Josiah Phukwana has almost given up hope of ever getting a kidney. He has been on dialysis since 1999 and his whole life is now concentrated on going to and from hospital for treatment.
The articulate 52-year-old has had to give up work and family life and lives with his mother and their extended family in Zola, Soweto.
They are supportive, as are the congregants of his church. But life is a burden.
Three times a week he takes a taxi from home to Johannesburg General, where he is hooked for four hours to the dialysis machine that scrubs his blood of the toxins his failed kidneys no longer remove.
He had a kidney transplant in 2002, but the organ was not sufficiently closely matched to his body, which rejected it.
"After five years of waiting I have almost given up hope of getting another kidney," he says with resilient despair.
He is almost part of the furniture in dingy ward 475, where the dialysis machines hum all day long treating fellow victims of kidney disease.
Is he used to the procedure? Does life continue normally?
"It's difficult. It's not normal," he responds quietly, as if not to call attention to himself in this ward of desperate patients, each with a similar tale.
"I feel great when I come off dialysis, but I'm exhausted by the time I get home and sit down. The next day I feel better."
What does he think his chances are of getting a suitably matched kidney?
"People are afraid. They don't understand," he says in anguish. "Even the members of my church are reluctant to become donors.
"[Kidney disease and transplants are] a huge problem and people should get to understand the problem. We are stuck here [until we can get kidneys].
"People must think about this and get to know about this condition. Cultural and religious fears about organ donation are costing so many of us our lives."
He was diagnosed with high blood pressure in 1999.
"My siblings have high blood pressure and diabetes, so there is no hope of getting an organ from my immediate family."
Like so many victims of kidney failure, money is tight since he had to stop working as a clerk at a paper-supply company. He must spend so much time being treated and travelling to and from hospital that no employer would want to keep him on the payroll.
Like many other long-time patients on dialysis, time is running out. The ward's nursing sisters, whom he calls his family, can hook up the dialysis machine to only so many points on his body. But over the years the points have become infected and damaged. Now they are using the last spot they can on his tired body.
What happens if that fails?
His answers with a shrug.