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it's a deal one person's health is traded in exchange for another's. weapon it scares me that this is my only steady income and. illegal don't tell them at the border what you're planning to do or they might arrest you. as long as we're about to sell our blood plasma. the united states exports blood plasma as a raw material one market germany. on a customer without a plasma would be no medicine for us. this is the us mexican border the world's most committed plasma donors are mexican assume that saddam tried to stop tonight in past my. european and glue. noble pharmaceutical companies are conducting

transactions bordering on the illegal. or strongly encourage people to not use their document for that the passerby. this is a film about people who save lives and about the risks that they are exposed to. her. story. for all. to. see. and his daughter here in this is are on their way to the border from sued out juarez in mexico to el paso in the united states. with us but you know it's a normal day but today i'm feeling even worse than usual donating plasma wears me

out i'm tired all the time and i barely manage to lift even light things at the office because my it out. when aluminum was indoors it was little i'm not proud of being a donor looking little rooster opener. but we do whatever it takes to make ends meet. as an urban design that says that is what they do and those. are my hero and his daughter go there twice a week in spite of physical warning signs pharmaceutical companies lure them to the united states by offering dollars they accept donors with a visitor visa. but kinesis can feel that there's something wrong to let the cat or some border officials don't let you through or take away your visa when you say you're going to donate plasma at the cuban embassy that makes me panic and it's very risky. this is going to be as it was. only got one.

thing. it's a trade at the borders of law and health but the father and his daughter are not the only ones our research shows that every week at least $10000.00 mexicans travel to the united states to sell their plasma. after donating they return to mexico. they leave their bandages in the u.s. to avoid attracting attention from border officials. and what if i use the money to pay for university. or transport to travel expenses counseling to go to university tuition fees. there are not tired but my pension is very small i still deny plasma because it helps me get by we got them here. donors need the money

patients need the medicines made from donors blood. patients like looks at the opposite end of the supply chain some 1000 kilometers away every 3 days he undergoes the same procedure the infusion of plasma proteins take several hours for her mom i mean before i got infections all the time i was my life consisted of restrictions and sacrifices. or maybe when i started taking the medicine i got better i could live my life again and enjoyed the man leaves. this change was only possible after looks was diagnosed with immunodeficiency he doesn't have enough antibodies to give his body what it lacks he gets the infusions from guns you don't mention i get antibodies from a lot of people. the one i take the medicine these antibodies help boost my immune system and make me feel better i think but that's ok. it's not

just patients with immune deficiencies who need these medicines doctors use them during operations for example to compensate for severe blood loss the medicines are also used to prevent hepatitis or rabies infections. it's good in some situations we depend on plasma products to save patients' lives is pollution cool each of us might need a plasma product at some point in our lives the probability is almost 100 percent those who took in. europe can't find enough donors the united states on the other hand can the u.s. is the world's largest supplier of blood plasma there are more than 800 donation centers in the country donors are allowed to give plasma up to $104.00 times a year that's almost twice as often as allowed in germany. the worst exports the commodity worldwide europe is the main consumer having used 18800000 liters in 2017

the medicines are then sold worldwide. in germany alone 6000000 liters of u.s. plasma were made into medicine this last year. the 43 donation centers at the u.s. mexican border are the most productive in america they're mainly owned by the australian based company c.s.l. which has a german subsidiary c.s.l. bearing a spanish company great falls and smaller entities such as be pealed which supplies the u.k. with plasma. the company is currently building 2 new centers. all of these companies declined requests for interviews. but during our yearlong investigation we spoke to dozens of former and current employees from phlebotomists right up to managers some let us record their interviews or allowed us to quote them. the c.s.l. senators that are right on the border i would like to say i'm pretty confident

saying 100 percent but let's say 99 percent of the donors cross from mexico. so plan to make their move more these companies said tom right next to the border because they know the locals need money they take advantage of that it was a poor. donors are paid and eligible for extra bonuses the companies use flyers radio spots and videos on social media to target their market of the month you can recruit as many friends for donations as you like the more frenzy recruit the more money you can earn. a plasma is an easy way to earn up to $400.00 a month as a new dollar while saving lives. that's right for turning down or also see monthly bonus payouts and i get more points. only donors who give it the maximum frequency allowed by u.s. regulators receive the full payment from mexican donors it's the equivalent of a small fortune but the payment is never referred to as such but we big to me when

i 1st started. was that we. don't need. and we compensate people based on their time here because we bought it from the individual that's a form of prostitution it made me. how much of a great area are we operating and we can't even we're giving you money for. only grief provided us with a written response it says donors receive compensation for their time and their commitment as returning donors. for the company's business at the border pays off we gained access to internal documents from great falls that show that a center in the united states gets an average of $164.00 donations per day. centers at the border more than double that amount the most successful center in el paso registers more than $600.00 donors a day and this is the record breaking center run by

a group feels most of the donors are mexicans but despite the large number of donors there's no public awareness about the blood plasma business at the border. we asked officials in mexico city the response was surprise the country band paid plasma donation in 1987 and all associated advertising. cohen are is the national council for self regulation and advertising ethics. got it is in mexico it's illegal to sell one's blood no one is allowed to advertise a product that they're not allowed to sell this. thank you this morning on the outskirts of see it out of water is a city ravaged by mexico's drug war 44 year old guy you know runs a gym here he needs to earn enough to provide for himself and his youngest daughter

. your normal because i always donate on wednesdays and on fridays or you have a lemon that today i'm going to donate with he says. so they pay right away so yeah we get paid for every donation so they give you a debit card and then you go to an a.t.m. with it. they transfer money to the card to you but yes when you're finished donating the money is on your card. the companies call it the compensation it amounts to 4 times would come a year earns from his gym. for the moment when you have a kid my little girl needs food toys fruit. thanks to the plasma i can pay for all these things. out of the 1000 us dollars are worth a lot here most everyone at the end of the day you're doing a good deed saving lives but it will cause you to be this are you going to let

your. a few kilometers away 21 year old here this is using the plasma money to pay her tuition fees like everybody i'm studying to become a paramedic my job will be to look after patients on their way to the hospital. he doesn't want something better i want to earn good money so that i can stop going to el paso. maybe to go shopping instead of going to this place now i'm a patient myself in the future i will take care of patients. as a trainer earns $100.00 a month but cost of living statistics show a $150.00 are needed per person per month to cover the bare necessities to secure an extra bonus tries to win over his client says donors as well. it's very

interesting very tempting. the only reason i'm. hesitant is the question what are the side effects what is a live look it doesn't matter. plasma is a blood component. the yellow liquid only becomes visible when separated from the rest of the blood. it contains valuable proteins immunoglobulins for example which protect against infections the plasma donation is different from a blood donation plasma is filtered from the blood and the other blood components are returned to the donor. that's passed the earth and not the plant is wrong is extracted. provided to the plasma company and made into medicines i mean the one. muser sold in pharmacies which is where i pick them up or do without. the practice of paying donors is legal in germany but compensation sums of up to $25.00 euros are comparatively small. giving plasma isn't

a problem as long as the donor undergoes a federal health check. standards in the united states in germany differ greatly. with which is to be in principle plasma donations in the us are also regulated and supervised by the author orators of all but tests of plasma protein levels are undertaken far less frequently than in germany and germany had started ahead of every 5th donation in the us it's done every 4 months. within 4 months so don't know might have donated plasma up to $34.00 times without a single check on their level of critical plasma protein or that. you know. this can lead to deficiency symptoms in us dollars says professor hirsch dan he conducted one of the few studies on the effects of long term plasma donation. first the donor doesn't notice this decline in his protein levels that's the tricky thing is that the lower the immunoglobulin g.

level the higher the risk of illnesses like pneumonia meningitis or urinary tract infections. if you can hold and soon going out on dates in fact and then you can die from that because it is a very serious infection. in the us less frequent health checks translate into a higher risk for donors in deutschland under german law every past month donation has to be coupled with a donor risk and health assessment. forked. another regulation that doesn't exist in the united states instead of the mandatory presence of a doctor physicians only need to be on call 9 of them have on site doctors and depending on the standard that you work at. your doctor might calm once a week for 4 hours which is the minimum that they require too. many donors in the us have been giving plasma for decades with no adverse side effects.

others suffer immediate symptoms. but continue donating anyway. some of my arms and legs go numb and i'm going to have my vision turns black is if i'm about to faint i get migraines and that's usually how i feel like one of us. and i want to sometimes staff more than tast if you're still reacting but that's all they don't really pay a lot of attention to the people donating. the money they give me a wrap. and nothing more. to some team isn't talking i feel like a guinea pig and like livestock but i judge them i'm more like

a commodity than a patient or a donor they're in. chaos and don't know and. of course it was more about numbers and i would compare it to like a factory type setting. although the majority of the people i work in telecoms aren't malicious and they don't home with malintent they know that if this donor didn't state specifically that they passed out and we just say oh she just had her eyes closed and bad they wouldn't have to look into as much. p.p.t.a. is the trade organization that represents plasma producing pharmaceutical companies it's former president bush is visiting labs at the us mexican border. i have nothing and good words to say about dissenters that i have seen on the border some just. dealing with mexican donuts. many mexicans cross the

border on a temporary b. one b. 2 visa it allows for visits to the united states provided applicants apply the necessary documentation. one of the requirements is people do need to establish the fact that they have a reason to return to mexico that they have a home or wife something like that there that they're not just using it to come into their country and add to the u.s. population in the illegal manner. under the trump administration border officers are focused on catching those entering the country illegally. but they usually try to slip in beneath the border bridges. the placement owners arrive the official way holders of a valid visa are issued a border crossing card and are allowed to pass through.

in order for a mexican don't have to cross the border they need to have a u.s. visa the u.s. fisa is supplied by the u.s. . government on a couple of conditions for that and they go and then donate the plaza. with this piece a mexican's register at the u.s. donation centers upon entering the country there checked by u.s. customs and border protection officers. people using a b. one b. to be said to cross the border and earn money selling plans what they could put that document at risk. and why is that. because the b. one b. 2 visa is not a document that allows someone to work or live in the united states simply a document that allows them to enter for other reasons so the pattern offenders say it's not right if that happened they said i more and i want more and i think i'm on the left. but that's your position. you know people are being compensated they're being paid. i each week

thousands of dollars are paid by these centers apparently nobody has ever asked whether it's legal for mexican donors to be paid in the u.s. . the p.p.t.a. says plasma donors are not employees of donation centers. the u.s. state department issues their visa and confirms. generally an exchange of goods or services for remuneration in the united states is found to be inconsistent with permissible activities on the b. one b. 2 visa. technically under the trump administration there are strict rules for entering the country but plasma donors have been managing to get through for years the p.r. declined our request for a response c.s.l. angry falls wrote see ourselves plasma complies with all laws in the countries in which we operate. all donors regardless of where they come from must comply with all necessary health regulatory and legal requirements to

donate there are no exceptions. some employees of donation centers offer precautionary advice. i told them at the border don't say you're coming today max or you might lose your visa. i do know for you that we. don't all just don't have your current going tony coming to your aunt's house or your cousin's house or you're going for whatever reason to the mall. it's the donors who carry the risk though they're largely unaware of the possible consequences. the one thing the organ was my understanding is that it isn't illegal but if you fall into the hands of an ill tempered officer they can take away your visa because it's like it was so you better not say where you're crossing the border. and all but i cannot. believe look at what i always tell

them i'm visiting my aunt who lives in the city center. one of you carrying anything of a water bottle in my id. what do you do for a living but over that i work at a gym and an assembly plant. ok i take your. success. w.-o. has been crossing for 9 years kinesis for 3 most of the blood plasma donated in the us is exported to europe the us and europe are the biggest global markets for plasma medicines. paul stringer is the head of an association of plasma producers that advocates unpaid donations unlike the p.p.t.a. we should be very happy that in the united states so much class most collected because we need the plasma for the patients who are in need for the products however if you are becoming very dependent on one country and there is

a monopoly there you see that the balance is not ok. leo test is one of several plasma processing companies in germany it makes medicine out of frozen blood plasma . in nearby marburg c.s.l. bearing process is blood plasma including from supplies harvested in the u.s. revenue in germany amounts to 2000000000 euros. the firm grip falls distributes the medicines in germany with sales of some 280000000 euros it also operates the commercial blood donation chain hamma. demand for blood plasma is growing more and more donation centers are opening in the united states in germany the number of donations has been stagnant for years. many european countries now rely on us plasma germany is on course to such dependency experts are concerned. when there is an disaster in the past for supply united states for example because

i knew that the chicken is being direct access which cannot be inactivated then the whole passed by industry will collapse and europe will be. absolutely defective of that situation. 2 hours later each donor earned $40.00 today in return for $800.00 milliliters almost a leader of blood plasma. donors are weighed before every donation and i don't know alan i mean i weighed one pound 2 little in the minimum wage is 50 kilos i tried to make myself heavier with my backpack but it wasn't enough and. messy until more or less i'm so mad i didn't even have my health to sell today. but . for the 1st visit with all the bills a little it's like suddenly being unable to go to work and losing your source of income. as this was going ok i know i'm trading my health for my others

apparently need the help of us donors more that's all right but what price are we paying. in fact it would be easy to protect donors even beyond national borders the german city of gurlitz on the polish border offers a case in point crossing one of the border bridges on foot takes just a few minutes on the german side there's a plasma center run by the same company that dominates the collection market at the u.s. mexican border grief holds the owner of germany's him a donation centers. plasma donor tourism exists here as well.

donors are paid 22 year olds compensation. i think is one of them said she got over coffee this morning i told my wife i'm heading over to gurlitz to donate prize for the panel run a few errands here in town pick up some things in the drugstore you know. the kids are taking it here donating plasma isn't a matter of survival it's a way to earn a little extra income in your clothes or both of you but with some donors you can tell they come here a lot. yet there are children there are not earning their livelihood here but it is a small cash groups. and also. after 4 visits donors are examined to determine whether they have enough antibodies to give plasma a 5th time. in the u.s. there's a greater willingness to take risks both on the part of pharmaceutical companies because the law lets them and on the part of donors because they are poor. i would say you know. all

a large number of them are probably have some kind of condition or something that. they're maybe just not telling us about. donors often don't mention preexisting conditions they also receive little information about the possible long term effects of giving plasma. this willingness to take risks is based on ignorance and it begins with center employees. at the company actually and you can bureau about long term how will they really don't even use an employee they don't tell you hey this is what might potentially happen with any of your donors whether good or bad. the pharmaceutical companies declined to comment on specific allegations. to donna does not know what the long short term or long term side effects are you i have a responsibility in medicine and this medicine will act in order to to be ethical

in that regard. kinesis in gumma you know want to know if donating is affecting their health since the donation centers won't tell them we arrange a medical checkup based on the studies conducted by professor hellish to. the check up at the laboratory in ciudad juarez is far more detailed than those carried out in u.s. donation centers. there a fast test determines the amount of protein in the blood there isn't even a minimum value for the antibodies in assistant gemmell you know we're both allowed to donate this week. i feel fine i've always felt healthy since i started donating.

and i can feel that i'm not in a good state of health i think they're going to confirm that. i just hope that i don't have an advanced condition luke is nothing more. that be enough. on its own that was. the lowest. you ever felt bad and i think pain in your chest trembling lips stiffness in your hands or legs and must be nice to see you yeah that happens about twice a month sometimes twice a month. so you know i also keep coming down with the flu i'm always having to take something how often approximately and. the last time was a month ago. and it's coming back now. and look i mean it's.

84.7 kilos. what it is 48.2 kilos in clothes. sometimes i don't see myself the way i am sometimes i think i'm too thin other times i think i'm too fat. millisecond i like putting on clothes like these i love them i like seeing them and

touching them to me was funny doesn't hurt anybody and it feels very healthy to me . and it distracts me. waiting for the results. i. think that the welcome back i have to pay my college exam fees soon. how much is it . they think it's $140.00 that's expensive. we were like. my brother fell victim to organized crime he was executed we could go according to the autopsy he was tortured 1st and then buried in the

yard of some house after he was 28 years old. so i'd rather see him if he was done a plasma then sell her body or smuggle drugs into the united states. is a bit less risky. results. if you look at it in your immunoglobulin level which we can see here is about 200 milligrams below the limit. when i get sick so often. yes you probably know. he's got your turtle protein level is a bit too low as well this is definitely a consequence of your frequent passing my donations and that you have a lonesome day my friend once at. each.

of these are your results look at your immunoglobulin g. level is also below that limit just slightly. but this is my advice to you as a doctor is to stop donating for at least 6 months and the last month i meant. his message was they say it's very unlikely that you will recover if you carry on donating at this rate and to see you could face more serious consequences with increasingly serious infections bronchitis for example or new monia because your body's defenses are too weak. you know because i want you when you are in better health but i still recommend you reduce the frequency of your donations you currently do $98.00 times per month i would recommend a maximum of 5. on

the one hand i'm relieved that i'm not sick. on the other hand it appears i'm pretty vulnerable. to the fuel so i'm worried. about your health but the particular piece of. me had it just stop donating would be a luxury i can't afford. in the middle. i just feel it's very important that everything is ethically sound. good there are no shortcomings and people are not treated in ways that hurt them. so it. when we show him our footage from the us mexican border the 59 year old can

hardly believe it. as well now this is of course totally unacceptable and shouldn't be allowed to happen. just now to donors really should be taken better care of these are for this woman sake and for the sake of others who don't i wish i would wish to see a different ethical approach one that's more humane m m's. the father and daughter are not isolated cases studies have shown huge differences between american and european donors. spend on a considerable number of u.s. donors who we started also fell below the threshold values that apply in germany. and we discovered that if you pull the plasma off the different groups that's the argy level in the paid to go nation or group from the u.s. it was much lower and we can only find as a reason that the frequency of the nation was playing

a role here. different standards apply in the u.s. and they can carry a heightened risk to donors health that's something that could be of concern to german officials who inspect donor centers in the u.s. officials in the state of hessen for example from the darmstadt regional council they inspect all centers that export plasma to has and. german medical association guidelines are not applicable to inspections in the u.s. . german standards are not relevant here the polar bear lake institute also monitors u.s. donation centers by order of the federal ministry of health in all the cases where the plasma is destined for the german or european market. in name for we make on site visits we look at how donors that treated and selected we look at the quality of traceability systems the relevant e.u.

regulations lawyer fees are all important aspects that are inspected on site. but german inspectors aren't interested in the protection of donors but rather for the protection of recipients things not relevant to recipients are not subject to review in all other cases german officials refer to us jurisdiction. this results have given her a clear picture we show them to the paul ehrlich institute. in our view in the case of the female donor the results do not comply with the threshold values which means her donations would not be purchased or exempt and. in germany hennis is would not have been allowed to donate but that doesn't stop her plasma from entering the german market this creates a double standard one that benefits the pharmaceutical companies the p.p.t.a. maintains that american laws are being observed and says donors do not even give plasma that frequently. in the united states legally you're allowed

to donate twice a week which theoretically could mean donor could donate whole a 100 times a year away for when we look at our every change and we see every stone age about 17 times a year. but there are big differences between the national average and the centers at the border we've received an internal grief document that shows the majority of high frequency donors go to centers at the border. fences single male in. donate about $100.00 times a year. it's been 3 days since they got their test results. so they looked. after what the doctor said to try to stop donating a soon as possible. i'm still healthy and i want things to stay that way. but i'm extremely worried about you about how it's damaging you as tough a. principle i don't think you should continue donating. i think it was years in

the same way for their i can't stop it's my only source of income. you have so much you're young you're strong you're smart how are you doing. i'm fine. your results tell a different story of those. who used to have nothing to eat now you're lecturing me about my health. that's not what this is about stop exaggerating you're not the victim here. to impose there's always a solution ok. ok. you better not say any more. it blows my plasma business is not the most honest honest they should tell the

donors what could happen to them and often if i know you know they should take better care of us their ideas their. lives. brussels february 2019. the european union weighs in on the block's dependence on plasma from the us. a group of delegates urges the commission to take action. well we import about 40 percent from the united states why because we do not have enough. material here to work on so what we need is more. plasma donation. the problem in europe is that there are neither enough centers nor donors and the donors who do come don't come often enough. which nightgowns i've managed and i wish people would donate more so the conditions would improve. if conditions there were adjusted and raised to match those in europe and there was

a unified standard then donors over there would feel that they were valued. and that. can brussels do anything to protect donors. the e.u. sets the rules for plasma imports the laws are being reviewed says the german health ministry without being more specific. aligning standards is a topic that might be discussed. insiders would welcome such discussions in the us too. i think we can expect to milk our donors for as much harder move we can dad of them and then not talk about any potential negative effects that they might have. but no one feels like it's their responsibility to initiate this conversation much less raise ethical concerns. this is it's not subject to a regulator a control the ethical approach some to speak of. and

says coming at them when i dress up in costumes i like the way i look. is he then i feel good and of. course i don't know of your it's not a morally correct business. going to say obama as long as there's a buyer there's a seller. so we're just trading our health for dollars. you know you have no choice.

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