On the back of dire poverty, legal shortcomings and religious conservatism, a new mafia is prospering in Egypt and turning the country into the regional hub for the human organs trade, experts say.
There are no official statistics but in a country where social inequality is high and a quarter of the population is believed to live under the poverty line, more and more destitute Egyptians are falling prey to the phenomenon.
The large scars slicing the sides of many Egyptians in impoverished Cairo neighbourhoods most probably testify to an illegal kidney sale to a rich fellow countryman or a Gulf Arab who could not find a donor.
"A Saudi patient can pay up to 80,000 dollars split between the doctor, the donor and the go-between," says Hamdi al-Sayyed, the head of Egypt's doctors' union.
"For example, a Jordanian or a Saudi who needs a transplant comes to Egypt accompanied by a relative as an official cover and then looks for an Egyptian or a Sudanese who is ready to sell his organ," he explains.
While most donors are poor and hoping for a better life, not all are volunteers, with grisly accounts of forced organ 'donations' earning Egypt the sinister reputation of 'Brazil of the Middle East'.
Like millions of Egyptians, Abdelhamid AbdelHamid, Ahmed Ibrahim and Ashraf Zakaria were seeking better paid jobs in the Gulf but their quest cost them a kidney.
In a recent interview to the independent Al-Masri Al-Yom daily, they explained how they had been promised jobs but were requested to undergo a medical examination beforehand.
The doctor "discovered" they were all suffering from a kidney infection requiring immediate surgery. They woke up later in hospital with a missing kidney. The go-between had vanished but they feared to speak out.
A few days later, the health ministry caught a trafficker red-handed as he was selling a kidney to a Saudi citizen for 3,500 dollars. The Cairo hospital was supposed to be paid the same amount.
According to the main anti-narcotics body, a kilogram of bango, the popular local form of marijuana, fetches around 100 dollars on the drugs market. But dealers expose themselves to major risks to run their trade while organ trafficking can offer a safer and often more lucrative alternative.
"This mafia should be busted and the only way to do it is to pass legislation" regulating organ donation, Sayyed says.
Only cornea transplants are covered by legislation, with all other operations falling in a gaping legal loophole. "Some doctors see it as an opportunity to make easy money," he explains.
Sayyed, who is also a lawmaker, has been pushing for parliament to adopt new legislation slapping heavy fines and prison sentences on people found guilty of involvement in illegal organs trafficking.
His proposal also bans transplants between two people of different nationalities, in a bid to reduce the incentive for transplant tourism.
In the United States, selling organs is a criminal offense that can incur a fine of up 50,000 dollars and five years in jail, while laws are also very tough in Europe.
Yet in Egypt, the go-betweens cannot be prosecuted and the worst punishment facing corrupt doctors is to be stripped of their license by their peers.
Some of the unscrupulous doctors even sought the help of the judiciary to overturn bans by the doctors unions and won their cases.
"The situation is not tolerable. Not only does it feed a booming black market, it also leaves us with victims who are dumped after the transplant," says Haytham al-Khayyat, a regional official with the World Health Organisation.
Sayyed and Khayyat accuse a group of influential Egyptian figures, including doctors, of blocking the bill by hiding behind ethical and religious principles.
While Egypt's current mufti, or senior Islamic jurist, supports a bill, his predecessor Sheikh Nasr Farid Wasel vocally opposed it.
"We have the support of the official religious authorities, including Al-Azhar's Mohammed Sayyed Tantawi," who heads the highest seat of learning in Sunni Islam, Sayyed says, pointing out that the cleric himself volunteered as a donor in his will.
The Muslim Brothers, an Islamist movement which controls a fifth of parliament and is Egypt's main opposition force, also support introducing a bill. "Legislation is the only way to stem organs trafficking," spokesman Issam al-Aryan says.