Dr. Francisco José Mora Palma (right)

New details have emerged regarding the inner workings of a sophisticated organ trafficking network with international ties operating in Costa Rica, suggesting that the country's role in the international illicit organ trade may be evolving.

During the course of a trial for suspects allegedly involved in an organ trafficking ring in Costa Rica, judicial investigator Diego Castillo Gómez said that the alleged network may have had ties to Ukraine, La Nación reported September 15.

Costa Rican authorities first received a request from their Ukrainian counterparts in 2012 to investigate a telephone number linked to two Ukrainians who had been detained for organ trafficking, Castillo said. 

Upon further investigation, investigators discovered the phone number was used a number of times to communicate with Francisco José Mora Palma, a kidney doctor who was arrested in June 2013 along with two others for allegedly leading the illicit organ trafficking network. In February 2016, Costa Rican authorities formally announced charges against several individuals allegedly involved in the network and eventually took the case, the first of its kind in the country, to trial.

SEE ALSO: Coverage of Costa Rica

Previous allegations had already tied Mora Palma's ring to both local and international actors.

Among those allegedly involved in the network were Costa Rican urologists Maximiliano Mauro Stamati and Fabián Fonseca Guzman, peripheral vascular specialist Victor Hugo Monge, as well as Costan Rican National Police officer Maureen Cordero Solano, who was also allegedly one of Mora Palma's victims and received 6 million colones (around $10,400) for one of her kidneys.

According to La Nación, Solano would first target impoverished local citizens to recruit them as kidney "donors," allegedly earning $1,000 for each donor she recruited. Afterwards, Solano would direct the donors to a Greek businessman, Dimosthenis Katsigiannis Karkasi, who would offer them up to 10,000 colones (around $17,400) for the kidney. 

Karkasi, who owned a pizza shop across from the hospital where Mora Palma worked, would then take the "donors" for a consultation with the doctor to initiate pre-operation procedures, followed by a private examination. 

After then being transferred to one of the private hospitals, Mora Palma, with the help of the urologists and peripheral vascular specialist, would extract the kidneys and transplant them into the recipients, who allegedly paid at least $140,000 per procedure, $40,000 of which was supposed to go to the donors.

Afterwards, Mora Palma allegedly paid the donors in cash, if he paid them at all, and made them sign notarized declarations that stated they did not receive any payment for the kidney. As in the United States, it is illegal to pay someone for his or her organs in Costa Rica.

According to Castillo's testimony, Mora Palma coordinated examinations and operations for at least 14 kidney transplants at the private Bible Clinic and Catholic Clinic Hospitals. Mora Palma served for 13 years as the head of the nephrology department at the publicly-run Rafael Ángel Calderón Guardia Hospital in Costa Rica's capital, San José, and he allegedly worked out of his office at the hospital.

Mora Palma is charged with 14 counts of human trafficking with the purpose of illicit organ extraction, and 16 counts of embezzlement for using equipment and faciliates of the Costa Rican Social Security Fund (Caja Costarricense de Seguro Social - CCSS) to commit the crimes, among other charges. 

InSight Crime Analysis 

By all accounts, authorities in Costa Rica appear to have uncovered a major international organ trafficking ring operating in the country. Indeed, a 2014 investigation by the New York Times linked Mora Palma's network -- which had reportedly been operating since at least 2011 -- with "central players in Israel's sizeable black market for kidneys." 

However, according to Colombian lawyer Luz Estella Ortiz-Nagle, who is a recognized expert in human trafficking, Costa Rica may be transforming from a tiny player in the global organ trafficking trade into an "epicenter" for illegal organ trafficking, in large part due to corruption that has helped fuel a sophisticated "transplant tourism" industry as well as the global imbalance between the limited supply of kidneys and the high demand for transplants. 

SEE ALSO: Coverage of Human Trafficking

Ortiz-Nagle explained in a June 2017 interview with La Nación that corrupting officials in various sectors is essential for these networks to operate successfully given the breadth of their operations.

"There is a facilitator or recruiter who locates the victim or donor … an international coordinator or broker, a site for the transplant, a recipient … who receives the donation, and medical professionals: transplant doctors, anesthesiologists, nurses, medical technicians, laboratories and hospital administrators," she said.

According to the US State Department's 2017 Trafficking in Persons Report, the Costa Rican government is making significant efforts to combat trafficking, but still does not comply with US minimum standards.

Investigations

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