By Ayesha Akram
BBC News, Lahore
Mr Amjad works 10 to 12 hours a day but still cannot pay off his debts
Muhammad Amjad, 34, takes out his rosary during a five-minute-break between shuttling customers around Lahore in his auto rickshaw.
These noisy machines, which can be heard from afar revving their four stroke engines like buzzing locusts, are usually decorated with brightly coloured motifs or poetic verses.
But the back of Amjad's rickshaw, which he has been driving for almost a decade, is completely covered by a white cloth banner with an advertisement sprawled across it in black and red painted letters.
The advertisement has been put there by Amjad who is eager to sell his kidney (blood group A+) to the highest bidder.
"I don't have any other options," he says. "My family can't help me. The government doesn't help me. What can I do?"
Amjad is one of many poverty-stricken Pakistanis driven to desperation by the recent escalation in the prices of food and oil, caused by the global food crisis and the coalition government's inability to provide sufficient state-subsidies.
Almost one-third of the Pakistani population - about 40 million people - lives below the poverty line, according to the World Bank.
Amjad's greatest problem is the loan of $4,200 he took out two years ago to take care of hospital expenses during his mother's illness.
Almost daily, Amjad's creditor knocks on his door and screams at him.
"He (my creditor) insults me all the time," he says. "I am tired of feeling helpless."
Desperate times are prompting many Pakistanis to adopt dangerous measures.
In three villages near Gujranwala, located about 75km (47 miles) from Lahore, one member from each of the 300 families living there has sold a kidney.
Atta Chohan, a resident of the area, says the stories of many kidney sellers are similar to Amjad's tale of woe.
"Often the kidney seller is a brick kiln worker who has taken a loan from a landlord and is unable to pay it off," he says.
Selling kidneys is a potentially fatal procedure
"Sometimes men sell their kidneys to pay for the weddings of their daughters or hospital bills."
Besides Gujranwala, the kidney trade is also flourishing in southern Punjab especially in cities like Sargodha.
Here, more than half of the people living there have sold a kidney.
The reasons for the flourishing kidney trade are simple - the poor are reaching their breaking point according to economist Dr Qais Aslam.
"There are both short-term and long-term affects of the grinding poverty," he says.
"In the short term, criminalisation is increasing, people are selling their children and in some cases parts of themselves. The tragedy of Pakistan is that a majority of the population is being forced to scavenge themselves."
Amjad, who spends a good 10 to 12 hours a day ferrying customers around Lahore, says that despite the long hours he pulls at work he can only afford one meal a day for his family.
The kidney trade is flourishing in parts of Pakistan
On good days, he makes about 1,000 rupees (about $14) to 1,200 rupees (about $16), out of which 200 rupees (approximately $3) is spent on petrol and another 200 rupees is paid to the owner of the rickshaw from whom he leases the vehicle.
"It's just not possible to live on this amount," he says, beads of sweat glistening on his forehead and worry etched on his face.
Abdul Sattar Edhi, popularly referred to as the Mother Teresa of Pakistan, says that stories like those of Amjad are proof that Pakistan is at the worst stage in its history.
"I fear that we will soon come to a stage where the poor will start dying of hunger," he says. "I have never seen such depressing conditions in Pakistan before."
But Amjad still considers himself to be fortunate. His friend recently committed suicide after he was unable to raise finances for his daughter's wedding and his mother's illness.
Many of Amjad's neighbours have started mobile-snatching or indulging in other petty crimes, he says.
"At least I'm earning my living honestly," he says.