One day last May, a dishevelled young man from Nigeria walked into the police station at Staines, in Middlesex, saying he was homeless and destitute, and pleading for help.
It was the beginning of an astonishing and chilling story.
A story that led to a landmark trial at the Old Bailey, which reached its denouement yesterday, and exposed the sordid underbelly of Britain’s burgeoning ‘health tourism’ industry, revealing it to be ripe for exploitation.
Some of the information the boy gave was false. He said his father had died when he was young, when both his parents are, in fact, alive — and that he was aged 15. Checks conducted after he was taken in by Surrey social services showed him to be 21.
However, the essence of his story proved to be all too true. Some two months earlier, he had been trafficked to Britain by one of Nigeria’s most prominent and powerful families, believing he had been brought here to find work.
To his horror, however, he belatedly discovered that they intended to harvest one of his kidneys for their daughter, who had attended two elite English private schools and graduated from university here, but had fallen seriously ill and needed a transplant.
The £80,000 operation was to have been performed privately by a leading surgeon at the world-renowned Royal Free Hospital, in Hampstead, North London.
Under a deal brokered by a grasping middleman, the wealthy family (said to own 40 properties in London, Dubai, the U.S. and Nigeria) were to pay the unwitting ‘donor’ somewhere between £2,400 and £7,000; a pittance for them, but a king’s ransom for him — a self-described ‘hustler’ who earned a few pounds a day by hawking mobile phone accessories from a wheelbarrow in Lagos.
Yesterday, the three architects of this vile plot, Senator Ike Ekweremadu, 60, his wife Beatrice, 56, and Dr Obinna Obeta, 50 — the fixer who ‘did their dirty work’ — were found guilty of conspiracy to facilitate the travel of the young man (who cannot be named) with a view to his exploitation, an offence which carries a maximum ten-year prison sentence.
They were the first people to be tried in Britain for trafficking someone with the intention of harvesting an organ under the Modern Slavery Act 2015.
Sonia Ekweremadu, whose essential dialysis sessions delayed the trial, had faced the same charge, but the jury accepted she was unaware of the conspiracy, and she was acquitted.
As the verdicts were announced, she and her mother, whose bail was revoked pending sentence, clung to one another for comfort and sobbed.
Ironically, during his time in government Senator Ekweremadu helped to instigate laws banning commercial organ harvesting in Nigeria. His elegant wife runs a family foundation that pays for poor Nigerians’ hospital treatment and education.
Yet in the damning words of prosecutor Hugh Davies KC, they and their fixer treated the intended donor and his body parts as a ‘disposable asset . . . a commodity’ in an ‘arms-length, emotionally cold transaction’.
The significance of this case goes far beyond one privileged African family’s callousness and sense of entitlement, however.
It has serious implications for Britain, where there is such a shortage of kidneys that 5,341 people are awaiting a deceased donor. They can expect to wait between two and three years.
It revealed how our hospitals, 36 of which are licenced for transplant surgery, are wide open to deception by overseas ‘health tourists’.
It also exposed alarming flaws in the vetting procedure overseen by the Human Tissue Authority (HTA), the regulatory body entrusted with ensuring transplants involving living donors are ethical and safe. (Yesterday the HTA insisted its checks were ‘thorough and robust’.)
And it showed the apparent ease with which overseas donors — who are permitted to travel to Britain to give organs if they are doing so altruistically — can obtain UK visas on medical grounds, and then remain in Britain illegally.
In this case, it seems the donor wasn’t even interviewed personally at the British High Commission in the Nigerian capital Abuja.
His application was accepted without question after an online form was submitted on his behalf, falsely describing him as Sonia’s cousin.
A source closely involved in the prosecution believes it to be ‘the tip of an iceberg’ and says other bogus foreign transplant donors have probably slipped through the net.
Though only three people were convicted, the trial identified a wider network of characters embroiled in the plot, some out of reach in Nigeria.
Among them was Evelyn Agbasonu, a long-serving Royal Free Hospital secretary who acted as the victim’s interpreter (she spoke Igbo, one of the languages spoken in Nigeria) when he was interviewed to assess his suitability as a donor.
She was said by prosecutor Hugh Davies KC to have accepted a £1,500 bribe to ‘coach’ him into answering questions convincingly.
Though Ms Agbasonu was not on trial, the prosecution described her as ‘corrupt’ and one defence lawyer remarked, ‘she has not been collared . . . yet’.
Approached by the Daily Mail at her South London home, she declined to comment. The Royal Free declined to say whether she has retained her job.
Another name frequently mentioned during the trial was that of Dr Christopher Agbo, a kidney consultant employed by North West Anglia NHS Foundation Trust.
The court heard how the 50-year-old specialist, based at Hinchingbrooke Hospital, in Huntingdon, Cambridgeshire, supplements his NHS salary — typically around £100,000 — by running Vintage Health Group, a health tourism venture that brings overseas clients, mainly from Nigeria.
His company was paid £8,000 to facilitate the donor’s visa application and his passage to Britain, and to liaise with the Royal Free. (The Ekweremadus negotiated Dr Agbo’s fee down from £10,000 after grumbling that he was exploiting them.)
This was the third time Dr Agbo had brought an overseas transplant patient to the Royal Free; a fact that emerged in an email exhibited in court, in which he asked for an ‘incentive’ for putting business the hospital’s way.
And prosecutor Mr Davies told the court: ‘In terms of arranging for a Nigerian national to travel to the United Kingdom to donate a kidney, the role of the company is bound to attract suspicion.’
Mr Davies added that ‘on the existing evidence, he and his company were not directly responsible for what was said on the various false declarations that were made to secure a visa for [the donor].
Whether Dr Agbo knew the claimed family relationship (between Sonia and the donor] was false is under investigation’.
The General Medical Council says Dr Agbo, president of an association representing Nigerian medical professionals in Britain, is being permitted to continue working under a restrictive licence pending the outcome of their inquiry into the matter.
He, too, refused to comment when I called at his impressive, mock-Georgian detached house in the Cambridgeshire village of Fen Drayton, where a sporty blue Jaguar was parked in the drive.
The sale of kidneys is so commonplace in Nigeria that prosecutor Mr Davies described it as ‘endemic’. The reasons are clear.
While almost two-thirds of the country’s 220 million population subsist below the poverty line, 25 million — more than 10 per cent — suffer kidney disease, according to a 2018 report.
The causes of this medical tsunami include rampant diabetes and sickle cell anaemia, but, sadly, another factor is the fashion for skin-whitening creams, which can damage the kidneys and are used by 77 per cent of Nigerian women, according to the World Health Organization.
Though the defendants portrayed Nigeria as a country where altruistic donors were readily available because, in their culture, everyone was regarded as a brother or sister who must be helped in their hour of need, this is far from the truth.
Doctors in Nigeria explained how many people hold the superstition that by giving away a body part they will also give away part of their soul.
‘Culturally, we are not altruistic, even to our siblings,’ consultant haematologist Dr Ibrahim Musa told the Mail.
‘There is a general hesitancy, even for blood donation among Nigerians, not to speak of kidneys or other organs.
[But] Nigerians have a penchant for making money, and once money is involved there are people who will be willing to donate their kidney to those who can pay the right price.’
The healthcare system in Nigeria is ‘overwhelmed’, he added, and operations must be paid for. Even for the few who can afford transplant surgery, outcomes compare poorly with those in Western hospitals.
Faced with the need for a transplant, 90 per cent of patients go to India, where surgery is cheaper, and regulations are lax.
At Christmas, 2019, however, when Sonia Ekweremadu was diagnosed with a life-threatening kidney condition called FSGS (focal segmental glomerulosclerosis), her family decided she must be treated by world-class clinicians in London.
Why so? Well, for one thing her family could easily afford it. During his 20 years as a senator, Ike Ekweremadu amassed a fortune estimated at up to £15 million.
His global property portfolio includes an apartment in Westminster, bought for £830,000 in 2008, and a £1.5 million house in Willesden Green, the family’s residence in North-West London.
His wealth was unveiled during an investigation by Nigeria’s Economic And Financial Crimes Commission, which accuses Ekweremadu of money-laundering, and last November won a court order for 40 properties to be seized, claiming he bought them through political associates and shell companies.
He vehemently denies the accusations, claiming them to be politically motivated.
Whatever the truth, Sonia, one of his four children, enjoyed a gilded upbringing. She attended the now-closed Abbots Bromley School in Staffordshire, and Old Hall School, Norwich, both of which charge boarding fees north of £20,000 a year.
She then gained a media and communications degree at Coventry University and had begun a post-graduate course at Newcastle University when illness struck.
As her social media posts show, however, she enjoyed a lifestyle beyond most students, holidaying in Dubai, California, Mexico and St Tropez, among other exotic spots.
Though she cut a sorry figure in court and, as Mr Davies remarked, everyone who witnessed the proceedings would doubtless wish her a life-changing transplant, the contrast between her background and that of her chosen donor could hardly be greater.
It was an arduous task for a Daily Mail representative to negotiate the potholed dirt-track leading to the donor’s village, in south-eastern Nigeria, and home for him and his eight siblings was a bare concrete hovel.
Communications are so poor there — mobile phone and internet — that his father, a carpenter, told us he would not believe his son was still alive until he physically saw him again.
Without any prospect of finding work in the village, he had left to chance his luck in Lagos at the age of 15.
How, then, was this uneducated young man — who claimed in court that he didn’t even know what a kidney was until it was explained to him by Dr Peter Dupont, his prospective surgeon at the Royal Free Hospital — thrust into the role of Sonia’s saviour?
It is a convoluted story, several conflicting versions of which were presented to the jury. However, drawing on thousands of texts, WhatsApp messages and emails retrieved from the defendants’ electronic devices, the prosecution built a compelling narrative.
They showed how the ‘model’ for the plot was established by Dr Obeta, a radiologist in Nigeria, who himself underwent a kidney transplant at the Royal Free, in July 2021.
Again, he used a young Nigerian donor, describing him as his ‘cousin’ (though Mr Davies said there was not a jot of evidence to support this assertion); again, he claimed the kidney had been donated on compassionate grounds; and again, the operation was arranged through Dr Agbo’s company, which appears to have charged Obeta £10,000.
Obeta’s ruse evidently fooled clinicians at the London hospital, and also the HTA, who must ratify all UK transplants by living donors.
Yesterday, the HTA — pointing out that Sonia’s case had been vetoed before it reached the HTA — told the Mail: ‘We have . . . increased the scrutiny we give to cases that involve overseas donors and cases taking place in the private sector.’
Indeed, it says that the Ekweremadu case prompted a review of hundreds of cases ‘with potentially similar features to determine that there were no identifiable weaknesses in the process’. The Royal Free, for their part, said it had decided not to go ahead with Sonia’s transplant after assessing her case in accordance with national guidance.
However, as Mr Davies remarked in his closing speech: ‘You may think, if there is a lesson to be learned here, that those clinicians ought to set their index of safeguarding somewhat lower. But that is not for these proceedings.’
In evidence, Obeta claimed his donor was a former employee at his hospital who acted out of kindness. The more likely truth came from the prosecution, who described a huge ‘pool’ of impoverished Nigerians only too willing to sell their kidneys to improve their lot.
By chance, Obeta and Sonia’s uncle, Diwe Ekweremadu, were contemporaries at medical school, and when Obeta heard of her plight he saw the chance to recoup some of the debt he had incurred by paying for his private transplant by acting as the family’s middleman.
His messages suggest he owed some £27,000 and, having remained in London with his wife and two children, had been working ‘under the table’, as he put it, in menial jobs.
Obeta’s donor also stayed in Britain after the transplant and knew of someone who would leap at the chance of joining him — his friend who sold phone accessories from a wheelbarrow in Lagos — which is how the 21-year-old man came to be recruited.
Whether or not he knew he was being offered thousands of pounds to give a kidney, or whether he naively assumed he was being brought to London to work, as he insisted in court, was irrelevant to the case.
For although defence barristers portrayed him as the true exploiter — a street-smart opportunist who played along with the plan, then claimed to have been trafficked so he could stay in the country — the Modern Slavery Act is designed to protect those who become willing parties to their own exploitation.
The deceit that enabled the donor to come here could fill an entire chapter in this story.
Suffice to say that, with a letter of support from the Royal Free and a false declaration that was written for him, stating that he would be ‘donating an organ to my closest cousin . . . in appreciation of her sacrifices towards me’, the barrow-boy —who had never met Sonia — had his visa application approved by the Home Office in London.
Before leaving Nigeria, he had been provided with a passport, shunted between Lagos and Abuja for medical tests, and ‘drip-fed’ minimal amounts to cover his expenses. Then, on February 7, last year, he was put on a plane to London, arriving at Heathrow without any luggage.
Billeted in Obeta’s house, near the Old Kent Road in South-East London, he told the court he was allowed out only to attend hospital appointments and familiarise himself with Sonia, alongside whom he said he was photographed — to prove their ‘close relationship’.
Where the clinicians had been hoodwinked by the falsehoods peddled by Obeta and his donor, however, this time they were not taken in.
Dr Dupont, who interviewed Sonia and her donor, told the court he was suspicious from the outset. Given the sacrifice he was to make for her, the consultant expected her to display her gratitude, yet she seemed ‘distant’ from him.
And as her kidney condition was not genetic, he wondered why a closer family member had not come forward. It was also clear that the donor knew little about the operation, the long-term risks being higher for a younger person.
‘My assessment for this donation going ahead was a straight No,’ he said. Though the allegedly bribed interpreter, hospital secretary Ms Agbasonu, tried to sharpen the donor’s performance before a second interview, an independent specialist shared Dr Dupont’s opinion, so the transplant did not take place.
The Ekweremadus were not about to give up, however. Within days of the decision, those employed to do their ‘dirty work’ in Nigeria were hunting for a fresh compatible donor (enlisting a nameless woman who claimed to have been in the organ-harvesting business for ten years).
This time the transplant would take place in Turkey, where transplants undergo markedly less scrutiny. In fact, the senator and his wife were transiting through Heathrow, en route from Istanbul to Nigeria, when they were hauled off a plane and arrested.
Their daughter was also arrested at their London home. However, her barrister, John Femi-Ola KC, claimed she had fallen ‘down the Alice In Wonderland hole’ after becoming ill and that, protected by her family, she was oblivious to the conspiracy.
The jury accepted this. Even so, her apparent insouciance surfaced when her father sent her photographs of two possible replacement donors for the planned transplant in Turkey and invited to choose between them. ‘The dark one looks better. The light one looks like he will run away,’ she replied.
Meanwhile, after being rejected, the original donor trafficked to London was kept in Obeta’s London home for almost three months.
He told the court he was treated like ‘a slave’: forced to do the household chores and sleep on the sofa. As Mr Davies told the court, this sordid story might never have emerged if he hadn’t escaped.
Giving evidence, the young man told how a sinister episode made him decide to flee. One day, some men arrived and took him upstairs. One was a doctor and they asked him to remove his clothes and pressed his abdomen.
Prosecutor Mr Davies spelled out the purpose of their visit.
‘On any view,’ he said, they ‘were measuring him up, literally, for a transplant [for another wealthy client], no doubt using tests that had already been [produced]. He is a continuing asset.’
For three days after his escape, he wandered through London and slept on the streets, eventually reaching Staines, 27 miles away. There, he was briefly taken home by a Good Samaritan before going to the police.
Why did he lie about his age and family background?
Under cross-examination, he found that difficult to explain. Surrey social services placed him in temporary foster care, and, as a victim of modern slavery, he was given discretionary leave to remain in Britain pending the outcome of the trial.
For Sonia, the future seems bleak. Her mother’s application for bail so that she could care for her was rejected by Justice Jeremy Johnson, who accepted that she might find the means to flee the country rather than face a possibly lengthy prison sentence.
The judge said Sonia’s siblings, who are in London, could care for her. That she could seemingly have had the transplant on the NHS, if only her parents had taken the moral option of advising her to join the waiting list for a dead person’s kidney, along with 5,000-plus others, or wait for a genuinely altruistic donor, is yet another irony.
For having lived here for many years as a student and acquired an NHS number, friends say she was quite entitled to have the transplant for free.
Though ‘hundreds’ of strangers have offered to give her a kidney since hearing of her arrest and seeing her online appeal, she is said to have been warned that British hospitals are unlikely to accept her case now.
That is the sad corollary to this grim morality story. A story that exposes a system ripe for exploitation, and from which few of the central characters emerge with their reputations untarnished.