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What is a kidney worth?

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Every day, 17 Americans die of organ failure. In Israel, the average wait for a kidney transplant is four years. In response, a global gray market has bloomed. In India, for example, poor sellers are quickly matched with sick buyers from Taiwan. Critics call it "transplant tourism." Proponents say the market is meeting a need.

The Monitor follows three men: an unemployed Brazilian and an ailing Israeli, as well as a South African investigator who helped bust an organ-trafficking ring.

The case raises anew hard legal and ethical questions, such as: Who owns our bodies? Should it be illegal to sell an organ if it could save someone's life? What is the government's role in protecting two vulnerable groups - the poor, who are willingly exploited, and the sick, who are desperate for healing?

On a warm afternoon in Recife, a city on Brazil's northeastern coast, Hernani Gomes da Silva sits alone in the Bar Egipcio, quietly nursing a drink, ruminating about his predicament. He is 32 years old and still lives in his mother's two-room house. Rain comes in through the roof, and cockroaches and rats scuttle across the cement floor. He has three kids, a wife who loathes him, and a mistress 20 years his senior. He is unemployed with no money, no skills, and a criminal record. The future is bleak.

Suddenly the words "we pay people $6,000" leap out at him from behind. His radar clicks on.

"I don't mean to eavesdrop," he says, turning to the bald man sitting at a nearby table. "Were you talking about earning money from transplants?" He has heard of others in Recife who have sold their organs and can't believe his good fortune.

"Yes," says the man.

"Which organ?" Hernani asks.

"The kidney. Why, are you interested?"

"Of course I'm interested."

"What blood type are you?" the man asks.

"O-positive," says Hernani.


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