The men living in the tough Baseco dockside shantytown on Manila Bay carry one of two badges to prove they belong -- tattoos for the gang members and surgical scars for the kidney sellers.
Built on muck dredged from the bay on the orders of former first lady Imelda Marcos for a visit by Britain's Queen Elizabeth, who never came, the 52-hectare (128-acre) open garbage dump is a grim reminder of the desperate poverty of the Philippines.
Few escape from the ranks of the largely unskilled and poorly educated settlers who arrive by ferry from other islands to hire themselves out as stevedores and porters.
When things get bad the men sell their blood.
And when all seems lost many resort to selling an organ.
"I was paid 160,000 pesos (3,848 dollars)," said Joey Rosco, 38. A curved, 13-inch scar running along his left side from below his ribcage to his hip is the only evidence of the 1991 surgery.
"The money is long gone now, and I am still poor," the father of five with a tattoo of a woman's face on his right bicep tells AFP outside his cramped hut of plywood, bamboo and tin sheets.
But he could consider himself lucky since he appears reasonably healthy.
He says a neighbour and fellow donor died from complications seven years after undergoing the same procedure, while a third donor accidentally killed his pregnant wife after using the money he earned from selling his kidney to buy a handgun.