Four years ago few Georgians had ever heard of Nobel a remote town in Walker County near the Tennessee border. However as the investigation into the affairs of Ray Brent Marsh and his Tri-State Crematory began to unfold, the ghastly horror branded the names forever.

The first case of its kind in Georgia, Marsh accepted human remains from 50 funeral homes throughout Alabama, Georgia and Tennessee for cremation at the family owned business. Rather than cremate, the bodies were deposited throughout the property and cement dust and other debris were returned to families falsely representing the remains of the diseased.

The investigation would finally lead to his indictment on 787 criminal charges associated with dumping 336 bodies. Rather than stand trial, Marsh pled guilty in 2004 and was sentenced to 12 years in prison last January.

According to reports, more than $80 million in damages have been awarded in civil lawsuits filed in conjunction with the case.

However, as horrible as the Tri-State Crematory story is, it pales in scope and profit when compared to the illegal trade in human organs, cells and tissues.

Documented cases show that trafficking in human bodies is as old as “the republic.” In 1788, New Yorkers stormed the facilities at Columbia College Medical School in search of stolen bodies used in the medical school.

With the emergence of human medicine, cadavers were needed for research and training. When there were no donors, the schools acquired the remains by whatever means at their disposal.

In the early 1800s an English physician, D. Robert Knox of Edinburgh was found to be in collaboration with two criminals, William Burke and William Hare, who were suspected of killing up to 30 people in London.

Burke and Hare murdered the people and sold the corpses to Dr. Knox for medical research. Burke was tried, found guilty and hanged in 1829. Hare died a pauper in 1858 and no charges were ever bought against Dr. Knox.

When Mary Shelley published the immortal work Frankenstein in 1818, it was considered a work in fiction. The general public could not have conceived that 100 years later doctors would be transplanting body parts to create and sustain life.

Leaping forward a century, the development of anti-rejection drugs such as cyclosporine and immunosuppressant drugs in the 1970s led to the development of the modern transplantation industry.

In the early days of this modern industry involving the harvesting of human organs and subsequent transplantation, there were few regulations and less monitoring of the illegal trade that emerged. When waiting lists for donated organs began to mount, profiteers established networks to make organs available to those with the resources to pay the price.

Both living and deceased sources were used to meet the growing demand. Centers for commercial transplant emerged in India, Iraq, Iran, Eastern Europe, South America and the Philippines.

Since a human can survive with only one kidney, this organ emerged as the body part of choice. People of means from all over the world have paid between $50,000 - $145,000 to acquire a commercially harvested kidney.

According to an article published in the Medical Journal of Australia, prior to 1994, India was considered the transplant capitol of the world, and 60% of all transplants were from paid donors. Prior to passage of the Organ Transplantation Act of 1994, it was not illegal to sell organs in India.

After the passage of the Act, a scandal that literally shocked the world came to light in January 1995. Customs officials in Delhi uncovered a ring selling organs and arranging for the harvest of organs in established medical facilities by licensed doctors.

On January 29, 1995, police busted a racket in Bangalore where the kidneys of 1,000 people had been removed for resale to willing purchasers. During the ensuing investigation, most of the donors said they had gone to the clinic to give blood only to awaken later to discover the surgical scar left when their kidney had been removed. Others reported being paid only a fraction of the agreed price for their kidney.

Although the paid donors received a couple hundred dollars, the harvested organs were sold through brokers according to the buyer’s willingness to pay.

An investigative report published in 2001, uncovered the trade of body parts flourishing in the republic of Moldova. According to the report an agent named Ms. Scobiola working inside the impoverished country offers jobs to men out of work. The jobs require relocation to Turkey.

The unwitting donors were then transported to Istanbul to rendezvous with another agent named Scobiola. When the jobs did not materialize, the recruits were given the option of selling an organ as a means of earning money.

According to Veleriu Galit (quoted in the published report), of Moldova's Department of Organized Crime, the doctors were Turkish and the recipients were mainly Israeli.

A film by Stephen Frears, Dirty Pretty Things, 2002, staring Audrey Tautou, illuminates the trafficking in human body parts by the impoverished. It called attention to the thousands of transactions each year taking place undercover to feed the profits of exploiters at the expense of the desperate.

It is now illegal to sell human body parts in all countries except China and Iran. Reports show that China transplants the organs of executed prisoners.

During the 1980s, reports began to emerge in the world press that western consumers were paying for the organs of kidnapped children along the Mexican border. The reports became so widespread that the U.S. Department of State was prompted to issue an official statement on the matter:

“…The baby parts myth has now such widespread currency that it continues to feed on itself and, tragically, is widely believed despite numerous corrective statements, authoritative statements pointing to the impossibility of such practices occurring and the fact that despite almost ten years of searching, no government, non-governmental body, or investigative journalist has ever produced any credible evidence to support the charges.” [Created May 30, 1996 and updated January 27, 2005, US Department of State, International Information Programs]

In November 2004, the US Congress passed the Human Tissue Act that established the Human Tissue Authority. The Authority does not become active until April of this year, but currently the Federal Drug Administration (FDA) is in control of monitoring Human Cells, Tissues, and Tissue Based Products (HCT/Ps).

Recent cases will test the law to determine if those trafficking in human body parts can be tried and convicted.

According to the American Association of Tissue Banks, there are more than one million tissue grafts performed in the US each year. This tissue is supposed to be from properly screened volunteer donors.

Common uses for this tissue includes: femur bone used in hip replacements; cancellous bone chips, a spongy material used to fill in bone fractures and gaps left by the removal of bone tumors; patellar tendons from knees used to repair torn anterior cruciate (a common sports injury); and skin grafts for severely burned patients and reconstructive plastic surgery.

With this number of transplants, problems are bound to occur. In 2001, A Minnesota man died of complications from knee surgery involving infected cartilage. A year later, several patients were diagnosed with hepatitis C after receiving donated organs from a single corpse.

The spread of communicable disease in some of these cases has been traced to illegal activities involved in the harvest and sale of human cells, tissues and organs.

In 2004, the Willed Body Program at UCLA became the subject of a criminal investigation that led to the indictment of Henry Reid, 54, the program’s director and Ernest V. Nelson, 46, for receiving stolen bodies. The case alleged that from 1998 through 2003 Reid received $704,600 for 496 cadavers donated to the UCLA program.

Subsequently, Nelson claimed that acting as a middle man for medical researchers he had purchased 800 cadavers from UCLA and in some cases used campus facilities to cut-up cadavers to harvest knees, hands, torsos, heads, and other parts over a six year period.

Late last year, a story broke in Brooklyn, New York involving 6 funeral homes selling body parts to Biomedical Tissue Services, a Fort Lee, New Jersey tissue bank founded by former dentist Michael Mastromarino.

Joseph Nicelli, 49, an embalmer at several Staten Island funeral homes is charged in the case for procuring the bodies paying between $500-$1000 each and forwarding the remains to Mastromarino, 42, who would harvest the tissue and prepare them for shipment throughout the U.S.A. and Canada.

The story came to light when the body of 95 year old Alistair Cooke, host of the PBS series Masterpiece Theater for 22 years, was carved up for skin tissue, bones, tendons and body parts and sold prior to cremation with out the consent of his family.

Official medical records show Cooke died of cancer and FDA rules forbid the use of any body tissue harvested from a cancer victim being used for transplant. Records sequestered by the FDA show the age lowered to 85 and cause of death altered to show heart attack.

Investigators exhumed the body of a Queens, New York, grandmother in October last year. Prior to burial, all the bones below the waste had been removed and replaced with PVC pipe.

On October 13, 2005, the FDA issued a recall of products made by tissue processors in New Jersey, Florida, Georgia and Texas.

With the case against Mastromarino and Nicelli still pending, on January 31, 2006 the FDA issued an Order to Cease Manufacturing and to Retain Human Cells and Tissue Based Products Mastromarino and his company Biomedical Tissue Services, Ltd.

The reasons sited for the order include: failure to insure donor eligibility; falsifying death certificates; falsifying ages of donors and cause of death; recovered HCT/Ps from unclean environment which caused contamination and cross contamination; and accepting bodies that had not been refrigerated.

"FDA’s investigation of Biomedical Tissue Services revealed serious widespread deficiencies in their manufacturing practices that provide the agency reason to believe that allowing the firm to manufacture would present a danger to public health by increasing the risk of communicable disease transmission,” said Margaret O’K Glavin, FDA’s Associate Commissioner for Regulatory Affairs in her press release on February 3, 2006.

It is clearly a crime to accept money for cremation and then drop the remains in the woods, i.e., Ray Brent Marsh, but can laws and punishment begin to address selling body parts for profit or fraudulently taking the diseased remains of the dead and selling them to unsuspecting recipients only to have them contract and spread deadly disease and infection?