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The Xinjiang Procedure: Published in The Weekly Standard (http://www.weeklystandard.com)

Where have all the Uighurs gone?

The Xinjiang Procedure:  Beijing’s ‘New Frontier’ is ground zero for the organ harvesting of political prisoners.

Ethan Gutmann
December 5, 2011, Vol. 17, No. 12

To figure out what is taking place today in a closed society such as northwest China, sometimes you have to go back a decade, sometimes more.

One clue might be found on a hilltop near southern Guangzhou, on a partly cloudy autumn day in 1991. A small medical team and a young doctor starting a practice in internal medicine had driven up from SunYat-sen Medical University in a van modified for surgery. Pulling in on bulldozed earth, they found a small fleet of similar vehicles—clean, white,with smoked glass windows and prominent red crosses on the side. The policehad ordered the medical team to stay inside for their safety. Indeed, the view from the side window of lines of ditches—some filled in, others freshly dug—suggested that the hilltop had served as a killing ground for years.

Thirty-six scheduled executions would translate into 72 kidneys and corneas divided among the regional hospitals. Every van contained surgeons who could work fast: 15-30 minutes to extract. Drive back to the hospital. Transplant within six hours. Nothing fancy or experimental; execution would probably ruin the heart.

With the acceleration of Chinese medical expertise over the last decade, organs once considered scraps no longer went to waste. It wasn’t public knowledge exactly, but Chinese medical schools taught that many otherwise wicked criminals volunteered their organs as a final penance.

Right after the first shots the van door was thrust openand two men with white surgical coats thrown over their uniforms carried a body in, the head and feet still twitching slightly. The young doctor noted that the wound was on the right side of the chest as he had expected. When body #3 was laid down, he went to work.

Male, 40-ish, Han Chinese. While the other retail organs in the van were slated for the profitable foreigner market, the doctor had seen the paperwork indicating this kidney was tissue-matched for transplant into a 50-year-old Chinese man. Without the transplant,that man would die. With it, the same man would rise miraculously from his hospital bed and go on to have a normal life for 25 years or so. By 2016,  given all the anti-tissue-rejection drug advances in China, they could theoretically replace the liver, lungs, or heart—maybe buy that man another 10 to 15 years.

Body #3 had no special characteristics save an angry purple line on the neck. The doctor recognized the forensics. Sometimes the police would twist a wire around a prisoner’s throat to prevent him from speakingup in court. The doctor thought it through methodically. Maybe the police didn’t want this prisoner to talk because he had been a deranged killer, a thug, or mentally unstable. After all, the Chinese penal system was a daily sausage grinder, executing hard core criminals on a massive scale. Yes, the young doctor knew the harvesting was wrong. Whatever crime had been committed, it would be nice if the prisoner’s body were allowed to rest forever. Yet was his surgical task that different from an obstetrician’s? Harvesting was rebirth, harvesting was life, as revolutionary an advance as antibiotics or steroids. Or maybe, he thought, they didn’t want this man to talk because he was a political prisoner.

Nineteen years later, in a secure European location, thedoctor laid out the puzzle. He asked that I keep his identity a secret.Chinese medical authorities admit that the lion’s share of transplantorgans originate with executions, but no mainland Chinese doctors, evenin exile, will normally speak of performing such surgery. To do so wouldremind international medical authorities of an issue they would ratheravoid—not China’s soaring execution rate or the exploitation of criminalorgans, but rather the systematic elimination of China’s religious andpolitical prisoners. Yet even if this doctor feared consequences to his family and his career, he did not fear embarrassing China, for he was born into an indigenous minority group, the Uighurs.

Every Uighur witness I approached over the course of two years—police, medical, and security personnel scattered across two continents—related compartmentalized fragments of information to me, often through halting translation. They acknowledged the risk to their careers, their families, and, in several cases, their lives. Their testimony reveals not just aprocedure evolving to meet the lucrative medical demand for living organs, but the genesis of a wider atrocity.

Behind closed doors, the Uighurs call their vast region in China’s northwest corner (bordering on India, Pakistan, Afghanistan,Tajikistan, Kyrgyzstan, Kazakhstan, and Mongolia) East Turkestan. The Uighurs are ethnically Turkic, not East Asian. They are Muslims with a smattering of Christians, and their language is more readily understood in Tashkent than in Beijing. By contrast, Beijing’s name for the so-called Autonomous Region, Xinjiang, literally translates as “new frontier.” When Mao invaded in 1949, Han Chinese constituted only 7 percent of the regional population. Following the flood of Communist party administrators, soldiers, shopkeepers, and construction corps, Han Chinese now constitute the majority. The party calculates that Xinjiang will be its top oil and natural gas productioncenter by the end of this century.

To protect this investment, Beijing traditionally depicted all Uighur nationalists—violent rebels and non-violent activists alike—as CIA proxies. Shortly after 9/11, that conspiracy theory was tossed downthe memory hole. Suddenly China was, and always has been, at war with alQaeda-led Uighur terrorists. No matter how transparently opportunisticthe switch, the American intelligence community saw an opening for Chinesecooperation in the war on terror, and signaled their acquiescence by allowingChinese state security personnel into Guantánamo to interrogate Uighurdetainees.

While it is difficult to know the strength of the claimsof the detainees’ actual connections to al Qaeda, the basic facts arethese: During the 1990s, when the Chinese drove the Uighur rebel trainingcamps from neighboring countries such as Kazakhstan and Pakistan, someUighurs fled to Afghanistan where a portion became Taliban soldiers. Andyet, if the Chinese government claims that the Uighurs constitute theirown Islamic fundamentalist problem, the fact is that I’ve never met aUighur woman who won’t shake hands or a man who won’t have a drink withme. Nor does my Jewish-sounding name appear to make anyone flinch. In oneof those vino veritas sessions, I asked a local Uighur leader if he wasable to get any sort of assistance from groups such as the Islamic HumanRights Commission (where, as I found during a brief visit to their Londonoffices, veiled women flinch from an extended male hand, drinks are forbidden,and my Jewish surname is a very big deal indeed). “Useless!” he snorted,returning to the vodka bottle.

So if Washington’s goal is to promote a reformed China, then taking Beijing’s word for who is a terrorist is to play into the party’s hands.

Xinjiang has long served as the party’s illicit laboratory: from the atmospheric nuclear testing in Lop Nur in the mid-sixties (resulting in a significant rise in cancers in Urumqi, Xinjiang’s capital) to the more recent creation in the Tarim Desert of what could well be the world’slargest labor camp, estimated to hold 50,000 Uighurs, hardcore criminals, and practitioners of Falun Gong. And when it comes to the first organ harvesting of political prisoners, Xinjiang was ground zero.

In 1989, not long after Nijat Abdureyimu turned 20, he graduated from Xinjiang Police School and was assigned to a special police force, Regiment No. 1 of the Urumqi Public Security Bureau. As one of the first Uighurs in a Chinese unit that specialized in “social security”—essentially squelching threats to the party—Nijat was employed as the good cop in Uighur interrogations, particularly the high-profile cases. I first met Nijat—thin, depressed, and watchful—in a crowded refugee camp on the outskirts of Rome.

Nijat explained to me that he was well aware that his Chinese colleagues kept him under constant surveillance. But Nijat presented the image they liked: the little brother with the guileless smile. By 1994 he had penetrated all of the government’s secret bastions: the detention center, its interrogation rooms, and the killing grounds. Along the way, he had witnessed his fair share of torture, executions, even a rape. So his curiosity was in the nature of professional interest when he questioned one of the Chinese cops who came back from an execution shaking his head. According to his colleague, it had been a normal procedure—the unwanted bodies kicked into a trench, the useful corpses hoisted into the harvesting vans, but then he heard something coming from a van, like a man screaming.

“Like someone was still alive?” Nijat remembers asking.“What kind of screams?”

“Like from hell.”

Nijat shrugged. The regiment had more than enough sloppiness to go around.

A few months later, three death row prisoners were being transported from detention to execution. Nijat had become friendly withone in particular, a very young man. As Nijat walked alongside, the young man turned to Nijat with eyes like saucers: “Why did you inject me?”

Nijat hadn’t injected him; the medical director had. But the director and some legal officials were watching the exchange, so Nijatlied smoothly: “It’s so you won’t feel much pain when they shoot you.”

The young man smiled faintly, and Nijat, sensing that hewould never quite forget that look, waited until the execution was over to ask the medical director: “Why did you inject him?”

“Nijat, if you can transfer to some other section, then go as soon as possible.”

“What do you mean? Doctor, exactly what kind of medicine did you inject him with?”

“Nijat, do you have any beliefs?”

“Yes. Do you?”

“It was an anti-coagulant, Nijat. And maybe we are all going to hell.”

I first met Enver Tohti—a soft-spoken, husky, Buddha of a man—through the informal Uighur network of London. I confess that my first impression was that he was just another emigré living in public housing.But Enver had a secret.

His story began on a Tuesday in June 1995, when he wasa general surgeon in an Urumqi hospital. Enver recalled an unusual conversationwith his immediate superior, the chief surgeon: “Enver, we are going todo something exciting. Have you ever done an operation in the field?”

“Not really. What do you want me to do?”

“Get a mobile team together and request an ambulance.Have everyone out front at nine tomorrow.”

On a cloudless Wednesday morning, Enver led two assistantsand an anaesthesiologist into an ambulance and followed the chief surgeon’scar out of Urumqi going west. The ambulance had a picnic atmosphere untilthey realized they were entering the Western Mountain police district,which specialized in executing political dissidents. On a dirt road bya steep hill the chief surgeon pulled off, and came back to talk to Enver:“When you hear a gunshot, drive around the hill.”

“Can you tell us why we are here?”

“Enver, if you don’t want to know, don’t ask.”

“I want to know.”

“No. You don’t want to know.”

The chief surgeon gave him a quick, hard look as he returnedto the car. Enver saw that beyond the hill there appeared to be some sortof armed police facility. People were milling about—civilians. Enver half-satiricallysuggested to the team that perhaps they were family members waiting tocollect the body and pay for the bullet, and the team responded with increasinglysick jokes to break the tension. Then they heard a gunshot, possibly avolley, and drove around to the execution field.

Focusing on not making any sudden moves as he followedthe chief surgeon’s car, Enver never really did get a good look. He brieflyregistered that there were 10, maybe 20 bodies lying at the base of thehill, but the armed police saw the ambulance and waved him over.

“This one. It’s this one.”

Sprawled on the blood-soaked ground was a man, around 30,dressed in navy blue overalls. All convicts were shaved, but this one hadlong hair.

“That’s him. We’ll operate on him.”

“Why are we operating?” Enver protested, feeling forthe artery in the man’s neck. “Come on. This man is dead.”

Enver stiffened and corrected himself. “No. He’s notdead.”

“Operate then. Remove the liver and the kidneys. Now!Quick! Be quick!”

Following the chief surgeon’s directive, the team loadedthe body into the ambulance. Enver felt himself going numb: Just cut theclothes off. Just strap the limbs to the table. Just open the body. Hekept making attempts to follow normal procedure—sterilize, minimal exposure,sketch the cut. Enver glanced questioningly at the chief surgeon. “Noanaesthesia,” said the chief surgeon. “No life support.”

The anaesthesiologist just stood there, arms folded—likesome sort of ignorant peasant, Enver thought. Enver barked at him. “Whydon’t you do something?”

“What exactly should I do, Enver? He’s already unconscious.If you cut, he’s not going to respond.”

But there was a response. As Enver’s scalpel went in,the man’s chest heaved spasmodically and then curled back again. Enver,a little frantic now, turned to the chief surgeon. “How far in shouldI cut?”

“You cut as wide and deep as possible. We are workingagainst time.”

Enver worked fast, not bothering with clamps, cutting withhis right hand, moving muscle and soft tissue aside with his left, slowingdown only to make sure he excised the kidneys and liver cleanly. Even asEnver stitched the man back up—not internally, there was no point to thatanymore, just so the body might look presentable—he sensed the man wasstill alive. I am a killer, Enver screamed inwardly. He did not dare tolook at the face again, just as he imagined a killer would avoid lookingat his victim.

The team drove back to Urumqi in silence.

On Thursday, the chief surgeon confronted Enver: “So.Yesterday. Did anything happen? Yesterday was a usual, normal day. Yes?”

Enver said yes, and it took years for him to understandthat live organs had lower rejection rates in the new host, or that thebullet to the chest had—other than that first sickening lurch—acted likesome sort of magical anaesthesia. He had done what he could; he had stitchedthe body back neatly for the family. And 15 years would elapse before Enverrevealed what had happened that Wednesday.

As for Nijat, it wasn’t until 1996 that he put it together.

It happened just about midnight, well after the cell blocklights were turned off. Nijat found himself hanging out in the detentioncompound’s administrative office with the medical director. Followinga pause in the conversation, the director, in an odd voice, asked Nijatif he thought the place was haunted.

“Maybe it feels a little weird at night,” Nijat answered.“Why do you think that?”

“Because too many people have been killed here. And forall the wrong reasons.”

Nijat finally understood. The anticoagulant. The expensive“execution meals” for the regiment following a trip to the killing ground.The plainclothes agents in the cells who persuaded the prisoners to signstatements donating their organs to the state. And now the medical directorwas confirming it all: Those statements were real. They just didn’t takeaccount of the fact that the prisoners would still be alive when they werecut up.

“Nijat, we really are going to hell.”

Nijat nodded, pulled on his beer, and didn’t bother tosmile.

On February 2, 1997, Bahtiyar Shemshidin began wonderingwhether he was a policeman in name only. Two years before, the ChinesePublic Security Bureau of the Western city of Ghulja recruited Bahtiyarfor the drug enforcement division. It was a natural fit because Bahtiyarwas tall, good-looking, and exuded effortless Uighur authority. Bahtiyarwould ultimately make his way to Canada and freedom, but he had no troublerecalling his initial idealism; back then, Bahtiyar did not see himselfas a Chinese collaborator but as an emergency responder.

For several years, heroin addiction had been creeping throughthe neighborhoods of Ghulja, striking down young Uighurs like a medievalplague. Yet inside the force, Bahtiyar quickly grasped that the Chineseheroin cartel was quietly protected, if not encouraged, by the authorities.Even his recruitment was a bait-and-switch. Instead of sending him afterdrug dealers, his Chinese superiors ordered him to investigate the Meshrep—atraditional Muslim get-together promoting clean living, sports, and Uighurmusic and dance. If the Meshrep had flowered like a traditional herbalremedy against the opiate invader, the Chinese authorities read it as adisguised attack on the Chinese state.

In early January 1997, on the eve of Ramadan, the entireGhulja police force—Uighurs and Chinese alike—were suddenly ordered tosurrender their guns “for inspection.” Now, almost a month later, theweapons were being released. But Bahtiyar’s gun was held back. Bahtiyarwent to the Chinese bureaucrat who controlled supplies and asked afterit. “Your gun has a problem,” Bahtiyar was told.

“When will you fix the problem?”

The bureaucrat shrugged, glanced at his list, and lookedup at Bahtiyar with an unblinking stare that said: It is time for you togo. By the end of the day, Bahtiyar got it: Every Chinese officer had agun. Every Uighur officer’s gun had a problem.

Three days later, Bahtiyar understood why. On February5, approximately 1,000 Uighurs gathered in the center of Ghulja. The daybefore, the Chinese authorities arrested (and, it was claimed, severelyabused) six women, all Muslim teachers, all participants in the Meshrep.The young men came without their winter coats to show they were unarmed,but, planned or unplanned, the Chinese police fired on the demonstrators.

Casualty counts of what is known as the Ghulja incidentremain shaky. Bahtiyar recalls internal police estimates of 400 dead, buthe didn’t see it; all Uighur policemen had been sent to the local jail“to interrogate prisoners” and were locked in the compound throughoutthe crisis. However, Bahtiyar did see Uighurs herded into the compoundand thrown naked onto the snow—some bleeding, others with internal injuries.Ghulja’s main Uighur clinic was effectively shut down when a squad ofChinese special police arrested 10 of the doctors and destroyed the clinic’sambulance. As the arrests mounted by late April, the jail became hopelesslyovercrowded, and Uighur political prisoners were selected for daily executions.On April 24, Bahtiyar’s colleagues witnessed the killing of eight politicalprisoners; what struck them was the presence of doctors in “special vansfor harvesting organs.”

In Europe I spoke with a nurse who worked in a major Ghuljahospital following the incident. Nervously requesting that I provide nopersonal details, she told me that the hospitals were forbidden to treatUighur protesters. A doctor who bandaged an arm received a 15-year sentence,while another got 20 years, and hospital staff were told, “If you treatsomeone, you will get the same result.” The separation between the Uighurand Chinese medical personnel deepened: Chinese doctors would stockpileprescriptions rather than allow Uighur medical staff a key to the pharmacy,while Uighur patients were receiving 50 percent of their usual doses. Ifa Uighur couple had a second child, even if the birth was legally sanctioned,Chinese maternity doctors, she observed, administered an injection (describedas an antibiotic) to the infant. The nurse could not recall a single instanceof the same injection given to a Chinese baby. Within three days the infantwould turn blue and die. Chinese staffers offered a rote explanation toUighur mothers: Your baby was too weak, your baby could not handle thedrug.

Shortly after the Ghulja incident, a young Uighur protester’sbody returned home from a military hospital. Perhaps the fact that theabdomen was stitched up was just evidence of an autopsy, but it sparkedanother round of riots. After that, the corpses were wrapped, buried atgunpoint, and Chinese soldiers patrolled the cemeteries (one is not farfrom the current Urumqi airport). By June, the nurse was pulled into anew case: A young Uighur protester had been arrested and beaten severely.His family paid for his release, only to discover that their son had kidneydamage. The family was told to visit a Chinese military hospital in Urumqiwhere the hospital staff laid it out: One kidney, 30,000 RMB (roughly $4,700).The kidney will be healthy, they were assured, because the transplant wasto come from a 21-year-old Uighur male—the same profile as their son.The nurse learned that the “donor” was, in fact, a protester.

In the early autumn of 1997, fresh out of a blood-worktour in rural Xinjiang, a young Uighur doctor—let’s call him Murat—waspursuing a promising medical career in a large Urumqi hospital. Two yearslater he was planning his escape to Europe, where I met him some yearsafter.

One day Murat’s instructor quietly informed him that fiveChinese government officials—big guys, party members—had checked intothe hospital with organ problems. Now he had a job for Murat: “Go to theUrumqi prison. The political wing, not the criminal side. Take blood samples.Small ones. Just to map out the different blood types. That’s all youhave to do.”

“What about tissue matching?”

“Don’t worry about any of that, Murat. We’ll handlethat later. Just map out the blood types.”

Clutching the authorization, and accompanied by an assistantfrom the hospital, Murat, slight and bookish, found himself facing approximately15 prisoners, mostly tough-guy Uighurs in their late twenties. As the firstprisoner sat down and saw the needle, the pleading began.

“You are a Uighur like me. Why are you going to hurt me?”

“I’m not going to hurt you. I’m just taking blood.”

At the word “blood,” everything collapsed. The men howledand stampeded, the guards screaming and shoving them back into line. Theprisoner shrieked that he was innocent. The Chinese guards grabbed hisneck and squeezed it hard.

“It’s just for your health,” Murat said evenly, suddenlyaware the hospital functionary was probably watching to make sure thatMurat wasn’t too sympathetic. “It’s just for your health,” Murat saidagain and again as he drew blood.

When Murat returned to the hospital, he asked the instructor,“Were all those prisoners sentenced to death?”

“That’s right, Murat, that’s right. Yes. Just don’task any more questions. They are bad people—enemies of the country.”

But Murat kept asking questions, and over time, he learnedthe drill. Once they found a matching blood type, they would move to tissuematching. Then the political prisoner would get a bullet to the right sideof the chest. Murat’s instructor would visit the execution site to matchup blood samples. The officials would get their organs, rise from theirbeds, and check out.

Six months later, around the first anniversary of Ghulja,five new officials checked in. The instructor told Murat to go back tothe political wing for fresh blood. This time, Murat was told that harvestingpolitical prisoners was normal. A growing export. High volume. The militaryhospitals are leading the way.

By early 1999, Murat stopped hearing about harvesting politicalprisoners. Perhaps it was over, he thought.

Yet the Xinjiang procedure spread. By the end of 1999,the Uighur crackdown would be eclipsed by Chinese security’s largest-scaleaction since Mao: the elimination of Falun Gong. By my estimate up to threemillion Falun Gong practitioners would pass through the Chinese correctionssystem. Approximately 65,000 would be harvested, hearts still beating,before the 2008 Olympics. An unspecified, significantly smaller, numberof House Christians and Tibetans likely met the same fate.

By Holocaust standards these are piddling numbers, so let’sbe clear: China is not the land of the final solution. But it is the landof the expedient solution. Some will point to recent statements from theChinese medical establishment admitting the obvious—China’s medical environmentis not fully ethical—and see progress. Foreign investors suspect thateventually the Chinese might someday—or perhaps have already—abandon organ harvesting in favor of the much more lucrative pharmaceutical and clinical testing industries. The problem with these soothing narratives is that reports, some as recent as one year ago, suggest that the Chinese have not abandoned the Xinjiang procedure.

In July 2009, Urumqi exploded in bloody street riots between Uighurs and Han Chinese. The authorities massed troops in the regional capital, kicked out the Western journalists, shut down the Internet, and, over the next six months, quietly, mostly at night, rounded up Uighur males by the thousands. According to information leaked by Uighurs held in captivity, some prisoners were given physical examinations aimed solely at assessing the health of their retail organs. The signals may be faint, but they are consistent, and the conclusion is inescapable: China, a state rapidly approaching superpower status, has not just committed human rights abuses—that’s old news—but has, for over a decade, perverted the most trusted area of human expertise into performing what is, in the legal parlance of human rights, targeted elimination of a specific group.

Yet Nijat sits in refugee limbo in Neuchâtel, Switzerland, waiting for a country to offer him asylum. He confessed to me. He confessed to others. But in a world eager not to offend China, no state wants his confession. Enver made his way to an obscure seminar hosted by the House of Commons on Chinese human rights. When the MPs opened the floor to questions, Enver found himself standing up and speaking, for the first time, of killing a man. I took notes, but no British MP or their staffers could be bothered to take Enver’s number.

The implications are clear enough. Nothing but self-determination for the Uighurs can suffice. The Uighurs, numbering 13 million, are few, but they are also desperate. They may fight. War may come. On that day, as diplomats across the globe call for dialogue with Beijing, may every nation look to its origins and its conscience. For my part, if my Jewish-sounding name tells me anything, it is this: The dead may never be fully avenged, but no people can accept being fatally exploited forever.

Ethan Gutmann, an adjunct fellow at the Foundation for Defense of Democracies, wishes to thank Jaya Gibson for research assistance and the Peder Wallenberg family for research support.

Copyright 2010 Weekly Standard LLC.

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