Last week a woman died in hospital after packages of drugs, thought to be cocaine, burst inside her, causing a massive overdose. Clara Ayemenre, a Nigerian, collapsed at Heathrow's Terminal 3 before reaching customs. Surgeons at Ashford Hospital in west London who operated on her found 84 packages of the drug in her stomach.
Other couriers are luckier. Although being caught means they face punishment, medical techniques usually mean their contraband is discovered and removed before it kills them.
Customs officers have the power to detain, for an initial period of 96 hours, anyone they suspect of carrying drugs internally. Of all the messy jobs in the world, taking suspected drug 'swallowers' to the lavatory and then sifting through their faeces to find small packets of swallowed heroin and cocaine must be one of the least appealing. But it is a daily task for the customs and medical officers who work in the custody suites at Heathrow.
In the days of the Portaloo and the plastic bag, the work was really unsavoury; it involved a spatula, colander and perfumed face mask. Now the 'throne room' is all stainless steel, perspex and transparent plumbing. The washing down of drug packages takes place in a sealed sluice, from which only the contraband emerges to be submitted for analysis.
The number of swallowed drug packages recovered is usually between 80 and 150. The drugs are wrapped in condoms, balloons or cling-film, forming neat packages about the size of a large grape, and swallowed with syrup to make them more palatable. Couriers take a constipating agent before they embark and tend not to eat during the flight.
Apart from the damage their trade does to the health of others, smugglers who use their bodies as a vehicle for drugs put their own lives on the line. If a package of heroin comes open in transit, the chance of death is high. When a detainee passes an empty condom, he is rushed to hospital. It may just be the outer wrapping of several layers, but it may equally well be the first sign of a medical emergency.
Another risk is of intestinal obstruction caused by packets jamming together in the gut, so any sign of abdominal pain must be taken very seriously. Laxatives are unwise in this situation, since increasing the fluid content of the faeces could lead packages to swell and burst. The surgical removal of swallowed drugs from detainees at Heathrow is required two or three times a year, and
hospitals in Uxbridge and Ashford are well acquainted with the
'Stuffers', as opposed to 'swallowers', will use any orifice available. The vagina in particular proves commodious, especially in women who have had several children; a photograph in one case record shows a package the dimensions of a decent-sized marrow that was carried into the country this way.
Having stopped a passenger on suspicion, customs officers must look for evidence. A strip search - which detainees can refuse until their appeal is heard by either a senior customs officer or a magistrate - will only reveal what is visible on the naked body. And while grease around the anus or a protruding string clearly give the game away, the suspect can still refuse an intimate body search.
If the detainee does agree to a medical examination of body orifices, the fingers of the examining doctor may be able to detect vaginal packages, or those concealed in the rectum. One of Heathrow customs' two medical assistants has earned the nickname 'Goldfinger' because of his expertise.
When it comes to the 'swallowers', X-rays provide useful information: packages in the gastrointestinal tract show up because of air trapped within the wrapping. The British Medical Journal once published a paper describing this technique of detection under the title 'An Unusual Case of Pot Belly'. But women typically plead pregnancy as a means of avoiding X-rays, and men are also within their rights in refusing to submit to this examination.
All swallowed packages leak, however tightly they are tied, and the drug is absorbed into the bloodstream to be excreted by the kidneys. One of the most useful medical tools of the investigators' trade is a sophisticated laboratory device that detects trace quantities of drugs in urine.
Some passengers test positive because of drugs they have taken for legitimate medical reasons, and they must be carefully excluded. Others may have taken illegal drugs, but before embarkation, and that cannot be held against them. But a drug level in urine that increases over the hours after arrival is good evidence that packages are concealed internally. Such evidence is sufficient for suspects to be taken before magistrates and remanded back into customs' custody for an extended period of detention.
If all possible searches have failed or been refused, it is a waiting game, as one medical officer recalls: 'A suspect was remanded on the evidence of a positive urine test and my statement saying I had felt three packages in the rectum. But over the next 48 hours the detainee refused to eat or drink, and nothing was passed. At the second court attendance, the magistrate said he had no case to answer and he was released. But shortly afterwards customs re-arrested the man. Over the next day, he passed 37 drug packages.'
The longest time officers have waited for a suspect to deliver is 19 days, a performance that would put the most anal retentive personality to shame.
A question customs officers are always asked is how they decide whom to stop in the first place. The origin of a flight certainly attracts attention: West Africa, Pakistan and Colombia are obvious sources of drugs. Over a recent six-month period, half of the 149 Heathrow suspects who appeared before Uxbridge magistrates were accused of cocaine smuggling.
Almost 10 per cent of them were Colombians.
Nevertheless, the majority of defendants were British; and for these people, the likelihood of being stopped is often determined as much by the way they leave the country as by how they enter it. A suitcase containing condoms in unusually large quantities excites suspicion. So, too, do large amounts of dental floss, since it is used to tie drug packages. Other suspects are earmarked for detention when they return because of intelligence gathered in this
There is said to be a particular way of walking that comes from having a rectum full of drugs, but an officer I spoke to thought that was not a significant factor.
Neither did he regard profuse sweating and agitation as a good guide.
It certainly cannot be that the traffickers look guilty, since we all do. 'I don't like going through customs myself,' he said.