When the body becomes an ATM

In Cairo, a thriving black market matches men desperate for money with those desperate for an organ transplant.

March 13, 2008|Jeffrey Fleishman and Noha El-Hennawy | Times Staff Writers

CAIRO — He sits quietly at the corner cafe, a gold watch flickering on his wrist. If you need a liver, or want to sell a piece of yours, grab a chair and get acquainted with Mustafa Hamed, a 24-year-old ex-bus driver who fell unexpectedly into a life as a broker in human organs.

Hamed's 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.

There was another way, one whispered about for those with nothing. A man could wager part of himself, slip into a hospital gown, and wake up with an incision above the gut.

Hamed sold a section of his liver for a bit more than the price of his son's operation. The boy died in surgery.

With his scar healing and his son buried, Hamed, whose knowledge of anatomy would perhaps fill a single page, decided that driving a bus was not the fate of the man he wanted to be. He brokered his first liver deal four months ago. He earned $900. Four more sales have followed.

"Things shouldn't be this way, but they are," he says. "I sold part of my liver to save my son. I had to do it. . . . You cut your body and sell your pieces. But some people who come to me aren't that desperate. They could find other solutions. Many men I see now want to sell their organs so they can afford to buy an apartment to get married. That doesn't seem desperate enough to me. I try to tell them: 'Be patient. You don't need to do this.' "

Patience and desperation move in curious currents in Cairo. Nearly half of Egyptians live in poverty, and although the nation's economy is privatizing and growing, inflation is crushing the poor and working class. The price of green peppers has risen 90% in the last year.

Thousands have moved to the richer Persian Gulf; many have put off marriage, a delay that in Egypt is the stinging sign of a man's failure. Others, such as Hamed, have bartered kidneys and livers to pay off debts and reinvent dreams.

Similar tales echo around the globe. Human organs are brokered from Pakistan to China; kidney-theft rings have swept through villages in India. The poor in underdeveloped nations, such as Moldova and the Philippines, are offered "transplant tourism" packages that arrange for them to travel to another country and sell their organs to rich patients. It is a market of desperation and ingenuity in which doctors ask few questions and donors often end up ill, and sometimes dead.

The business has thrived for years in Egypt. The country has no laws and little oversight regarding most transplants. Statistics are unreliable. Medical groups estimate that as many as 500 unlicensed kidney transplants are performed each year, but a legislator investigating the practice indicated that the actual number is much higher.

Donors and patients in Cairo know where to go. There are cafes near clinics and labs where the brokers sit, stirring tea and smoking, cellphones buzzing like insects on the tables.

Those needing organs are easy to spot. They carry X-rays and blood work charts under their arms. Some are ashen, some drawn; they need what they need quickly. They come from Upper Egypt and the Nile Delta, their purses and wallets bulky with borrowed money, and if they're lucky enough they'll be able to hire the Japanese transplant surgeon who flies in once a month.

"My doctor told me to come to this place," says an agricultural engineer from Upper Egypt who was shopping for a kidney near a lab in Cairo's Dokki neighborhood, where horse carts clatter and puffed bread cools in the breeze.

He will not give his name as he straightens his pressed tunic. "I'm 58 years old. I'm in renal failure and I have no children. I need a donor. Kidneys sell for between 20,000 and 40,000 pounds [about $3,600 to $7,300]. I'm bargaining, but I can't pay more than 30,000 pounds."

The donors face hardships of their own. Ayman Abdullah was an accountant in Upper Egypt when he and his brother decided to take their parents' savings and move to Cairo to open a cellphone shop. In a nation that's mostly desert, Cairo is a gritty, crowded neon promise of minarets and high-rise banks that attracts those willing to risk what little they have. Others who had left Abdullah's village had made a fortune in the city, or so went the stories that trickled back home.

Abdullah and his brother trusted a man -- he called himself a partner -- more than they should have. The man vanished with the money, and suddenly the brothers were 75,000 pounds, or about $13,700, in debt.

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