn said he had the iPad for a few days before police came asking for the purloined tablet, which was returned to the Jobs family.

The professional entertainer said he never examined the device’s contents. Instead he downloaded the “Pink Panther” and other songs to play while entertaining kids and tourists during his clown routine.

Kahn said had no idea where the 64GB iPad came from until his friend, 35-year-old Kariem McFarlin of Alameda, was arrested on August 2.

Apple investigators identified McFarlin after he used his iTunes account to connect to the internet with the stolen devices, police said. He confessed to police that he broke into Jobs’ residence, as well as other homes, and wrote an apology letter to Jobs’ widow, according to the police report.

McFarlin targeted the unoccupied Palo Alto home on July 17 because it was under renovation, authorities said. When construction crews left, he hopped a fence and found a spare key, according to the Mercury News. The suspect apparently didn’t realise he was in Jobs’ house until he saw a letter addressed to the Silicon Valley icon.

During a 15-hour overnight heist, the suspect took Jobs’ wallet and driver’s licence as well as iPhones, iPads, iPods, Mac computers, Cristal Champagne and $US60,000 ($A57,300) worth of Tiffany jewellery.

McFarlin sold some of the jewellery to a Pennsylvania dealer and gave the iPads to a daughter and a friend, according to the report.

Kahn, who unsuccessfully ran for mayor in Alameda and San Francisco, met McFarlin when he coached him on a high school basketball team in Alameda more than a decade ago.

“He’s a nice guy who made a horrible, horrible decision,” Kahn said. “Before the public sees him as this horrible monster, I’d like to hopefully think we can somehow get across that he just made the worst mistake of his life.”

McFarlin remains jailed on $US500,000 bail and is expected to appear in court on Monday. If convicted, he faces almost eight years in prison.

The Santa Clara County Public Defender’s office, officially representing McFarlin, declined to comment, according to the Mercury News. McFarlin has recently hired a private attorney who wants to remain anonymous until Monday’s hearing.

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After deadly attack in Egypt’s Sinai, bedouins wonder who will protect

Sinai Bedouin (Claus Rebler)

By Heba Afify

AL MASRY AL YOUM/Worldcrunch

RAFAH – Those living in Rafah have military forces responsible for securing the border at their doorsteps.


While this should provide extra protection for the locals, on Sunday, it was the locals who struggled to save the soldiers undergoing a brutal attack.

The failure to prevent an attack on a military checkpoint, carried out by unknown militants, and the slow response of both forces on the ground and officials stand as a staggering demonstration of the ongoing security vacuum in Sinai, Egypt’s strategic eastern gate.

While local media and politicians alike are busy mourning the deceased soldiers, and sounding alarms about the rise of terrorism in the Sinai, there is little attention to the broader failure of the state on the peninsula, locals say.

As they were getting ready to break their Ramadan fast, leaving the watchtower vacant, soldiers at a military checkpoint situated two miles away from the Karam Abu Salem border crossing were attacked by unknown militants who killed 16 soldiers and injured seven others.

Witnesses said the attackers came in three cars, shooting the soldiers and stealing a military tank. The tank headed toward the Israeli border and was destroyed by Israeli aircraft seconds after crossing into its territory.

Those residing near the attack site who rushed to the scene to help the injured soldiers said they had to act on their own, and faced a lack of cooperation from military forces stationed at checkpoints set up every few miles inside Rafah.

Bassam Ouda, who was among the locals who transported the bodies to Rafah Hospital in their personal cars, said the military forces in nearby checkpoints refused to help them.

“We told the officers to come secure us while we got the injured soldiers. They refused, saying that they hadn’t received such orders and couldn’t desert their posts,” Ouda said.

Witnesses said ambulances arrived after locals had already transported most of the bodies and the injured soldiers to Rafah Hospital, and that military forces arrived at the site after the attack had finished and the perpetrators had escaped.

Mohamed al-Moattar, a shop owner who lives near the site, said that members of different tribes were still chasing the attackers on the loose. He said this has always been Sinai’s version of law enforcement, which lacks any reliance on the police.

Slow action on the ground was mirrored by similarly slow reactions on the official level. President Mohamed Morsi only issued standard statements following the attack and failed to show up to the soldiers’ military funeral on Tuesday.

A failing state

Many who witnessed the attack are saddened by the difference between the slow reaction on the Egyptian side and the swift response on the Israeli side, especially with reports in the Israeli paper Haaretz that Israeli officials had warned the Egyptian government of possible attacks. There are reports that Israel evacuated its citizens from the area two days in advance.

Saleh Abu Lefeita, a car dealer and a Rafah community leader, said the government had evacuated some residents on the border 20 days prior to the attack.

Many locals complained this is not the first time military forces have failed to take the necessary action. Locals said the many Rafah checkpoints are only for show, as extremist groups train out in the open and goods smuggled into Gaza through illegal tunnels pass right through the checkpoints.

Last month, two soldiers were shot at another Rafah checkpoint, and in August last year, Israeli forces killed five Egyptian security officers on the border, triggering a temporary diplomatic crisis. In another demonstration of loose security in Sinai, the pipelines delivering gas to Israel have been bombed 15 times in the last year and a half.

Sunday’s attack escalated security fears for Sinai residents. Sawsan al-Ayesh, who lives next to the attack site, left her home and took her children to her mother’s. When the attackers threw what seems to have been a smoke bomb, Ayesh thought her house was going to be blown up with her and her children in it.

“We used to feel safe, with the military around us. Now we’re scared and we can’t go back home. We’re scared that we’ll get blamed for this while we are in the line of fire. These soldiers are family for us,” she said.

The incident has caused renewed calls for the modification of the three-decades-old peace treaty with Israel, which allows Egypt only a limited number of soldiers on the border, with meager arms.

Pillars of security

Locals vehemently denied early reports that the operation was a joint effort between Palestinian factions and Sinai Bedouins, saying that while Bedouins could have been hired by the perpetrators to help them, they couldn’t have been involved in planning the attack.

“People here may get involved in individual acts of violence related to revenge, but this kind of organized operation doesn’t happen in this area,” Abu Lefeita said.

The incident has also triggered anti-Palestinian sentiment among Bedouins in Sinai who blame Palestinian factions.

Many witnesses said they recognized the perpetrators’ Palestinian dialect and that they were repeating jihadist chants as they carried out the operation.

Morsi has been criticized for opening up the Rafah crossing, a decision that was reversed following the attack.

Saeed Hamad, an elderly Bedouin whose house is across from the attacked site, cried as he recounted how the locals were unable to come to the rescue of the soldiers after they were shot.

“These are our children that died. This is an Israeli plot, we would be fools to think otherwise,” said Hammad.

Read the full article, which was originally published in Egypt Independent’s weekly print edition.

Photo – Claus Rebler

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Who can get a fair trial in China? A visit to Foshan Detention Center

Behind bars (photoverulam)

By Zhang Yansheng*


FOSHAN – As a professional criminal defense lawyer, I have been to detention centers everywhere.


They are of course all different, but at a recent first-time meeting with a criminal suspect he was separated from me by frosted glass.

Because I had come all the way from Beijing, the pre-trial official of the Public Security Bureau at Foshan City, Guangdong Province was very straightforward and agreed to “accompany” me to the meeting the following day.

The center, which is situated in the Nanhai District of Foshan, greets visitors with a very tall gate. The road in front is wide with large, dense trees on either side.

The detention center looks quite impressive.

Like a lot of other family members and lawyers waiting for their planned encounter, I squatted at the roadside under the shade of the trees and waited for their opening hours after the lunch break. It didn’t take long before the pre-trial policeman arrived in his official car. I followed him into the reception room.

After some formalities I was led in to the innermost interview room at the end of a narrow corridor. The room was very old and no bigger than about six or seven square meters, separated into two parts. The larger part is for the lawyer and occupies two-thirds of the room, equipped with one broken desk and two chairs on which you can barely sit near the inner side of the room.

The lower part of the partition wall is made of brick while the upper part is completely sealed by a transparent frosted plastic board, turning yellow with age.

At one side of this partition is a wobbly door. On the other side is where the prisoner sits. It’s a long but very narrow inner room. There is no ventilation whatsoever.

We heard a noise, and suddenly all the criminal suspects appeared escorted by guards.

“Here they are!” roared the pre-trial policeman. A small and pale criminal suspect walked towards us with quick, short steps. “In you go! In you go!” The policeman’s voice echoed in the tiny meeting room. Once the small pale man had gone through the wobbly door, he was shut into the small, unventilated space.

“Hello. Are you…?” I said, pronouncing his name quite loudly toward the plastic board while staring hard in an attempt to recognize the person inside. But I couldn’t see clearly at all through the frosted glass separating us.

The obscure shadow made some echoing noise. Like when the egg white and yolk have been beat together, everything was impossible to separate. Some sound emanated from the door crack. I couldn’t understand a thing.

“”Hey, I can’t hear you…get closer! I cried out loud to the blurred shadow. Out came another series of turbid cries of the voice, before I saw a vague face pressed up against it. I could hardly distinguish his nose, let alone other parts of his face.

It was extremely hard to have a conversation. Almost every sentence was to be repeated many times. The interview dragged on like this.

Our time was almost over. Our dialogue was still floating somewhere in the cloud. Finally, the policeman accompanying me saw it was all so unbearable that he suddenly yanked open the door. The noise from inside suddenly rushed out. I gasped a big sigh of relief. Even though there was still an echo I could at last hear the person clearly. I felt so exhausted after 30 minutes of desperately trying to see the person during the whole interview. Of course, I knew the person inside must have been far more anxious than I was. The lawyer he had long waited for had finally come, yet he couldn’t even see what I looked like.

It has been more than a month since I came back from Foshan City, but I just can’t wipe that blurred face and muddy voice from my memory. A colleague laughed at me by saying, “You were not there on a date. What does it matter that you didn’t see the person’s face?”

But yes, we are often forced reluctantly to work under such conditions and people much too often accept it as normal. But has anyone thought about how many wrong verdicts have come about because of such tough conditions? How many have lost their lives unjustly because of these restrictions?

In the detention center, ripping away those plastic boards and replacing them with steel bars would have transformed the way the lawyers meet their clients and would have made the meeting much more productive. Effective communication would be beneficial to the criminal proceedings themselves, but would also show criminal suspects that they are fairly treated. Would the detention center ever think to allow that?

*Zhang Yansheng is a criminal defense lawyer who writes for Caixin media.

Read more from Caixin media in Chinese

Photo – photoverulam

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US party conventions approach

Polls show a razor’s edge separating the US presidential candidates as Republicans assemble next week to formally anoint Mitt Romney as standard-bearer and sign on to his promises to cut the US deficit, shrink government and cut taxes.


Romney brings with him Paul Ryan as his vice presidential choice, a politician best known as author of a Republican plan to slash spending for social safety net programs and to fundamentally change the country’s half-century-old Medicare program, which is government health insurance for Americans over age 65.

President Barack Obama, polls show, maintains a slight lead over Romney even though the incumbent receives significantly lower marks for handling of the struggling economy, the top issue among US voters.

That may be a result of the president’s campaign having largely avoided the larger economic issues for nearly a month now.

Obama managed to keep much of the campaign focused on Romney’s gaffe-filled trip overseas, the vastly wealthy Republican’s refusal to release more than just two years of his federal returns, and on Ryan.

The Republican vice presidential pick is a darling of the hard-right tea party wing of the Republican party, and his vision for the future of Medicare has stirred a tumultuous debate over the beloved program.

Much as Republican Senator John McCain did four years ago in choosing Sarah Palin as vice presidential running mate, Romney is believed to have turned to Ryan as a way of solidifying his support among the conservative Republican base.

The increasingly deep conservatism that marks the party has made it difficult for Romney, who had a moderate record as governor of Massachusetts, to generate much excitement among Republicans.

Both sides will continue trying to inflict bruising punishment on each other in the week left before the Republicans officially nominate Romney and Ryan. Then the Democrats assemble in North Carolina for their party jamboree to celebrate Obama’s run for a

second term with Vice President Joe Biden.

Brutal as the campaign already is, it promises to grow even nastier once the conventions are done and Romney-Ryan and Obama-Biden begin the final two months of battle before the November 6 vote.

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Belarus recalls diplomats from Sweden: Asks Swedes to leave



Belarus announced on Wednesday it was pulling all of its remaining embassy staff from Sweden and gave Swedish authorities until August 30 to withdraw their own diplomats from Minsk.


The move worsened a disupte about a pro-democracy teddy bear drop over Belarussian territory in July that embarassed authorities and further strained relations with the European Union.

Reuters reports that Belarus had already expelled Swedish ambassador Stefan Eriksson on August 3 after the teddy bear incident, in which a Swedish public relations firm parachuted 800 toy bears into the country with messages urging authorities to respect human rights.

In retaliation for Eriksson’s expulsion, two Belarussian diplomats were expelled and a new ambassador to Sweden was refused entry after the previous one left his post several weeks before, according to the Local. The Belarussian foreign ministry accused Sweden of worsening the dispute with these decisions, which prompted Wednesday’s announcement.

Belarus President Alexander Lukashenko has been in power since 1994. His harsh policies towards the opposition have strained relations with the West and the European Union, according to Reuters.

Swedish Foreign Minister reacted to Wednesday’s announcement on Twitter.

Lukashenko is now throwing all Swedish diplomats out of Belarus. His fear of human rights reaching new heights.

— Carl Bildt (@carlbildt) August 8, 2012

We remain strongly committed to the freedom of Belarus and all its citizens. They deserve the freedoms and the rights of the rest of Europe.

— Carl Bildt (@carlbildt) August 8, 2012

Last week Stefan Eriksson was expelled for meeting with Belarussian opposition groups, according to the Local.

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Mali: New government formed after coup

Mali’s interim leaders have announced a new government months after a military coup allowing an Islamist takeover of the country’s north and forcing nearly half a million people to flee homes.


The government has 31 ministers, including five said to be close to coup leader Captain Amadou Sanogo, who nominally handed over power to a civilian interim government months ago but still hasn’t relinquished control.

None of the ministers in the new government are closely linked to the democratically elected president who was ousted in March, according to the list announced on state television on Monday.

West African leaders had threatened to expel Mali from their regional bloc and impose sanctions if it failed to assemble a unity government as promised.

The country’s interim leaders had already missed an August 10 deadline for doing so, raising concerns about the political transition, with rumours also swirling about the interim prime minister’s ties to the coup leader.

Critics wanted Mali’s unity government formed as soon as possible, hoping it could better fight radical Islamists now ruling the vast north, an area the size of France.

The militants have solidified their hold amid the power vacuum in Bamako – even stoning to death an adulterous couple and chopping off the hand of a suspected thief in their quest to implement a strict version of Sharia.

“I hope the new government together will make the liberation of the north its No. 1 priority,” said Malian civil society leader Aboubacrine Assadek Ag Hamatta on Monday.

Mutinous soldiers staged their March 21 coup just months before elections, driving the country’s democratically elected president Amadou Toumani Toure into exile not long before he was due to step down anyway.

Sanogo later signed an agreement pledging to return the country to civilian rule, and the interim president and prime minister were named as part of that deal.

Even after signing the agreement, though, he showed little interest in stepping aside completely.

Prime Minister Cheick Modibo Diarra has become an increasingly divisive figure in Mali in recent weeks due to allegations he’s been meeting with the coup leader.

The reports have raised suspicions Sanogo – and not the interim administration – is making key decisions about the country’s future.

Mali’s crisis has displaced an estimated 435,624 people, with more than half fleeing to neighbouring countries, according to the United Nations.

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In Germany, it is all too easy to skip the organ waiting list

By Johannes Wiedemann

DIE WELT/Worldcrunch

BERLIN – Normally in Germany, there’s a waiting list procedure for organ transplants.


The Deutsche Stiftung Organtransplantation (German Foundation for Organ Transplantation) coordinates the information about available organs from donors, and these organs are then allocated by the Netherlands-based Eurotransplant to seven central European member countries. In Germany, transplants take place at 50 transplant centers located around the country.

But that’s only half the truth. Increasingly, organs donated by older, sick people are being fast-tracked directly to patients requiring transplants, thus bypassing the waiting list procedure. This also means that the questions that are usually asked — such as, what are the chances that the transplant will be a success? or just how urgent the patient’s need for a replacement organ is — are not being asked.

German Health Ministry statistics obtained by Green party MP Harald Terpe indicate that this accelerated donation process has increased markedly.

According to the new Health Ministry statistics, the number of fast-tracked liver donations grew from 9.1% to 37.1% between 2002 and 2012. For hearts, those figures were 8.4% to 25.8%, and for lungs 10.6% to 30.3%. The biggest increase of all was for pancreases: in 2002, only 6.3% were expedited, as opposed to 43.7% in 2012.

Terpe said the huge increase in these expedited transplants called for an explanation. He told the Berliner Zeitung that after recent cases of organ manipulation in Göttingen and Regensburg, “we must do everything to ensure that the system isn’t being manipulated elsewhere.”

The organ manipulation scandal Terpe was referring to relates to two transplant doctors who, at the Göttingen and Regenburg university hospitals, are alleged to have falsified medical records in nearly 50 cases, to push patients further up on the Eurotransplant waiting list. The scandal had observers concluding that if the regular system was so easy to manipulate, then bypassing it must be even simpler.

Left-wing politician Kathrin Vogler, who is vice chair of the federal parliament’s committee on health issues, called for immediate examination at an open meeting of all regulations concerning organ donation and allocation.

Manipulation and corruption

However, the president of the German Medical Association, Frank Ulrich Montgomery, told Die Welt that it would be wrong to draw the conclusion that the rising number of expedited transplants is down to manipulation. He said that the exceptions — as set down in the German Medical Association guidelines — for which fast-tracking is considered legitimate were in no danger of becoming the rule. If there was an increase in the practice, he stated, it was due to changes in directives made between 2002 and 2008. The number of allowed expedited procedures varies with each organ.

Also speaking against any assumption of manipulation and corruption, he said, was the fact that across the country, the number of transplants had increased at all the centers — no particular center stood out. Finally, he pointed out that Eurotransplant was involved, and that patients who got fast-tracked organs were on their lists. The organization is monitoring expedited transplant practices.

Montgomery added that the changes to the guidelines regarding fast-tracking are down to changing demographics and increasing instances of particular diseases. The expedited procedure mainly concerns organs that are otherwise considered unfit, he said.

According to Montgomery: “Donors are getting older and older, and they often have pre-existing conditions or are overweight.” In the regular Eurotransplant procedure, their organs are often refused by doctors who say that these organs aren’t suitable for recipients. Yet while a liver may be too big for someone’s abdominal region or have gallstones — it doesn’t mean that it can’t save someone’s life.”

If an organ is refused for medical reasons three times (for livers, five times) Eurotransplant no longer considers it allocable and it is up to the transplant centers to decide who receives it. Montgomery believes the expedited system makes sense: “Germany lacks so many donor organs that we can’t waste a single one.”

Wolfgang Zöller, the German federal government’s commissioner for patient’s affairs, also told Bayerischer Rundfunk that fast-tracking had been introduced so as to avoid wasting a single organ.

Eugen Brysch, the chairman of the patient protection organization Deutsche Hospiz Stiftung, takes a more critical stance towards fast-tracking, saying that a report it commissioned years ago stated that the practice was susceptible to manipulation and corruption. “The 50 transplantation centers mostly remove, allocate and transplant organs on their own hook,” he said.

Brysch believes that it is entirely possible that richer patients have easier access to organs. He is therefore seeking more information about the number of private patients and foreign patients who receive fast-tracked organs.

Read the original article in German

Photo – Tiiu Sild