In 2011, the journalist and author Scott Carney popularised the evocative phrase "the red market": the sometimes legal (but more often not) trade in human body parts. It’s a business, he says, with which people feel fundamentally uncomfortable – evoking some sense that "the body should not be a mere assembly of spare parts", as Al Gore put it in a 1984 address to the US Senate.
For decades now, people have found ways to make money through simple "red market" sales in Cambodia. Common options include selling hair (legal) and blood (outlawed in 1991, and increasingly uncommon).
Last year, Cambodian courts handed down the country’s first conviction for organ trafficking, in a case which saw at least three men persuaded to cross into Thailand to have a kidney removed.
A US company evocatively named Ambrosia Labs in the past few months started paying 10 women in Stung Meanchey to have their breast milk pumped, packaged and shipped to the US.
And as the Kingdom’s medical facilities have improved, it’s opened even more new avenues for what some deem to be exploitation.
According to Carney, author of The Red Market: On the Trail of the World’s Organ Brokers, Bone Thieves, Blood Farmers and Child Traffickers the conditions necessary for a sophisticated "red market" to flourish are simple.
"Red markets flourish anywhere there are high quality hospitals and medical infrastructure in close proximity to sizeable populations of desperately poor people," he wrote in an email to Post Weekend.
Following Thailand’s crackdown on surrogacy last year, IVF clinics have moved across the border. As a result, Cambodia’s first generation of babies impregnated as part of commercial surrogacy arrangements are due to be born any day now and that the eggs of Cambodian women are being used to impregnate infertile women.
Amid questions about the morality and legality of certain trades, Cambodia’s authorities are playing a game of catch-up.
Confusion rules over what the ultimate ruling will be on surrogate births, with the government issuing and then contradicting statements on whether the trade would be treated as human trafficking or not.
And even in the case of the sale of organs – clearly outlawed under Cambodian law – there is room for uncertainty.
"We used to hear from other countries that people donated [kidneys] to family members without money, but they would just say thank you to the donor or financially support the family which was poor after the donation," said Keo Thea, deputy head of the Phnom Penh Municipal Anti-Human Trafficking and Juvenile protection office.
"I am not sure whether it is wrong to do it," he said of the unofficial support that recipients might provide to donors, adding that it was also extremely hard to establish whether money was changing hands.
Medical professionals say Cambodia’s lack of high quality surgical theatres is the condition that is currently holding Cambodia back from becoming a destination for the darkest aspects of the red market trade.
"We don’t have organ selling to control because we don’t even have modern medical equipment to operate on organs such as the kidneys, liver or others," said Dr Chea Por, a physician and general manager at DN Polyclinic.
Accoring to Por, sick patients will not undertake major surgery of any kind in Cambodia.
But transplants are not impossible in Cambodia. Indeed, in 2014 a supposed kidney trafficking ring was discovered to be operating out of Preah Ket Mealea military hospital – an allegation that was subsequently retracted amongst considerable confusion when it was announced that the transplants were part of a voluntary training scheme. Keo Thea said he was unsure of what the end result had been.
"It is really a mystery to try and control it," he said of the potential trade in organs.
Perhaps a more transparent index by which to gauge Cambodia’s medical infrastructure is the readiness of international companies to use the country as a cheap destination for clinical trials – a money making option that Carney brackets under the same red market label.
In a 2011 article for Outsourcing Pharma, journalist Nick Taylor proclaimed that Cambodia and Vietnam were the next countries on the "outsourcing map" for clinical research organisations (CROs) who pay patients to get sick and test run potential cures.
But while Vietnam has followed the trajectory anticipated by Taylor, Cambodia has yet to establish itself in this potentially lucrative market. When contacted by Post Weekend, both Roche and Quintiles – the two organisations Taylor thought might be interested in setting up operations in the Kingdom – said they had yet to make a move.
A Roche representative explained via email that a "certain infrastructure" was still lacking in Cambodia that would make trials feasible.
The significant exception to this rule is in the field of malaria research. In Pailin, known globally as the point of origin for drug resistant malaria, companies studying the effects and potential cures have little choice but to go to where the patients are.
And as Didier Ménard, head of the Malaria Molecular Epidemiology Unit at the Pasteur Institute, explains, it’s a situation that has introduced the same uneasy financial transactions that typify red market trades.
He recounts an anecdote from a friend working in Pailin, who encountered two children trying to get malaria because of the payout they’d likely receive: $10 or $20 depending on whether a hospital stay was required.
"We need to pay the patient because they waste their time – we have to compensate them for lost time, so we need to pay. But after that...how much? What is the good price? I don’t know."
If Carney is to be heeded, the conditions necessary to avoid these clashes of money and morality multiplying in Cambodia would have to be a rise in living standards for the general population that matches the arrival of sophisticated medical technology on offer in the capital.
"If [new] hospitals can attract high paying patients from abroad or from within the country then you have all the right ingredients for exploitation," he said.