Start with the instruments. The surgical stapler alone — the device that cuts and seals the stomach — costs between 10,000 and 60,000 Egyptian pounds. That range depends on whether it's a Chinese generic or an American brand-name. Then there's the hospital: operating room, anesthesia team, nursing staff, one or two nights stay — that's another 30,000. The surgical team fee is comparable to the instrument cost. Do the math: the floor for an ethical bariatric surgery is 120,000 to 130,000 pounds minimum.

Let me tell you what I've seen with my own eyes. Disposable surgical staplers — plastic devices designed for single use — being sterilized and reused on the next patient. Some have forged labels: a sticker that says the brand name of an American company, glued onto a Chinese counterfeit. The patient pays for premium instruments and gets counterfeits. This is fraud, and it endangers lives.

I've reoperated on patients who came to us after complications from cheap surgeries at other clinics. A leak from a defective staple line. Bleeding from an improperly sealed vessel. The cost of fixing what went wrong was triple what the original proper surgery would have cost. You can have a hundred problems in life. But the moment you have a health problem, you have only one problem. Fix it right the first time.