The Egyptian Initiative for Personal Rights issued a report titled, “Health in Egyptian Prisons: a field study on the determinants of health behind bars.” The study found poor health and living conditions in Egypt’s prisons that did not fulfill the minimum components for the right to health, including availability of healthcare services, quality of services and the competence of healthcare providers. The study documents the difficulties prisoners face in obtaining quality, adequate healthcare services and the lack of clear measures to enable prisoners to access care inside prisons.

“The study examines health conditions in 16 prisons and police stations in Egypt through interviews with 37 people, including former inmates and prison doctors, lawyers and experts,” said Heba Wanis, an EIPR researcher. “The assessment is based on a detailed survey covering all aspects of health in detention facilities, derived from the basic determinants of health as set forth in General Comment 14 on the International Covenant on Economic, Social and Cultural Rights, as well as contact with the outside world, an element included in the Standard Minimum Rules for the Treatment of Prisoners and the Optional Protocol to the Convention against Torture.”

The study looks at the availability and quality of healthcare, including ease of access, qualifications of service providers, access to medication, facilities and infrastructure of healthcare, discrimination in access to care, treatment of critical cases, healthcare for women and children, psychiatric care and the fundamental determinants of health.

The study finds that the level of health services varies greatly from one prison to another in terms of the basic infrastructure, facilities and human resources. The research findings indicate that there are shortcomings in the provision of urgent services in emergency cases and that procedures and decisions needed to intervene in critical cases move slowly. This is especially significant since physicians in detention facilities are not affiliated with the Ministry of Health, but with the Prison Authority; they are wholly subject to the Authority’s oversight and disciplinary measures, and have Ministry of Interior police ranks. This has a negative impact on the independence of medical opinion in prisons, particularly in cases that require release on health grounds.

Psychiatric care is entirely absent from the health system of detention facilities, despite its importance, as evidenced by the testimonies of former prisoners. The report finds that while healthcare services for women and children are of varying levels, they are inadequate and at times inappropriate in all prisons.

The report notes that severe overcrowding and a lack of cleanliness and maintenance of cellblocks and toilets have a negative impact on prisoners’ health. Some prisons are so overcrowded that cell space is doled out by the centimeter, and some prison rooms have no beds. Poor ventilation and cigarette smoke—many prisoners smoke—as well as summer heat and humidity create an environment conducive to the transmission of skin and respiratory diseases, something most prisoners interviewed complained of.

The study found that there is no oversight to guarantee the enforcement of laws that protect the health and lives of prisoners and that penal institutions’ compliance with laws on inmates’ health, as well as other laws, typically depends on the inclinations of individual prison administrators.

The Egyptian state is legally obligated to protect the health of prisoners and detainees and provide the necessary healthcare to them under the Egyptian Constitution, the 1956 Law on Prisons Regulation and the 1961 Prison Regulations, which define and regulate the roles and duties of healthcare providers, especially doctors, in Egyptian prisons. This is in addition to international conventions ratified by Egypt, including the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment.

On 10 May 2014, the EIPR sent hard copies of the report to the Prison Authority, the Ministry of Interior’s Human Rights Division and the Ministry of Health’s Preventive Medicine Sector, enclosing a letter detailing the most significant findings and recommendations of the report. At the time of writing, the EIPR has received no response from any official body.

The report is available here