Ayah El-Ghandour says that her father was murdered. Arrested and taken from his home in the middle of the night Dr Tarek El-Ghandour was everything that the Egyptian regime despises: anti-government, anti-regime ideology, affiliated with the Muslim Brotherhood and professor of dermatology and venereal diseases at Ain Shams University, an institution that has hosted several anti-coup student protests.
Around a year into his detention, El-Ghandour started to bleed profusely when stitches from an operation on his oesophagus became loose, yet nobody in the hospital would treat him. He paid a member of staff at the hospital to give him a medical balloon and put it in place; eventually, the bleeding subsided, but doctors later pulled the balloon out.
"One of the blatant medical mistakes, which in my opinion was the reason behind the murder of my father, is that they took him to the operating room and removed the balloon," Ayah tells MEMO. "Of course, the balloon must stay in place for at least two days. When they removed it a fountain of blood exploded and they were unable to get the bleeding under control. His heart stopped and he remained in the ICU until he died on the morning of 12 November."
Ayah's father is one of 323 people who have died inside Egypt's detention facilities since August 2013. Like Tarek El-Ghandour, many of them died after being denied medical care even when there was evidence of how critical their situation was. Ayah sent MEMO this medical report, which states that El-Ghandour's health was in a serious condition and he needed to be transferred from the prison to a proper hospital for an operation.
The Egyptian authorities claim that they provided him with the medical care he needed but Ayah says this is simply untrue: "If they had given him medical attention they would not have left him to bleed for six hours without doing anything about it. If they had given him medical attention, they would not have removed the balloon he used to treat himself." Many others have confirmed what Ayah said; that when medical treatment is desperately needed, it is deliberately stalled.
Ahmad Al-Basousy told MEMO that his father, Dr Salah Al-Basousy, was healthy when he went into prison. Then one day Ahmad received a phone call from a fellow detainee to say that his father was suffering from internal bleeding in the kidneys and needed an injection. When Ahmad informed the prison authorities that treatment was needed they simply told him that they didn't open the cell doors at night. The next day they refused again and Ahmad's father died before dawn.
"This is a clear violation and it is medical negligence," says Thomas-John Guinard, legal officer for the Nile region of Alkarama, a Geneva based Human Rights NGO, commenting on the refusal to provide necessary medical care to a prisoner. Just because someone is in prison it doesn't mean that they don't have any rights to receive medical care and yet this is exactly what's happening in Egypt. "What we have seen in the past two years is that there is a systemisation of the denial of medical care to political prisoners," explained Guinard.
Throughout Egypt's history many prisoners have died in its dungeons. A recent report authored by Guinard for Alkarama, Death Behind Bars, documents that 52 died under interim military rule and 56 perished under Mohamed Morsi, whilst Mubarak oversaw 30 years' worth of violations. Yet Guinard says the culture of impunity under the current Egyptian authorities has reached "unprecedented levels" with figures more than trebling in the past three years. The report concludes that these deaths are the consequence of the Egyptian authorities' systematic abuses.
From their arrest to their death prisoners in Egypt are treated inhumanely. Taken from their homes in the middle of the night, their locations are kept a secret for days with families left to search and wonder. Often they are picked up for protesting but in many cases the exact reason for the arrest is not clear.
As well as being denied medical assistance prisoners are also systematically tortured, which in some cases has been the cause of their death and in many has certainly contributed towards it. Israa Said, niece of Dr Emad Hassan, told MEMO that after her uncle's arrest her family were still trying to locate him when they received a phone call from the prison requesting them to go and collect his body, which bore the signs of torture. "No one knows why he was taken," she says. "He didn't even protest."
Khalid Ali tells MEMO that his brother Emad was arrested at 3am on the charge of protesting, and was healthy before he went to prison. For the following eight days he was tortured, beaten and given electric shocks. When his health got worse he was denied medical assistance, despite his family offering to pay for treatment; eventually he was given antibiotics but it didn't stop him vomiting blood.
The prison authorities claimed that they were trying to help diagnose him but he was given no treatment, his tests were two weeks apart and no reports or results were produced; the delay was blamed on paperwork and the system. On Eid Al-Adha, a nurse called to say that Emad was dead. When asked if he will take the case to court Khalid replies simply, "There's no point, there is no law."
As highlighted by Deaths Behind Bars courts do not dismiss confessions obtained under torture, which in turn encourages officers to extract "confessions" in this way. The authorities refuse to open investigations and instead produce fake death certificates claiming that the person has committed suicide whilst at the same time providing no independent autopsy results.
In some cases the denial of medical care is torture itself and although it's hard to evaluate exactly where the threshold is, when the refusal is constant and based on political affiliation "torture is easily characterised," says Guinard. "What we have seen in the past two years is that there is a systemisation of the denial of medical care to political prisoners." That applies to any member of the opposition with little regard for their age, gender or position.
Somaia Safwat realised that her father – Dr Sawfat Khalil, a leader within the Muslim Brotherhood — was missing when their family returned home from a protest without him. Eventually, someone answered her sister's calls to say that he had been arrested and asked her not to call again.
Khalil had cancer and had previously had a leg amputated. The family showed the prison authorities official documents from the hospital in which he was being treated which said that he required special medical care and that he must continue his chemotherapy. Even so, the prison authorities wouldn't allow him to have any medication to ease the pain.
"They deliberately delayed his treatment sessions, and he was treated while being handcuffed," Somaia tells MEMO. "When we would beg them to un-cuff him only while he received his treatment, they would refuse this and say those were their orders. He was in pain both from the chemotherapy as well as the cuffs… this of course led to the severe deterioration of his health."
When Somaia visited her father she saw signs of torture on his arms and legs, which she believes pushed him to suffer from severe weakness and nausea. "This caused him to reach a very progressed st
age of his illness which ultimately led to his death," she says, but she won't take it to court because the lawyers used by political prisoners have also been arrested. "We do not have a judiciary," she says.
Like all the people MEMO spoke to for this article the conditions in which Somaia's father was held sound grim. "They brought [prisoners] their food in the plastic containers used to mop the floors," she says. "They used their hands to search any food brought in by the family."
Cells are often packed to three times their capacity, which means that detainees have to take shifts in standing and lying down. There are no beds and no exceptions for the disabled or pregnant women. The windows are small, which makes the summer unbearable, worsened when other inmates smoke and take drugs. Detainees report bedbugs, cockroaches, insects, rats, pigeons, unclean toilets and poor quality food whilst their private property is confiscated and visitation times are kept as short as two minutes. Illnesses which are fairly straightforward to treat, such as asthma, are exacerbated; Alkarama documents that five prisoners have died from suffocation after having asthma attacks.
"What emerges from the Egyptian detainees' testimonies about their conditions of detention is the absolute deprivation of their dignity," says Guinard. The video link below, recorded by a detainee in Minya Prison last year and sent to Alkarama, exposes these terrible conditions.
The human rights abuses revealed by these families' stories are a small part of the widespread violations that have taken place in Egypt in the past two years. Massacres, arbitrary arrests, death sentences, farcical trials, enforced disappearances, extrajudicial or summary executions, violations of freedom of expression and peaceful assembly and have all been documented widely; they have also been widely ignored.
Rather than taking a step back from Egypt the international community has shown support, says Guinard, pointing out that after the Rabaa massacre the US re-established military aid to Egypt, France sold aircraft to Al-Sisi and David Cameron did not address human rights abuses on the Egyptian president's recent visit to Britain. This is because Egypt is seen to be taking the lead in the fight against terrorism, but it does not do so with integrity. "Egypt, under the pretext of the fight against terrorism, commits a lot of human rights violations," says Guinard. "It's normal to fight against terrorism but this has to be done in a way that respects fundamental human rights, which Egypt is not doing."
Western countries in particular really see the threat of terrorism as something that is above fundamental human rights, he continues. "They themselves don't respect fundamental rights when they act against terrorism so of course you will have less chance of Egypt being criticised for its human rights record." Without international condemnation Egypt's civil society is blocked. "What we have today is a dictatorship in Egypt; it's a military regime and as long as the international community is OK with that it will continue to violate human rights."
This level of impunity will slow down the implementation of human rights in Egypt as will the fact that injustice in the country has turned on its head the simple notions of what is right and what is wrong. Somaia Safwat recalls waking up one day to see that her car had been set on fire. "When I thought about notifying the police," she tells me, "I was advised not to in order to avoid being arrested."
Somaia's story neatly demonstrates Egypt today: the victims of injustice are treated like criminals, while the real criminals get away, quite literally, with murder. And all, it seems, with the blessing of Western governments.
Laila Ahmet contributed reporting
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.