The New York Times-20080125-Trying to Support a Family After a Kidney Transplant- -Series-

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Trying to Support a Family After a Kidney Transplant; [Series]

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Ranny Smith, 51, became an American citizen in 1999, but he still carries Jamaica with him. It is in his first name -- meant to be Danny, he said, but misspelled there on his birth certificate -- and in his speech, accented with the molasses lilt of his homeland.

In 1993, he immigrated to New York. To make a living, Mr. Smith said simply. Those countries are hard. Life in Jamaica is hard. He worked construction jobs, earning minimum wage as he learned the new trade. In Jamaica, he was a mechanic.

He had planned to work, save and then start school to become a mechanic here, explaining that both the qualifications and the cars are different. He never got that far. I take sick, Mr. Smith said.

Feeling weak, vomiting, and with a bad taste in his mouth, Mr. Smith saw a doctor, who did a blood test.

His kidneys were failing. His blood pressure was high, which can cause the illness, but Mr. Smith does not know when it began, or whether an earlier diagnosis could have lessened the severity.

By 1995, Mr. Smith's days were almost completely taken over by his treatment. He could take on only odd jobs between dialysis appointments: three times a week, four hours a session, which left him exhausted.

He had come to New York to earn a living and support his family, who live in both countries. He shares an apartment in Brooklyn with a niece. He has three children -- the youngest is now 18 -- in Jamaica. They rely on me, he said.

Instead, he is just lucky to be alive. If the condition had been spotted in Jamaica, where he had no medical insurance, it would have been different. I would have died, he said. I couldn't afford it. You'd have to be a millionaire to afford that down there.

In May 2000, Mr. Smith had a kidney transplant. He is no longer on dialysis but takes six daily medications, including one that keeps his body from rejecting the kidney.

It's a wicked tablet, but I have to take it, he said. Side effects include high blood pressure, weight gain and an increased risk of diabetes.

Mr. Smith lives on about $300 a month in Supplemental Security Income benefits, and what he earns working part time stocking shelves at a dollar store in Brooklyn, about $630 a month. His portion of the monthly rent is $350. He also receives about $150 in food stamps. Medicaid covers the cost of his prescriptions.

He is not well enough to work full time and not strong enough to return to construction. Though he is eligible to collect full disability benefits, in 2005 he approached the Brooklyn Bureau of Community Service, one of the seven agencies supported by The New York Times Neediest Cases Fund, for help in finding work.

I'm tired of sitting down, Mr. Smith remembered thinking. I can't stay in the house every day. The exercise of the part-time job is also good for his health. He found the position through Brooklyn Bureau's Supported Employment program. Living on his income takes careful budgeting, and it is hard to find extra money for seasonal necessities. This winter, Mr. Smith turned to his job coach, Venus Burgess, at the employment program, with a specific request for help.

I went to Miss Venus and I explained to her that the cold is coming, he said. He needed a winter coat and boots, but could not afford them. I have to pay rent, gas bill, food bill, and I have to go to the doctor.

With $250 from the Neediest Cases Fund, Mr. Smith was able to buy winter clothes. I appreciate that 100 percent, he said.

In the spring, Mr. Smith hopes, he will find some help to replace his old mattress, which is hard on his arthritic back, he said. On his own, he cannot afford $800 for a mattress, frame and box spring. If they help me with half, it would be no problem, he said.

[Illustration]PHOTO: Ranny Smith manages a part-time job, despite his condition. (PHOTOGRAPH BY G. PAUL BURNETT/THE NEW YORK TIMES)
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