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What is a kidney worth?

(Page 11 of 11)

In South Africa, four alleged syndicate members have been charged and await trial. Johan Wessels and Captain Helberg and his team have expanded the investigation to hospitals in Johannesburg and Cape Town.

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In Brazil, Captain Ivan is one of 28 ringleaders who have been indicted. In all, some 50 cases are being investigated by a parliamentary committee, which is expected to submit its findings in September. Hernani has been helping, despite receiving death threats. When he testified before Parliament in January, he wore sunglasses and a shirt up over most of his face to hide his identity.

Daisy, meanwhile, has made up her mind to leave him - as soon as she can raise the money to support herself and their children. At one point, she considered selling a cornea. She's heard the going rate is nearly $30,000.

Around the world, meanwhile, organ-sale laws are shifting. In Israel, for instance, one proposed law by the Ministry of Health aims to halt the country's involvement in the trade by targeting organ brokers - including penalties of up to three years in prison. Another proposal would allow voluntary organ donors to have all of their related healthcare costs picked up, as well as compensation for lost time at work when recuperating from the surgery. Others in Israel, such as Friedlaender, argue that the government should set up a fund to give substantial compensation to those who volunteer to be living donors.

In the US, Wisconsin recently became the first state to give living donors a tax deduction of up to $10,000, to write off lost salary, and medical and travel costs. At least 14 other states are considering similar measures. And in April, President Bush signed the Organ Donation and Recovery Improvement Act, which reimburses living donors for expenses incurred during the process and funds research projects aimed at increasing donations.

But laws may not keep pace with a global market moving at the speed of commerce. There is, for instance, skyrocketing demand for pieces of livers, which can grow into a fully functioning organ in a recipient. Now a website - - promises "transplant surgery in as short as 10 days" in the Philippines.

Sitting in his office in Jerusalem, Friedlaender points to a small trinket hanging from one of his bookshelves. One of his patients brought it to him a couple of months ago after going abroad to get a new kidney. It's from a country that may already have replaced South Africa as a hot spot for body-part trading.

It's a red paper lantern from China.

Editor's note

This report was written as a nonfiction narrative. Specific scenes and dialogue are based largely on recollections of those who participated in the kidney-transplant trade, but did not know then it was illegal in South Africa. The reporting was done over five months in four countries.

Correspondent Andrew Downie flew to Recife, Brazil, and met with Hernani Gomes da Silva and his wife, Daisy, four times over four days, reconstructing what happened. Later, he confirmed more facts and details by phone with the da Silvas, their attorney, and Brazilian police.

The Monitor paid Mr. Gomes da Silva its standard photo fee for use of a picture of him with his Israeli kidney recipient in South Africa. Normally, the Monitor does not pay interview subjects for information to avoid conflicts of interest. In this instance, that risk seemed marginal.

Staff writer Abraham McLaughlin went twice to Durban, South Africa. He spent four days meeting with police and investigators and visiting St. Augustine's Hospital. From South African court documents, and a photo provided by Hernani, the Monitor tracked down the Israeli recipient of Hernani's kidney. But the recipient declined to be interviewed by staff writer Nicole Gaouette. In Jerusalem, staff writer Ilene R. Prusher met twice with Arie Pach and his wife, Mary, who were willing to relate their experience. They also spoke nearly a dozen times on the phone.

David Clark Scott
World editor