Who is responsible for the Aswan epidemic?

The people of Egypt are wondering about the causes of the so-called Aswan epidemic in the south of the country. Hundreds have become sick, and people are worried about a possible spread of cholera; there have been claims that Sudanese refugees are spreading it.

Despite official denials of the spread of an epidemic and confirmation that the health situation in Aswan is stable, the mysterious disease brought to mind the blackout imposed by the government during the 2020 Covid outbreak, before it claimed the lives of thousands of Egyptians.

Aswan is a major tourist destination during the winter season. This has led to more media coverage of the health conditions in the province, which lies on the border with Sudan.

According to the Egyptian authorities, 480 people are suffering from intestinal flu, with diarrhoea, nausea and vomiting. These cases come from Abu Al-Rish area and some villages in Daraw, north of Aswan, which has a population of about 1.6 million people, according to government data.

A man from Aswan, requesting anonymity, confirmed that some people have died while others are critical in intensive care units. He said that people are worried that the disease will spread with the start of the new school year, as classrooms are very crowded.

However, Egyptian Minister of Health Khaled Abdel Ghaffar tried to reassure local residents, denying that there are any cholera cases in Aswan and stressing that the results of all medical tests for all types of microbes came out negative.

Abdel Ghaffar kept his position and denied that the five people who had died in the province did so from intestinal flu, the symptoms of which are similar to cholera. During a press conference at the Friendship Specialised Hospital in Aswan, the minister rushed to blame the local people claiming that their digging of sewage pits close to drinking water sources could lead to sewage water mixing with drinking water.

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A document issued by Aswan University Hospital on 19 September described the death of a man due to a severe intestinal infection that led to dehydration, decreased kidney function and a stroke, according to a report published by Mada Masr.

Cholera is a bacterial disease that causes symptoms including severe diarrhoea and dehydration.

If left untreated, it can cause death within hours.

A few days ago, the Sudanese Ministry of Health announced that the cholera epidemic in the country has resulted in 15,500 cases so far, including 506 deaths since August.

A medical source in Aswan, also requesting anonymity, told me that the three main hospitals in Aswan had received hundreds of cases, including patients with cholera, noting that strict instructions were given so no one would speak to the media about the reality of the situation. “However, the situation is now calm,” he added, “and there has been a significant decline in infections.”

Egypt is a favourite destination for Sudanese refugees, who are concentrated in Aswan, Cairo and Giza. The number of Sudanese refugees registered with the UN High Commissioner for Refugees in Cairo is around 470,000. Unofficial estimates, however, suggest that the figure is much higher.

The raging war in Sudan has led to the spread of cholera, malaria, measles and dengue fever. The Egyptian authorities are raising the level of readiness on the southern border zone, especially in the ports of Arqin and Qastal, but an increase in smuggling activity via the desert paths is pushing thousands of Sudanese refugees into Egypt.

The second possible cause being discussed is related to contamination of drinking water. It is believed that toxic materials resulting from the discharge of waste from the Egyptian Chemical Industries Company, Kima, has contaminated water supplies. The company, which produces urea and ammonium nitrate fertilisers, denies responsibility.

The Egyptian government is planning to offer shares in Kima for sale on the Egyptian Stock Exchange. This means that the company is likely to be exonerated from the pollution incident, for fear of affecting its market value. The company’s revenues amounted to 6.53 billion Egyptian pounds ($130 million) during the fiscal year ending on 30 June, according to Stock Exchange data.

Aswan Drinking Water and Sanitation Company, is owned by the government. It confirmed that there was no contamination in drinking water that would lead to poisoning, according to local media.

Government employee Mohamed Mustafa blamed Kima, stressing that the drinking water was contaminated because of a leak in one of the chemical fertiliser production lines. Moreover, the company’s waste is being discharged into the River Nile. He pointed out that the factory management tried to reduce the criticism directed at it by sending a shipment of bottled mineral water to the residents of the areas affected by the pollution.

Accusing the Sudanese of spreading cholera, said Mustafa, is wrong, because hospitals did not receive any cases of illness among them. It does not make sense for them to be carriers of the disease, while remaining healthy.

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Surprisingly, Minister Abdel Ghaffar, who previously claimed that the laboratory samples were negative, said that the examination of diarrhoea samples showed an infection with Escherichia coli bacteria, which is spread through contaminated water or food, and can spread between people.

Such bacteria are found in food or water contaminated with faeces. They cause infection in the digestive system and urinary tract, and symptoms include diarrhoea and vomiting, but some types of Escherichia strains cause severe symptoms that may lead to death, especially in the elderly and those with chronic diseases.

Conflicting official statements and announcements continue to be made.

This has increased people’s fears that the government is hiding something, especially since there have been previous incidents in which the authorities were not transparent with the facts.

Local authorities say that they are working to ensure the safety of the water by taking samples from 103 drinking stations in Aswan. They are also checking food businesses to monitor compliance with safety standards, and following up on hospital attendance rates. A decrease in the rates of reporting cases of infection has been confirmed, compared with what it was two weeks ago.

Social media activists say that the flooding in Sudan in August caused the Nile to become cloudy and mixed with drinking water. Water treatment stations were unable to purify it, which caused intestinal infections. This claim may be supported by the transfer of dozens of cases of those infected in Aswan to kidney dialysis units, explained a doctor at Al-Masalla Hospital.

Residents of Abu Al-Rish, one of the infected areas, blocked the Aswan agricultural road for hours, because many of the villagers were suffering from fatigue. They called on the government to intervene urgently to save them.

An Egyptian media figure close to the government, Amr Adeeb, used his MBC Egypt show, “Alhikaya”, to call on the government to issue an official statement revealing the reasons for what is happening in Aswan. He stressed that the show’s production team have tried repeatedly to communicate with officials at the ministry of health, with no success.

According to observers, the government’s dilemma is that it doesn’t want to scare tourists away during the province’s main tourist season, especially with the outbreak of the infection coinciding with Aswan’s celebrations of World Tourism Day last Friday. Hence, the Governor of Aswan, Ismail Kamal, has tried to reassure everyone, claiming that reported cases of illness were due to the psychological effects of the presence of a disease. He also blamed it on eating sweets at Friday’s tourism festival. “We do not have a single cancellation of hotel reservations,” he insisted. “On the contrary, we have reservations for a month and a half ahead.”

Nevertheless, the two possible causes of the Aswan epidemic — cholera or water pollution or even both — remain plausible. The authorities are trying to keep the situation under control in the south of the country, but the crisis has revealed a lack of transparency from the Egyptian government, and a loss of credibility in its official statements.

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