Nicolae Birdan still chokes up at the memory of his father growing ill. Unable to find work as a welder, Birdan labored on a farm for a month, and almost all the money he made went to buy medicine for his father. He could barely feed his wife and infant son.

As he contemplated his dilemma, the 24-year-old could think of no way to raise money -- he had nothing to sell. Or did he? Finally, he heard something from a friend who put him in touch with a woman, and before long he found himself spirited out of the country and lying on an operating table in Turkey.

A week later he was on a bus back to Moldova with $2,700 in his pocket -- and one less kidney.

"I realized I wasn't going to come back the same," he says now, "but I had no choice. I needed money to treat my father."

Here in one of the poorest villages in the poorest country in Europe, at least 14 and possibly as many as 40 men and women made the same traumatic decision to sell body parts to survive. This is a desperate place where desperate choices seem reasonable and mafia-like rings prey on the unsuspecting. Young girls and women are sold into sex slavery abroad. Young men were shipped off to fight in the Balkans over the past decade. About 25 percent of the working-age population has left the country to try to find work.

Perhaps no place in Europe faces the wrenching problems of poverty quite as acutely as Moldova. Torn by civil war and lagging behind while the rest of Europe charges forward toward economic union, this landlocked former Soviet republic sandwiched between Ukraine and Romania has become a black-market hub of human trafficking.

Most prostitutes working in the Balkans came from Moldova, and European investigators consider this Maryland-sized farming country of 4.4 million a key source of kidneys sold to wealthy Israelis and Europeans. For a time last year, Moldova even cut off foreign adoptions for fear that babies were being sold for spare parts, a concern that proved unfounded but seemed credible enough to investigate.

"Poverty and personal problems force people to do this," said Adrian Tanase, head of the renal transplant department at the gloomy, run-down hospital in the capital of Chisinau. Every month someone walks into his office begging to sell an organ, which the doctor turns down. "In developed countries, that hasn't been done for a long time, but here you can buy or sell anything."

Moldova has struggled to transform itself into a modern state since gaining independence in 1991. In linguistic, ethnic and cultural terms, Moldovans are close if not identical to Romanians, and after the Soviet breakup many agitated to rejoin Romania -- which it had been part of between the world wars. That precipitated the tiny nation's own rupture, when a pro-Moscow eastern region, Trans-Dniester, waged war in 1992 to break off, taking with it the country's sole steel factory and a huge store of ammunition.

While pan-Romanianism has faded, Moldova has never fully recovered. More than 80 percent of its people live below the poverty line. For years, the government paid wages and pensions only sporadically, and until recently electricity was available just a few hours a day.

All of which made Moldova an easy target for exploitation. The International Organization for Migration considers Moldova the main European source of women and children for forced prostitution in Western Europe, the Balkans and the Middle East. A team from the Council of Europe, a human rights organization, visited last month to investigate Moldova's role in the human organ trade.

"The situation is very dire," said Jean-Philippe Chauzy of the migration organization, which set up a Chisinau center last year to fight sex slavery. "It's a lucrative activity, it's a low-risk activity. The women who are trafficked have no one to turn to. It's fair to say this phenomenon will not decrease anytime soon."

Typically, young women are lured overseas with the promise of waitress or housekeeping jobs, only to be forced into the sex trade, sometimes sold two or three times. In the organ-trafficking rings, Moldovan intermediaries are paid $100 or $200 for each person they recruit, similarly with false assurances of work in Turkey or Georgia.

"They were told they would be given jobs," said Simion Mita, a doctor in Minjir. "They were told at the last minute when they were in Istanbul that they would have to give up their kidneys. If they refused, they would be thrown out on the street without their documents for the police to pick up. Where could they go?"

Birdan, the destitute welder, knew what he was going for but now believes he was taken advantage of. "Of course I feel very bad and cheated to have to do it," he said recently, standing in the rain outside the plain cinderblock house he bought after selling his kidney.

About 50 miles southwest of the capital, Minjir offers its 5,800 residents a plain and impoverished way of life. Off the main road, the streets become mud pits during rain, impassable in some parts of the village. Horse-drawn carts slog alongside beat-up cars, some filled with apples or corn destined for market. The luckiest residents earn $60 a month canning vegetables.

In 1999, Birdan recalled, he was told he would be paid $3,000 for one of his two kidneys, minus $300 for travel and the broker's fee, and then was flown to Istanbul. After a few days waiting and a checkup, he was brought to a hospital for surgery. "There were a lot of Moldovans being prepared for their operations," Birdan recalled.

Most healthy people can live fine with just one kidney, but some later suffer if the remaining kidney becomes troublesome. Birdan, often drained of energy and wracked by headaches, went last month to a Moldovan doctor who told him he had a blood condition that may stem from the kidney operation.

Buying human organs is illegal throughout most of the world, but underground rings flourish because so many people need kidney transplants and donated organs from cadavers are so scarce. The ring that operated in Minjir served patients from Israel or Europe who paid up to $150,000 for a kidney, according to investigators. Finding voluntary donors in Israel is difficult because many Jews believe bodies must be buried whole. Israeli national health insurance, however, pays some of the cost of obtaining kidneys abroad. Moldovan investigators broke up the Minjir connection and charged the broker, who fled the country.

But officials here regard the problem with varying degrees of alarm. Some insist that the only victims of organ trafficking were 14 people from Minjir two years ago; the officials likewise maintain the sex trade has been overstated. "The situation is not nearly as bad as some people are trying to portray it," said an Interior Ministry official.

Other specialists estimate that 300 Moldovans have been taken abroad for their kidneys and thousands to work as prostitutes. Pyotr Serbinovsky, the former investigator on the Minjir case, said at least 40 villagers were involved there alone although just 14 cooperated with police. The organ trade continues in Moldova, hidden from authorities, he said. U.S. authorities are investigating reports that Moldovans were brought to the United States to have their kidneys harvested, although a U.S. official said the investigation stems from activity two years ago.

Foreign and Moldovan officials have moved to combat the problems. The government opened a human-trafficking department to investigate cases, while the U.S. Embassy helped start an anti-trafficking center last year and the migration office launched a public campaign to warn Moldovan women to beware of overtures from abroad.

The main weapon against such exploitation would be economic improvement, and some signs point to a turnaround. For the first time since independence, the economy grew 4 percent last year and is on track to grow another 6 percent this year. The government has ended wage arrears, resumed work with the International Monetary Fund and agreed to a European-brokered plan to resolve the Trans-Dniester dispute by granting the area broad autonomy.

"I'm sorry to say that the transition has been dragging on for a long time," said Prime Minister Vasile Tarlev. "We don't want it to go on forever. But most countries, including the United States, have gone through transitions and crises. Of course it includes a lot of problems, but for the first time in the 10 years of the transitional period . . . the quality of life is improving."

Nicolae Birdan sold his kidney to help his father buy medicine.