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The Xinjiang Procedure

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

Dec 5, 2011, Vol. 17, No. 12 • By ETHAN GUTMANN
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Nijat hadn’t injected him; the medical director had. But the director and some legal officials were watching the exchange, so Nijat lied smoothly: “It’s so you won’t feel much pain when they shoot you.” 

The young man smiled faintly, and Nijat, sensing that he would 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 anticoagulant, 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 was a general surgeon in an Urumqi hospital. Enver recalled an unusual conversation with his immediate superior, the chief surgeon: “Enver, we are going to do 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 assistants and an anaesthesiologist into an ambulance and followed the chief surgeon’s car out of Urumqi going west. The ambulance had a picnic atmosphere until they realized they were entering the Western Mountain police district, which specialized in executing political dissidents. On a dirt road by a 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 returned to the car. Enver saw that beyond the hill there appeared to be some sort of armed police facility. People were milling about—civilians. Enver half-satirically suggested to the team that perhaps they were family members waiting to collect the body and pay for the bullet, and the team responded with increasingly sick jokes to break the tension. Then they heard a gunshot, possibly a volley, and drove around to the execution field.

Focusing on not making any sudden moves as he followed the chief surgeon’s car, Enver never really did get a good look. He briefly registered that there were 10, maybe 20 bodies lying at the base of the hill, 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 had long hair.

“That’s him. We’ll operate on him.”

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

Enver stiffened and corrected himself. “No. He’s not dead.” 

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

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

The anaesthesiologist just stood there, arms folded—like some sort of ignorant peasant, Enver thought. Enver barked at him. “Why don’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 should I cut?”

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

Enver worked fast, not bothering with clamps, cutting with his right hand, moving muscle and soft tissue aside with his left, slowing down only to make sure he excised the kidneys and liver cleanly. Even as Enver stitched the man back up—not internally, there was no point to that anymore, just so the body might look presentable—he sensed the man was still alive. I am a killer, Enver screamed inwardly. He did not dare to look at the face again, just as he imagined a killer would avoid looking at 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 understand that live organs had lower rejection rates in the new host, or that the bullet to the chest had—other than that first sickening lurch—acted like some sort of magical anaesthesia. He had done what he could; he had stitched the body back neatly for the family. And 15 years would elapse before Enver revealed 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 block lights were turned off. Nijat found himself hanging out in the detention compound’s administrative office with the medical director. Following a pause in the conversation, the director, in an odd voice, asked Nijat if 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 for all 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 sign statements donating their organs to the state. And now the medical director was confirming it all: Those statements were real. They just didn’t take account of the fact that the prisoners would still be alive when they were cut up.

“Nijat, we really are going to hell.”

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

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

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

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

“When will you fix the problem?”

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

Three days later, Bahtiyar understood why. On February 5, approximately 1,000 Uighurs gathered in the center of Ghulja. The day before, the Chinese authorities arrested (and, it was claimed, severely abused) 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 incident remain shaky. Bahtiyar recalls internal police estimates of 400 dead, but he didn’t see it; all Uighur policemen had been sent to the local jail “to interrogate prisoners” and were locked in the compound throughout the crisis. However, Bahtiyar did see Uighurs herded into the compound and thrown naked onto the snow—some bleeding, others with internal injuries. Ghulja’s main Uighur clinic was effectively shut down when a squad of Chinese special police arrested 10 of the doctors and destroyed the clinic’s ambulance. As the arrests mounted by late April, the jail became hopelessly overcrowded, and Uighur political prisoners were selected for daily executions. On April 24, Bahtiyar’s colleagues witnessed the killing of eight political prisoners; what struck them was the presence of doctors in “special vans for harvesting organs.”

In Europe I spoke with a nurse who worked in a major Ghulja hospital following the incident. Nervously requesting that I provide no personal details, she told me that the hospitals were forbidden to treat Uighur protesters. A doctor who bandaged an arm received a 15-year sentence, while another got 20 years, and hospital staff were told, “If you treat someone, you will get the same result.” The separation between the Uighur and Chinese medical personnel deepened: Chinese doctors would stockpile prescriptions rather than allow Uighur medical staff a key to the pharmacy, while Uighur patients were receiving 50 percent of their usual doses. If a Uighur couple had a second child, even if the birth was legally sanctioned, Chinese maternity doctors, she observed, administered an injection (described as an antibiotic) to the infant. The nurse could not recall a single instance of the same injection given to a Chinese baby. Within three days the infant would turn blue and die. Chinese staffers offered a rote explanation to Uighur mothers: Your baby was too weak, your baby could not handle the drug. 

Shortly after the Ghulja incident, a young Uighur protester’s body returned home from a military hospital. Perhaps the fact that the abdomen was stitched up was just evidence of an autopsy, but it sparked another round of riots. After that, the corpses were wrapped, buried at gunpoint, and Chinese soldiers patrolled the cemeteries (one is not far from the current Urumqi airport). By June, the nurse was pulled into a new case: A young Uighur protester had been arrested and beaten severely. His family paid for his release, only to discover that their son had kidney damage. The family was told to visit a Chinese military hospital in Urumqi where 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 was to 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-work tour in rural Xinjiang, a young Uighur doctor—let’s call him Murat—was pursuing a promising medical career in a large Urumqi hospital. Two years later he was planning his escape to Europe, where I met him some years after. 

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

“What about tissue matching?”

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

Clutching the authorization, and accompanied by an assistant from the hospital, Murat, slight and bookish, found himself facing approximately 15 prisoners, mostly tough-guy Uighurs in their late twenties. As the first prisoner 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 howled and stampeded, the guards screaming and shoving them back into line. The prisoner shrieked that he was innocent. The Chinese guards grabbed his neck and squeezed it hard. 

“It’s just for your health,” Murat said evenly, suddenly aware the hospital functionary was probably watching to make sure that Murat wasn’t too sympathetic. “It’s just for your health,” Murat said again 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’t ask any more questions. They are bad people—enemies of the country.”

But Murat kept asking questions, and over time, he learned the drill. Once they found a matching blood type, they would move to tissue matching. Then the political prisoner would get a bullet to the right side of the chest. Murat’s instructor would visit the execution site to match up blood samples. The officials would get their organs, rise from their beds, and check out. 

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

By early 1999, Murat stopped hearing about harvesting political prisoners. 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-scale action since Mao: the elimination of Falun Gong. By my estimate up to three million Falun Gong practitioners would pass through the Chinese corrections system. Approximately 65,000 would be harvested, hearts still beating, before the 2008 Olympics. An unspecified, significantly smaller, number of House Christians and Tibetans likely met the same fate. 

By Holocaust standards these are piddling numbers, so let’s be clear: China is not the land of the final solution. But it is the land of the expedient solution. Some will point to recent statements from the Chinese medical establishment admitting the obvious—China’s medical environment is not fully ethical—and see progress. Foreign investors suspect that eventually 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. 

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