Zayed is representative of another class of individuals with the virus. They didn't contract it from the bilharzia-treatment campaign, but sometime after, once it took hold in the community and continued to spread. It's almost impossible to trace the source of infection for these people, especially since many patients can go years without knowing they have it. And because so many practices inherent to village life involve shared blood, it is extremely difficult for doctors to identify specific risk factors. The possibilities are endless: Could families share toothbrushes? Go to the same community barber who doesn't sterilize his equipment? Pass around the gouza, a water pipe, when some may have gingivitis? Have babies circumcised by nontraditional health practitioners?

"So you have this huge pool of infected people, living, aging, with HCV," says Mahoney of the U.S. Naval Medical Research Unit. "[Say] you go to the barbershop and people have HCV, and you get a nick. Things that are low risk in a low-prevalence country become high risk."

But the high potential for contracting the virus doesn't create much anxiety; nor does having the virus create much anger or fear. Zayed is feeling fine, so -- like many others who are antibody-positive -- his only complaint is that he missed an economic opportunity by staying in El Tod. His acceptance is not particularly unusual. Even those who were most likely infected by their government's medical campaign feel this way. "We believe it is all from Allah," explains Moawed El Sayeed, Hamdy's brother. "No one can prevent it."

Public health officials say this belief makes their job -- altering a population's behavior because of a disease's threat -- that much more challenging.

"Usually Egyptians are fatalistic," says Sharaf, the parasitology expert. "They may think, 'I may catch this anyway.' They are very religious but it makes them a little too fatalistic, so they're not careful enough. This concept has to be passed on to them: Do your part, protect your family, your children, and then be fatalistic." Protecting oneself can be as simple as not sharing needles for the administration of medication and using orally administered drugs as an alternative.

On the second floor of the National Liver Institute in Shibin El Kom, which sits in Minufiya at the heart of the delta, Dawood Faragiskander, a frail man who looks to be in his mid-50s, is slowly dying. He wears a red jogging suit that almost mocks the state he's in, one in which he can barely talk. "In 1996, I would smoke and it would hurt in my abdomen," says Faragiskander in a hushed tone that is more of a whisper. "[The doctors] didn't discover hepatitis C until I started vomiting blood."

His brother reveals Faragiskander's I.D. card -- he is pictured wearing a big cheeky smile, a bow tie and a dinner jacket. Now his skin looks more like a loose canopy tent, caving in where there are no bones to hold it up. The I.D. also shows how old he really is -- only 39. "He's been here since Sunday," says his wife, Amal Aziz. "We came here because we heard this is the best place."

Faragiskander has end-stage liver failure and has just waked up from a coma. Like most other people in the hospital here, he is not alone; his brother, and wife wait by his side.

"Can you do anything to help him?" asks his brother Samir, helpless, as he and the others start crying. "We are willing to give everything we have. We just want him cured somehow."

The family knows that a transplant is the only thing that can possibly save him. Faragiskander came in too sick for doctors to do much more. But what the family doesn't know is that the country's largest liver institution doesn't even perform them at this time. Same with the National Cancer Institute in Cairo.

Cultural and religious opposition to removing organs from the deceased has kept Egypt from recovering livers from cadavers. The only treatment option has been the partial liver transplant, in which doctors take a lobe from a healthy donor, and then place the reddish-brown organ into the person in need. But the surgery is prohibitively expensive -- hundreds of thousands of dollars -- and difficult to justify because it jeopardizes the healthy donor's life. A healthy man died last year following surgery at New York's Mount Sinai School of Medicine.

The partial transplant also doesn't guarantee that the virus won't invade the new liver, leading to failure once more. Nonetheless, doctors at both the Liver and Cancer Institutes say there are plans to begin split liver transplants in the near future. And some private hospitals have recently begun to do so as well.

It's too late for Faragiskander. He died a few weeks after I visited. He leaves two little girls, a wife, and a family without their main breadwinner.

During that time I also visited Hamdy in the hospital, where he drifted in and out of sleep. He looked tired but happy and talked about how much he missed his daughter. Asked if he is angry about contracting the illness, he said nothing but pointed up, to the heavens. There was no talk of reparations, no demand of the government, no grievance with anyone. "It's up to destiny," Hamdy said. "It's up to God if we should find treatment now." Soon afterward, he died.

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