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What is a kidney worth?

(Page 4 of 11)

They are several of the roughly 300 Brazilian and Israeli sellers that police say were brought to South Africa between 2001 and 2003. The syndicate was run, police say, by an Israeli named Ilan Perry. He and the other organizers were making hundreds of thousands of dollars in profits. They probably picked South Africa because it has top-notch medical facilities and one of the world's best transplant-success rates. It also has weak laws regulating the sale of human organs.

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Hernani has signed lots of forms, including one that says he's "related" to the man to whom he's about to give his kidney. Finally he meets this man - an Israeli named Amiram Aharoni - for the first time. Walking into the room, it's then that Hernani understands the magnitude of what he's about to do. Mr. Aharoni is all swollen and pale. He cries when he sees Hernani. He's too weak to lift himself up. But his wife passes along their message with a tender hug. "You are part of our family now," she says. "From this moment on, you are our flesh and blood."

The operation takes place on Nov. 26, 2002, and lasts several hours. Lying in two nearby operating rooms, Hernani and Aharoni undergo surgery at the same time. Hernani has three surgeons operating on him because of the complexity of the procedure, which sometimes involves removing a rib.

When Aharoni wakes up, he has a fresh kidney and a new lease on life. When Hernani comes to, he feels a tightness where the wound has been stitched shut. But three days later, when he finally boards the plane back to Brazil, he is a happy man. He is going to be rich.

* * *

That joy fades fast as he arrives back at his mother's house in Recife. It's been almost 24 hours since his plane landed, and Daisy is scowling at him. She suspects he's been to see Antonia. She's both relieved and depressed to see him alive and back in her life. She's tired of their sad marriage. She's sure he doesn't really care about the three children jumping around the street - or about Daisy herself, who dropped out of school at 14 to set up a home with him. Even after weeks on the other side of the world, the man taking a red bicycle out of the taxi doesn't even look at her.

"Luiza,go and get yourself ready. We're going into town to get you a bicycle," he shouts to his 9-year-old daughter as he hands the new bike to his son, Hernandes. Then he turns his back and walks toward the local plaza.

He's determined to have some fun. After all, he has money in his pocket - $5,500 in crisp new $100 bills handed to him by Captain Ivan under the table at a fast-food restaurant near a local branch of Citibank.

For someone who has been poor all his life, money is to be spent, not saved or budgeted. And spend it he does. In the first few months of 2003, Hernani pays $1,700 to replace the roof, the floor, the walls, the windows, and the wiring in his mother's house. He uses $1,600 to pay off her credit cards. Another $1,200 buys him a brand new Honda CG 125 motorcycle, which he insists the dealer deliver to his house so his neighbors can see. On New Year's Eve, he buys Daisy a new blouse and skirt. He figures that leaves him somewhere between $1,000 and $2,000 to spend on drink and other women. Life is good.

Paying a healthy stranger

While Hernani is busy blowing through his money, in Israel Arie Pach is hoping to avoid a life tied to a dialysis machine. But he's running out of options. He's been ruminating over them since 1995 when doctors first detected a problem with his kidneys. He knows that patients who get kidneys tend to live longer than those on dialysis. So he considers turning to his wife or sons for a kidney. Since they come in pairs, a healthy person can live on just one. But his wife and oldest son have the wrong blood type. His youngest son is a match, but he has health problems similar to Arie's. So getting a kidney from a related donor is out.