Meir Dagan, the former director of Israel’s Mossad, has received a liver transplant in Belarus. Reports from the Israeli press that have now made their way into western media sources state that Belarus’ president, Alexander Lukashenko, announced at a press conference on Oct. 16 that the operation had taken place ten days earlier and had been completed successfully.
Dagan has been among the most outspoken opponents of an Israeli military strike on Iran in Israel’s intelligence community. During a March 2012 interview with CBS’s Sixty Minutes he told Lesley Stahl that an Israeli attack on Iran would not only trigger a regional war, it would be ineffective. Hardly a dove, Dagan much prefers that a war against Iran be launched by the US, and believes that sabotage and other efforts to effect regime change in Iran can stave off Iranian nuclear capability until the US is ready to take action.
Why would a prominent Israeli, a citizen of a country whose medical system is renowned for its sophisticated and cutting edge medical research and groundbreaking innovations in liver transplants, choose to surreptitiously go to a third world European backwater, which boasts that it now ranks 53rd out of 190 countries in the world, for lifesaving treatment?
According to the Jerusalem Post:
“Lukashenko said that surgeons in several countries, including the US, Germany and Sweden, had refused to operate on the patient after learning of his former career as a spymaster, though he didn’t mention Dagan by name. The president added that doctors in these countries had recommended the Belarusian Transplant Center as the best place for the man to undergo his operation.”
Y-Net, the English language news site of the Israeli Daily, Yediot Acharonot, offered no grounds for the refusal, but cited sources close Dagan who claimed “Sweden was never asked to operate and the US did not fulfill criteria for the transplant”. UPI, citing Y-Net as its source, says “because of his condition, Dagan was found to be unsuitable for a transplant in the United States.”
Based on details provided to Al-Monitor by Israeli journalist Yossi Melman, Laura Rozen reports that Dagan had gone to Sloane Kettering hospital in New York two months earlier hoping to find a compatible organ but could not. “He returned to Israel and his health was deteriorating,” Melman said.
“Dagan’s illness, cancer, was known for a couple of months to a small group of confidants and colleagues and me, but it was decided for reasons of not invading his privacy not to report it,” Yossi Melman told Al-Monitor by email Tuesday. “Tonight the Belarus President Alexander Lukaschenko revealed it in a press conference trying to gain for himself and his pariah regime.”
Although Israel is among the most medically advanced countries in the world, organ transplants are subject to intense bureaucracy. At least part of that bureaucracy stems from religious concerns of many orthodox Jews about desecrating a human body after death by autopsy or organ removal. Defining “death” has also proven to be a religious obstacle, since once the standards of total brain death and respiratory death have been fully satisfied according to Jewish law, certain organs cease to be viable. Despite efforts to boost the number of available organs for transplants by promising would-be donors a slot at the top of the donor list should they need a transplant, only 12% of Israelis are registered organ donors. Bloomberg News reports that desperate Israelis are among the biggest clients for organ transplants abroad, which are often acquired by respectable hospitals from black market sources.
The US has a waiting list of nearly 17,000 patients for liver transplants, about 10,000 of whom have been awaiting a donor for more than a year. Whenever a prominent person like Steve Jobs receives a transplant, the question of “jumping the list” arises. It is more likely that Dagan would have been asked to wait his turn, rather than turned down because of his prominent role in Israel’s intelligence community, as Lukashenko claimed.
This, however, does little to address the question of “Why Belarus?”
Belarus, against which the EU renewed its sanctions the other day for persistent human rights violations, has much less stringent criteria for consent of organ donors than Israel, the US, and most western countries. These lower standards of consent allow it to promote “medical tourism” and advertise the ease and economy of organ transplants performed in Belarus. According to the website MedTravel Belarus:
Transplantation of organs taken from cadaveric donor is forbidden in many countries of the world and this is a reason for considerable increase of the list of those who need this operation because the amount of donors decreases significantly.
The problem of the removal of cadaveric organs is primarily related to the issues of legal and ethical qualities. For example, in the USA and many European countries, the principle of “consent of the requested” works, this means that the usage of a person’s organs without his legally formalized permission is forbidden, so the doctor is not entitled to do the removal. A presumption of consent to the removal of organs works in our country so the law permits the removal of cadaveric organs, but on condition that the deceased person during his lifetime, or his relatives have not expressed their opposition to it.
That is why Belarusian clinics are so popular among people all over the world. The transplantations of bone marrow, kidney, heart, liver are performed in our country, tissue transplantations and stem cells transplantations are performed as well. It also should be taken into consideration that the prices for this type of medical service in our country are much lower than in other countries.
In other words, Belarus is not bound by some of the bio-ethical constraints on transplants that apply in the US and Israel, and much of Europe. MedTravel Belarus claims that 70 liver transplants have been performed in the country since 2010.
While Dagan has devoted most of his career in the Mossad to countering “the Iranian threat” to Israel, Belarus –formerly part of the Soviet Union, and now part of the successor Commonwealth of Independent States (CIS) — is one of the very few European countries with whom Iran maintains good relations. In late June, Iran and Belarus co-sponsored an “International Conference on Modern Application of Nanotechnology” in Minsk. Ironically, Belarus, which apparently was Dagan’s best and perhaps only hope for obtaining a liver transplant, has been accused of aiding Iran in missile development and in evading western sanctions against its nuclear program:
Diplomats told Reuters on condition of anonymity that Belarus is beginning to act as a kind of middleman to help secure the Iranians access to Russian technology.
“Belarus is becoming a key element in Iran’s efforts to develop its SSM (surface-to-surface missile) and nuclear capabilities, especially with regard to navigation and guidance products, which are defined as dual-use,” a diplomat said.
Politics, indeed, makes for some strange bedfellows.
Some valid critiques, but you miss the obvious reason — at least that’s been reported — why Dagan didn’t get a transplant in Israel. The reason is that regulations there limit liver transplants to patients under 65. Dagan is 67.
I didn’t bring up the age factor because, in point of fact, the page of the website of Med Travel Belarus dealing with liver transplants states that “extreme old age”–60 to 70–is a contraindication for liver transplant surgery. Obviously the surgery was performed on Dagan despite the contraindication. As you point out, Dagan is 67. So the real question I was addressing wasn’t as much “why not in Israel?” but “why in Belarus?” Why is a country like Belarus willing and able to do such transplants on high risk patients such as Dagan when much more advanced and sophisticated health care facilities in other countries are not?
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