Incapability of Health Insurance and Medical and Administrative Inefficiency

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"Corruption in Egypt…A dark cloud that does not vanish" Ibn Khaldoun "Introduction" - 1377

Origins of Medical Industry Corruption

The medical services, which the state offers to its citizens, are considered an indication on the progress or backwardness of this state; imagine the extent a sector concerned with the health and lives of citizens may reach if corruption spreads in its various administrations and institutions. In the latest report of Transparency International, Egypt was ranked 72 in the corruption black list; the report confirmed that Egypt spends only 5% of its national income on health; the report revealed that there is a close relationship between administrative, financial corruption and medicare in many developing countries, including Egypt; the report pointed that the corruption which is spread in Egypt's health sector wasn't restricted to the public sector only, but it spreads also to the private sector; the report indicated that many hospitals turned into self-service centers which some persons exploited to raise illegal money.


So, it is natural that an official admits that the level of health services offered to citizens is subzero and that the salary of a dustman is more than that of a doctor: counselor Adli Hassan, the governor of Qlyoubiya admitted that the level of health services is low nationwide, confirming that there is a disorder in the health sector and described it as "subzero"; the governor pointed in his statement before the governorte's local council to disadvantages of the health sector, including the weakness of allocations for medicine and medical equipments in Qalyoubiay, saying that the citizen's share in the governorate is L.E. 2.5 out of a total up to L.E. 10 mln.


In another governorate, Menya, a report, issued by the public audit and control administration in the governorate, confirmed that the administrative services committed financial violations, the report described as grave, including embezzlements, thefts, and damages to public money up to L.E. 33.164 mln; the health sector led the list of violations s the number of violations in this sector reached 16 violations estimated up to L.E9.860 mln including forgery and damages to public money in the bills of early detection on diabetes and bandage rolls which don't meet specifications and fraud in selling in an auction, and manipulating in paying service improvement rewards and environment watch rewards and also doctor's forging signatures and stealing public money; also, it reached manipulating in the rewards of artificial kidneys and sequestering expired blood bags and buying auxiliary not needed drugs as a compliment to pharmaceutical firms and fining fake meals in a hospital and stealing sick people's meals and fake health certificates.


The press scoop achieved by Al-Masri Al-Yom newspaper is an evidence on the deterioration and disorder in the health sector, as three journalists wearing uniforms of three trained doctors in the biggest medical edifice in Egypt, Qasr Al-Einy hospital, toured inside it without being obstructed and entered the intensive care unit and examined all patients whom they met and read their medical history files and CAT scan. As for the Health Minister, he admitted that there is corruption in the ministry; Dr. Hatem Al-Gabaly, the Health Minister, admitted that there is a blatant maladministration in the Health Ministry, adding that the one who denies this is absolutely dishonest, specially that this corruption has been spread in the Ministry for years; the Minster said, in the meeting of the environment, population and health committee in the Shura Council, that Al-Takamul hospitals are merely an unsuccessful project and that the ministry is seriously mulling rescinding them, specially that the rate of occupation is no more than 16% in governorates all over the country, although they are state-funded with L.E 500 mln annually; Al-Gabaly admitted that he known nothing about the accounts of the health insurance, although he demands restructuring it and urged the Shur Council to vote for increasing the public budget of the country, saying that the current state budget is not sufficient for constructing pivotal projects specially that two thirds of the budget are paid in salaries and wages.


In this report, we will tackle three pivots: health insurance, fake drugs and doctors' errors.

Health Insurance

Preface: The health insurance project started in the 1960s and was scheduled to cover within ten years all Egyptians; however, 1967 war stopped the projects; after 1973 October war, the then Health Minister, Dr. Fouad Mohildeen, drafted a new bill law for the health insurance and he presented it to president Sadat in 1978, promising that ten years later, the project would have been completed, and it hasn't been achieved and the health insurance continues deteriorating one year after another and falling in many continuous crises and its permanent inability to do its role.


Currently, the health insurance covers 36 million citizens and supervises 602 comprehensive clinics, 6893 school clinics, 577 pharmacies, 41 hospitals, 28 kidney Dialysis Unit while medicine takes just L.E. 600 from its budget. 60% of the services of the health insurance are carried out by the health insurance units while 40% are carried out by buying from the administration.


Although health insurance is indispensable for offering a health service to a huge section of citizens because of the high cost of these services and that so many can't bear them, but the patient's problems with the health insurance are endless, beginning from being examined by the practitioner and a specialist to the medicine prescription and quality of drugs and ending with registration in hospitals contracted or owned by the health insurance, making insurance treatment a journey of torture riddled with red tape and complicated procedures. We can outline the problems from which the health insurance is suffering:


1-Health Insurance debt


2-nigligence and laxness in offering medicare 3-financial and administrative corruption


The health insurance system suffers from many problems foremost among which are the L.E1.5bln deficit in its financial resources; concerning these causes, Dr. Mostafa Abdol-Ati, the chairman of the health insurance service, says that: insurance was established 40 years ago, but the rates of contribution or estimations of the service costs, while the medicine cost jumped continuously; so, the expenditures were more than the resources, causing a deficit in the budget of the social insurance; so the system lacks resources, not bad service; he added that there is a bad need for a legislative amendment to some legislations to realize a financial balance between revenues and expenditure to end the current deficit and to expand in giving service to other sections among people. Also, the contribution of those benefiting from the health insurance system should be raised because the rate of costs increased 10 times more than it was before ratifying legislations; this wasn't met by doing an appropriate amendment to the rate of contribution, leading a dysfunction in funding; however, the health insurance system does its services as required within framework of the available capabilities, given that it offers an overall medicare to more than half the country's population, an appropriate alternative for offering medicare to all citizens after bearing medical expenses became difficult; so, efforts should be exerted to to develop it and solve its accumulating problems so as to extend it to more sections that may benefit from it. This should be within framework of finding sources for funding the health insurance so as to be able to apply the health insurance system, in medicine, medicare and the administrative system to end citizens' complaints on some aspects of disorder and to raise the general level of service; there are several proposals to develop the health insurance system, all of them are under study and research; no new legislative amendment on the health insurance has been issued or ratified yet. He pointed that, concerning the system of the private health insurance, there are several companies based in Egypt and do their work in this field without affecting the health insurance system.


 However, there are some proposals that try to heal, including amending health insurance laws and separating the service from the funding, although these attempts may lead to privatizing the insurance, triggering more burdens on the citizens. In a reportage published in Al-Ahali newspaper, Dr. Abdol-Monim Obeid, a professor in Cairo's faculty of medicine and a member of the health committee in the specialized councils, said that whenever talking about overhauling the health insurance increases, we get worried; the first thing striking our minds in this regard is what the Health Ministry declared concerning the weakness of doctors' salaries and the suffering while receiving health insurance services due to the huge increase in subscribers that reached some 35 million beneficiaries, 46% of the population fter including school students (17 millions) and newly born babies (9 millions), and within a budget up to about L.E. 2 bln and debts up to L.E. 500 mln, a quarter of the allocated budget; bearing into mind that the total of what the Egyptian people spend on medicine is nearly L.E. 20 bln half of it comes directly from their purses while they take a share in the second half through public taxes and the annual subscription in the health insurance service, we got amazed at the government outcry at the inefficiency of the health insurance.


Obeid adds that:" some international administrations, supporting the health overhaul plan in Egypt, recommended changing the health insurance service into a mere fund for buying service for beneficiaries from institutions that offer the services; the government echoed this plan under the slogan of- separating funding from the service- and that the job of the health insurance service is restricted to funding only, and to get rid if its hospitals and clinics, socially ominous advice as this turns the Egyptian health insurance service into a merely money investment company like the ones our country witnessed and which we are no in need of. Dr. Obeid concluded that the health issue can't be assigned to the private sector like education. Dr. Mohamed Hassan Khalil, a consultant in heart diseases in the public administration of the health insurance and a member of the society of health and environment development, said that the offered bill law leads an increase in the rate of subscriptions to the extent of making the beneficiary contribute with a third of the medicine outside the hospital part from chronic diseases and also his contribution to the service cost with no more than a third of the cost or price; khalil points that this law leads to a very serious disorder that may violate the very principle of insurance itself, as the core of insurance is paying just the averages in addition to symbolic fees instead of being forced to pay huge sums of money in case of disease; paying rate without a maximum may force the insured to pay limitless sums of money up to thousands of money. Dr. Mohamed Hassan Khalil adds that the new bill law excludes specifically that the health insurance service offers the service itself, and thinks that wasting the health insurance structure of hospitals and clinics as a trend related to the Health Minstry's health overhaul policy may solve the problems of bad service facing citizens, but we face many problems; the problem doesn't lie in giving a role to the private sector, but it is specifically excluding the public sector, thereby burdening the insured with the cost of the service in addition to a margin of profit leading to increasing the cost he may pay; where will this medical structure comprised of 40 hospitals and 140 comprehensive clinics which were built by the money of the insured. Dr. Mohamed Raouf Hamed, professor of pharmacology in the in the national administration of pharmaceutical research and control, spoke about the problem of medicine in Egypt, stressing that medicine is a very special commodity; it is indispensable for those who need it; this commodity depends on research activities; Dr. Hamed describes the medicine market as increasing geometrically and quickly; in 1976, the size of the pharmaceutical market in the world was $5.43 bln to reach $5.94bln in 1984; five years later, it reached $256bln till it reached $373bln in 2000 and reached $506bln in 2004. Dr. Raouf points out the core of the problem is that pharmaceuticals is related to the ability to research and develop; Trips Plus deal that may raise the prices of medicine comes amid the weakness of our research ability in this field. There was a general trend among attendees to reject the idea of splitting funding from service, while there was a disagreement over on offering an alternative bill law or to keep the government's bill law after making some amendments that my improve the service. The workshop concluded with laying down some alternatives and mechanisms to confront this government plan for privatizing the health insurance institutions, foremost among which is establishing committees to confront the health insurance bill law nationwide, maintaining a unified social structure for the health of the Egyptians and sticking to one law that protects the insurance rights of the Egyptian citizen, including the social and health insurance, and there should be one unified and independent service, the health insurance service, in addition to mobilizing the opposition force to press for confronting this new bill law, and showing a strong public opinion rejecting this; finally, the government's health policy should be rejected and defamed and establishing a permanent committee to follow up carrying out these mechanisms.


But, does the currently applied health insurance system does its role as required; this question is answered by Dr. Hatem Al-Gabali, saying:" the current health insurance law isn't flexible and doesn't allow its beneficiaries to receive treatment aoutside health insurance hospitals unless the medical treatment is provided by the health insurance (…); Al-Gabali revealed that 82% of those working in the private sector aren't covered by the health insurance, confirming that most poor sections are the ones suffering most from the cost of medical services as they spend some 15% of the incomes on medicare and 6% of them spend about 40% of their incomes on treatment and medicine, pointing out that the rich are the least spendthrift on medicare and medicine as they spend about 8.7% of their income on medicare; he indicates that the World Bank report confirms that the poorest society sections are the least receiving aid, as they receive 16% against 28% for the rich.


For his part, Al-Ard human rights centre warned of privatizing the health insurance as he sent a memo to the People's Assembly in which he demanded they reject the government plan aiming to privatize the health sector as it is unconstitutional. The memo said that this is amid the state's withdrawal from offering economic and social care and services to citizens in Egypt. The memo said that the new plan relieve hospitals of the government and the health insurance service of their responsibilities of offering health services to citizens; the memo added that this plan didn't mention to whom will move the ownership of these government hospitals, 1299 government hospitals in addition to 40 hospitals and 140 comprehensive clinics affiliated to the health insurance. The memo, currently in the hands of a number of members of parliament, warned of selling the state-owned health facilities with the lowest prices. "Aiming to glorify profits for the private sector" at the expense of the health of the poor citizens" and turning people's health into a commodity monopolized by the private sector's hospitals". The memo pointed out that these government procedures come at a time the health of the Egyptian citizen witnesses an unprecedented deterioration, as 4% suffer from malnutrition, 12% of the children suffer from weight loss, and the general administration for health insurance in Egypt covers only 41% of the population, while most citizens suffer from deteriorating conditions.


The memo added that the government plan in this trend has no participation or supervision over the proposed administration in the new bill law, except for the Health Minister, the government's representative, and the absence of the role of the beneficiaries who will contribute with 68.67% as a subscription to fund the budget of the administration".


The memo pointed out that the new system has no auditing or control systems for the total revenues; there is no guarantee that the service reaches subscribers. A number of People's Assembly MPs are scheduled to use the memo of Al-Ard human rights centre's memo in their discussions of the bill law when it is referred to the specialized parliamentarian committees… the memo said also that :" the government- through proposing the bill- is beginning to turn the Egyptian people into nationals who have no rights, because the state aims to collect taxes and subscriptions without clear commitments towards beneficiaries."


Al-Tagamoe party has proposed a bill as an alternative for the government bill law which is considered a disaster for the future of medicare for the poor and limited-income people.


The proposed government bill law states sentencing citizens and business men who give incorrect information or refuse to pay subscriptions, to 3 months in prison, while there is no stated punishments against the doctor or employee who is proved to have refused offering services to beneficiaries of the health insurance administration proposed in the government bill law.


It has become part of our daily life to read in newspapers about medical errors that take place in the health insurance as they have recurred so many times; this is just an example of dozens of examples which are continuously recurring, that there are four cases of epidemic hepatitis and that these cases have a renal dialysis without taking the necessary medical precautions to prevent infections to other patients:


The report of the fact-finding committee of the local council of Suez governorate confirmed that there is a negligence in some procedures of analysis and splitting and devices of the renal dialysis unit in the health insurance hospital; the committee found out through documents that there are 51 patients in the department including 26 C-virus positive; it demanded the officials discuss the phenomenon that exceeds more than 72% in comparison to the renal dialysis unit in Suez public hospital; the report added that the general manager of the health insurance area in Suez said that there are 4 cases which were infected with C virus and that those patients still make renal dialysis on the same devices and it was revealed that these four cases weren't subjected to the a separation process from the devices or workers in the renal dialysis department.

Administrative and Financial Corruption

Medical negligence isn't the only aspect of corruption in the health insurance system; there is also an administrative and financial corruption spread in its units; a nurse, in a Heliopolis health insurance clinic, cheated in registries and got undeserved 50 medical prescriptions including prescriptions of repeating medicine for persons who haven't visited the clinic, weren't medically examined, and most of them aren't covered by the health insurance; she rubber-stamped them with a fake rubber stamp and sold them to a pharmacy in Matareya in violation to law; her accomplices were nine doctors in the health insurance clinic. The legal affairs notified the administrative prosecution and counselor, Yusry Al-Hawari, the vice-chairman of the service referred them to the disciplinary board and notified the Central Audit Authority and the public prosecution to investigate into the criminal part and allocate an independent investigation with the chairman of the clinic.

Fake Medicine ….Fake Vaccines for Curing Polio in Egypt!

Early 2006, baby milk "Baby Zan1" was discovered to be not suitable for human use as it was causing some side effects, it was found in markets in big quantities.


A higher committee formed by the Health Ministry and headed by Minister Dr. Hatem Al-Gabaly to handle the problem of a subsidized baby milk product which caused vomiting and a diarrhea for children who drank it, confirmed that "Baby Zan1" product was banned because it is not suitable for human use. All packages- up to 400000 packages- were withdrawn fro markets; also, more than a million packages were banned from distribution from the Egyptian Company for Chemicals & Pharmaceuticals. The committee confirmed that there are three other substitutes of the subsidized milk in the Egyptian Company for Chemicals & Pharmaceuticals and in markets in huge quantities, which meet demands for the next nine months. The committee warned that some packages are still kept in pharmacies or by residents who stored them and that they must circulated nor used because this will be actionable. The higher committee issued several decisions of stopping the company's production line until knowing the cause of the contamination of the packages of this kind of milk apart from others produced by the same company.


The bay milk, which was withdrawn from markets, is subsidized milk whose price is available for most Egyptian families- about L.E. 3 against L.E. 25 for imported milks. Rescinding the production line of this brand of milk was to the benefit of other unsubsidized brands of milk, which are of considerably high prices.


Dr. Magdi Hassan, chairman of the Drug Holding Co. for pharmaceuticals, declared that the producing company imports the raw material "skimmed milk" and adds the other ingredients to this milk to takes its final shape.


What is striking in this issue is that from October 2005, it was discovered that this milk wasn't suitable for human use; however, the packages of the corrupted milk remained in pharmacies and markets and was used by children till later January 2006; it was used for three more months; the declarations of officials, on whether there was a decision of withdrawing the milk, have been conflicting since 2006; the pharmacists head denied outrightly that there have been since last year a decision of banning this brand of milk and that the pharmacies have been selling it so far, pointing out that pharmacies that handle 4000 brands of medicine have a humanitarian service mission and have nothing to do with selling banned medicine especially that the pharmacies law No. 127 of the year 1955 punishes those violating this with closing their pharmacies and making them actionable.


He denied also accusations against some pharmacies of selling some brands of medicine without prescription, pointing out that this doesn't happen except with brands known all over the world as shelf medicines which are commonly used without triggering fears. As for the classified drugs, they aren't sold except with prescription.


As for Health Ministry officials, they confirmed that a decision has been issued of stopping production of this brand of milk since October 2005; Dr. Nagda Rkha, chairman of the sector of health, preventive and endemic care pointed that since 29 October, when the ministry received the first complaint on the corruption of the milk packages, an immediate committee has been formed and went to the producing company based in the 10th of Ramadan, samples were taken to confirm that the defects in the packages are due to storage or due to primary items, but it was discovered that the samples were arsenic due to production; a decision was issued of stopping production and withdrawing all products from the market. The ministry analyzed the remaining raw material in the company and was sequestered. The committee decided not to give the company a license for production again except through a license from the higher committee, which was formed for this issue.


 As for Dr. Zeinab Obeid the Health Ministry undersecretary for pharmacies' affairs, she confirmed that the delay was due to rows over results of the analyses as some proved that the milk was OK was some others confirmed that it wasn't suitable in addition to Great Bairam; later on, a higher committee comprising professors from universities, medicine control and food control was formed; the committee decided to stop the production line and withdraw any packages of this brand of milk in the markets. Meanwhile, the pharmacists syndicate issued a release of withdrawing all packages of this brand of milk from all pharmacies and using substitute brands.


Dr. Zakareya Gad, the head of pharmacists, declared that he demanded in a release he sent to 30000 pharmacies in Egypt that they must recall to the company producing Baby Zan1 all the remaining packages after its use was banned by the technical committee formed by the Health Minister Dr. Hatem Al-Gabali after it was discovered to be harmful to health of children and specially that there are other substitute brands. Baby Zan One is a baby milk which was produced by LactoMisr, an Egyptian Arab company with investments up to L.E. 500mln; inaugurating this company was accompanied by unprecedented interest from the ex-Health Minister (Dr. Awad Tag Al-Din) who immediately held more than one press conference to declare that Egypt began to produce baby milk alone for the first time.


Baby Zan 1 caused many cases of vomiting and the diarrhea for breastfeeding infants to the extent that some of them died of this; a father tabled a complaint accusing the company producing the milk of leading to his daughter's death: accountant Magdi Ibrahim Yousof said in his complaint to Heliopolis police station that his breastfed infant Basma died on 4th January 2006 after suffering from vomiting and diarrhea and that the doctors who examined the victim described the case as gastroenteritis; he added that he was stunned by the Health Minister's warning quoted and published by newspapers of not using Baby Zan1 because it causes vomiting and diarrhea, and he discovered the cause of his daughter's death as she was fed on this brand of milk; the one who tabled the complaint, which was notified to the then minister's undersecretary for Cairo security, Major General Nabil Al-Izaby, accused the producing company of causing the death of his daughter. The prosecution was notified and it held an investigation. Only one year before discovering Baby Zan1 problem, there was another raised problem related to the subsidized milk: that it wasn't available in sufficient quantities in pharmacies, triggering an exchange of accusations between citizens, pharmacists and officials; the citizens accuse the pharmacists of purposely hiding the milk to sell it for a higher price while the pharmacists defended themselves saying their milk allocations are originally low; officials declared that the subsidized milk goes to patisseries factories and shops.


In an Al-Ahram reportage on this topic, Dr Mostafa Shahin, a pharmacist, said that the cause of the recent increasing problem is that there is only one subsidized brand of milk, while a few years ago, there were several brands to give the opportunity to choose; when a brand wasn't found there would be another one or a substitute; now, the only brand is actually not found and can't be reached not only by individuals but by pharmacies which may take one or two packages every month while there is a huge and increasing demand on the subsidized milk, triggering a state of rejection from citizens and an exchange of accusations with pharmacists accusing them of causing a crisis for personal and material purposes; in addition to lacking the subsidized milk, the pharmacies don't know the real cause of the unavailability of this; the distributor who comes to the pharmacies has no knowledge as he isn't a specialist (…) and thinks that the substitute for those who are badly in need is the cow or buffalo skimmed milk through filling a third of a cup with milk and filling the two thirds with water, a method that contributes to solve the problem of the absence of the subsidized milk and not to fall prey to the prices of other brands of milk, as the price of a package is up to L.E. 22, a total of L.E. 160 a month for an infant; solutions must be immediately found for this unprecedented crisis as rows erupt between pharmacists and citizens who seek food for their infants, specially in popular areas.


Dr. Mohamed HerHesh, a pharmacist in Minoufiya village, agrees on the previous opinion concerning the so little quantity given by the distributing company to pharmacies; he was receiving a box every month; as for now, he receives no more than L.E 2.95 package; as for prices of other milk brands, they range from L.E. 16 to L.E. 20; as for exploiting the milk and selling it to owners of patisseries shops- some did so-, it may occur as milk is suitable for use in food products.


The then Health Minister (Dr Mohamad Awad Tag Aldin, an ex-Housing and Health Minister) admitted there was a problem in baby milk, confirming that it isn't instantaneous, but it is a pile of previous years as the government subsidize baby milk with L.E. 70mln, L.E. 9 for every package. The Health Minister said:" the problem lies in the fact that some individuals manipulate the milk allocations and enter with the baby milk the black market; those individuals collect the baby milk packages from pharmacies and sell them to factories of patisseries, cheese and ice cream for the huge price gap, causing actual lack in some zones; thus, we invented a new method of distributing milk through Motherhood and Childhood Care Centers in every governorate. The baby milk's wasn't the last in the series of corrupt drugs; newspapers in this period (Jan. 2006) spotted another issue, the presence of fake vaccines with which children were vaccinated: the child Fayiz Hamad, a pupil in Makram Al-Akhlaq primary school, is currently hospitalized in Marsa Matrouh public hospital (the third floor, room 8 of economic treatment) after he was given a compulsory dose by persons roaming with an unidentified car (…) the child's father tabled a complaint in Marsa Matrouh police station; Dr. Abbas Al-Shanawani, Health Ministry undersecretary confirmed that the child was put under supervision for 24 hours and an immediate gastric lavage was made for the child and smples were taken from his blood and vomiting and were sent to central labs in the Health Ministry to be analyzed as a precautionary measure, confirming that there were no vaccinations during that period and that the published rumors are completely groundless and are done by those who want to spread panic and suspicion in the safety of the vaccinations.


 While a Health Ministry official declared that there were no vaccinations during this period, but Al-Waf published in its homepage citizen's confirmations that there were vaccinations for kids, this time wasn't in Marsa Matrouh, it was in Cairo: Al-Wafd newspaper received many contacts from citizens belying the Health Ministry's statement of denying presence of child vaccinations of any kind in this period; the citizens confirmed that there persons who pass by houses and vaccinate children who suffer later from a high temperature, vomiting and diarrhea; the citizens reported cases that were sent to hospital to receive suitable treatment. The latest case was in the Swiss neighborhood in Tenth Suburb of Nasr city where some persons dropped in houses and vaccinated children who suffered some pains forcing their parents to send them to Tabarak hospital which in turn sent them to Al-Dimirdash hospital to receive the suitable treatment and to follow up their status; the citizens confirmed that the Health Ministry's statement denying presence of vaccinations is incorrect and they denounced that the statement branded what happened as rumors, asking Dr. Hatem Al-Gabaly to come personally to Al-Dimerdash hospital to see himself the suffering cases after the vaccinations.


Al-Araby Al-Nassery Newspaper pointed there were fake vaccinations and that they were the cause behind what happened to the kids as it announced in a reportage that the Holding company for vaccinations imported blood derivatives which pose risks to public health and from countries banned to import from; this is in addition to the fact that the polio vaccine may had corrupt doses distributed recently and poisoned the children and the Health Ministry disclaims them.

In an attempt from the Health Ministry to eliminate fake drugs: Dr Hatem Al-Gabaly, the Minister of Housing and Health, said that a project for a good storage for drugs will be prepared to end the random distributions on pharmacies with the participation of the pharmacists syndicate in order to protect citizens from fake, expired and smuggled-from-abroad drugs which harm health of citizens. In a report of the Central Auditing Organization, it was revealed the Holding company for vaccinations imported some L.E. 24mln expired vaccinations, posing dangers to children and threatening the return of the lethal virus to Egypt, in addition to presence of 370000 bottles of the vaccine estimated $477000 in the production reception store of the company without having the date of production or the date of expiry on them, confirming that there was a fowl play for the importing company, Smith Clein; this endangers the lives of the Egyptian kids; what is serious in these vaccines is that some quantities of them were sent for medical supplies although they are not suitable (…). From fake polio vaccines to plasma- blood derivatives, which were stored for three years although the validity period is no more than one year; this is in addition to the plasma that was imported from England although it is one of the countries importing is banned from as it is one of the sources of sending lethal viruses which are harmful to public health through blood and its derivatives. Concerning the violations of the Holding Company for Vaccinations, revealed by the report of the Central Auditing Organization, AlAraby Newspaper said: the financial situation of the company deteriorated as well; its list showed L.E. 196mln working capital, revealing a disorder in the financial structure in addition to establishing projects without making use of them for 7 years and the company's dependence on loans to fund these projects and also doing bank overdraft to fund the current business activity; meanwhile, the Central Auditing organization described the Holding Company for vaccinations as a failure while it obsessed Dr. Awad Tag Al-Din and his successor Dr Hatem Al-Gabaly other than anything related to the health sector, making it a spoiled child who does frauds; it declared that there was a net production sale up to L.E. 693mln; what was stunning was that this contained L.E. 7.2mln rescinded sales to the organization of hospitals and educational institutes; also, human blood derivatives including Albumin 20% were bought from England although it was dangerous to health, for L.E. 10.5mln. It moved from trading in the lives of children and patients to wasting public money in contracting and implementation of a number of projects which the company constructed and remained under construction for many years and for sums of money up to L.E. 218mln; the Central Auditing Organization confirms that they included some L.E. 106mln projects which were amended to confirm that there were defects in the feasibility studies prepared by the holding company; these projects include a L.E. 45mln polio development project which includes buildings, constructions, machines and equipments which the Central Auditing Organization described as investments which have been idle since 1999; producing this brand, polio vaccine, wasn't introduced in the fiscal years 2004/2005 and 2005/2006.; this includes other L.E 32.2mln as mechanic and electric works for the polio project which were paid to Foster Willer company according to a contract in April 2000 all of them are idle investments which haven't been finalized till later June 2004; add to this L.E. 2.7mln for buying plastic bags from a company, given that the undersecretary of this company confirmed that his company with whom the Holding Co. for Vaccinations made a contract with, stopped producing these plastic bags; this confirms that state funds where paid for buying a non-existing product. Also, a new industry is beginning to flourish in the pharmaceuticals, second brand drugs, medical materials made of unsuitable raw material coming from China or India; they are raw materials with no real effectiveness, endangering lives of patients: a number of patients confirmed that it is cancerously spreading, warning of the dangers of the phenomenon; they said that many Egyptian companies and factories resorted to low-priced raw material coming from China and India which are unsuitable and ineffective raw material but are distinguished by their low prices, 10% less than their equivalents in the European markets. Officials in the Heath Ministry's drug watchdog confirmed that these raw materials are smuggled to enter the Egyptian market and most of them don't have any control measures; the companies using these raw materials do so secretly; this needs a security control to fight this drug mafia. Owners of pharmaceutical companies called for fighting the phenomenon which they described as serious, saying that it defames the Egyptian drug product and embarrasses pharmaceuticals in foreign markets. The value of the ineffective raw material entering Egyptian markets and pharmaceuticals is up to some $ 1/2bln, a huge and frightening amount that endangers people and a national industry that succeeded in opening international markets. Negligence of Doctors Medical negligence and abusing both rights of life and body safety

Although the phenomenon of medical negligence appeared in the international community along time ago, but the countries rushed to adopt legal and scientific policies to locally solve and limit the problem, having a negative impact on international human rights texts and legislatons, giving some kind of legal ignorance to the phenomenon on the international level, being satisfied with the international principles which were originally legislated to defend the human body and life from the aggression of the countries' executive authorities; here is the international charter for political and civilian rights, which Egypt approved according presidential decree No. 537 of the year 1981 on 3 Thol-Hijja 1401 (1st October 1981) in its 12th article: "1-the member states in this charter approve that every human being has the right of enjoying the maximum level of mental and physical health that he can reach. 2-The measures that the member states in this charter should take to secure a full practicing of this right, include the measures which are necessary for: Reducing mortality rates in newborn babies and suckling babies besides assuring a healthy growth for the child Developing all domains in health, environment and industry Protection against contagious disease, endemic disease and vocational ones and other diseases, besides treating them and combating them.

Providing conditions that assure medical facilities and medical care for all in case of sickness.

Reading these international texts, we conclude that right in life and protection by virtue of international conventions are restricted in protecting Man's life against the oppression of executive authorities without imposing a protection system for man's life against experimentation and medical faults on his body. Stipulated protection in the first covenant for economic and social rights lacks the mechanism of international censorship and punishment for breaching of countries these rules. On the contrary, civil and political rights saved by the protocol annexed to the convention, which stipulates establishing a concerned committee of human rights to observe implementing rules of the convention. Speaking about Egypt, the crisis has been escalating day after day, especially due to the absence of censorship on the performance of physicians and the widespread of random unorganized medical teaching that stem in unqualified doctors who can not deal with a human body as a living being who enjoys all rights and duties, rather this kind of random teaching produced a doctor who deals with a sick case void of all rights. And among the poor international legislations in protecting man's rights, comes our Egyptian legislation which ignores any clauses that speak about the fault of physicians in a direct manner, and this forces a researcher to exert efforts to implement general legal rules on charged doctors. Noteworthy, these rules where legislated to face social phenomena in fact, for example, the Egyptian legislation guarantees the general protection for the Egyptian citizen's health in articles hereinafter:"

Article 1

“The State shall provide cultural, social and health services, and shall make a special effort to ensure villages easy and regular access to them, to improve the villages’ standard [of living].” Art. 17: “The State shall provide social and health insurance, and disability, unemployment and retirement benefits to all citizens, in accordance with the law."

Article 43

"Any medical or scientific experiment may not be undergone on any person without his free consent."

Article 57

"Any assault on individual freedom or on the inviolability of private life citizens and any other public rights and Liberties guaranteed by the Constitution and the law shall be considered a crime, whose criminal and civil lawsuit is Not liable to prescription. The State shall grant a fair compensation to the victim of such an assault." When speaking about penal code, we find no articles that deal explicitly with medical faults, however, satisfied with general rules in articles 238, 244 that say: "" And due to the poor international and domestic legislation, the responsibility of doctors became the most important controversial matters that result in many efforts in the field of penal jurisprudence and the judicial implementations. While, the problems of creativity, limits and powers of the doctor stand as an obstacle in many lawsuits that may result in implementing inefficient punishment on charged doctors . One of the victims due to the medical negligence is "Muhammad `Emad Judah" who was 9 months old. He died as a result of a dose of vaccination in Al-Aqad health office. The nurse working there, due to the lack of experience, was unable to draw out the capsule that was stuck in his body falsely. Another case, a patient loses his vision in Ocular Oncology Institute, and another patient goes to Heliopolis Center for Cardiology to treat the atrium but unfortunately goes out with coronary occlusion. Another child called Abear, 4 years old, went to Abu Ar-Rish Hospital to treat osteocampsia but unfortunately her legs were amputated. Daily faults of doctors became a continuous matter and there are too many violations that are not subjected to any kind of censorship. Medical negligence is a result of corruption whether a corruption in administration or education or both, however the result is one; fatal errors that result in grievous cases and may lead to death with no administrative punishment for the charged person. Consequently, faults will continue with no end. There is a miserable story about medical negligence of an orphan child whose arm was amputated due to a doctor's faults. Fathi Rizq Ali, the child's uncle reports the incident, he said, "Muhammad was the youngest child for my late brother who was survived by three children." The family was used to visit Alexandria in summer vacation ..." And due to the hard conditions that the miserable family passes, Muhammad had to work in vacation for supporting his family and mother." Last July, Muhammad was playing football with his friends, and then he fell down." The uncle added. Muhammad's left arm was bruised and his friends rushed and carried him to the nearest clinic of one of the doctors. The doctor said that he must be sent to Al-hadra Hospital for Bones Nariman."In fact, we hurried to the hospital, and in the reception, one of the doctors diagnosed the case, then he called for making x-rays on his fractured arm, then they put his arms in a splint." He said. After that the family left the hospital, but not before the doctor told them to come back again in case of any tumor or the color of his arm changed to blue. "After only one day, we were astonished to find a tumor in his arm and that the color became changed and made Muhammad suffer from pains and high body temperature." The uncle continues to relate. The uncle rushed to the hospital, and doctors decided to keep him in hospital, they removed the splint and left him over the bed with no care. The next day a doctor came to the uncle and told him that he must sign on a paper to endorse that Muhammad may undergo an operation for amputating his arm as doctors said that his arm was infected with Gagarin and the arm must be amputated to save his bad health. The uncle said, "Of course, I refused to put my signature, and I tried relentlessly to know the reasons for this until they told me that the first doctor committed a mistake that occurred before and this result was inevitable. After that they advised me to go to Muharram Bey Police station affiliated to the hospital and appeal to them. I went to the police station then I lodged a complaint number 800 Muharram bey complaints dated on 8/7/2003, then sent to the prosecution. Prosecution asked me then to look for the child's health first and send him to a doctor away from the hospital then submit a detailed report about the case." The uncle carried the miserable child who was screaming out of pain and he searched for a doctor over night until it was dawn. Doctors refused to carry the operation of amputation in their clinics or private hospitals, and all were repeating the same word," The one who caused the misery must bear its consequences." The uncle was obliged to take the child back to the hospital but this time to At-talaba hospital in Sporting region as Muhammad is a child who enjoy medical insurance. However, doctors decided to take Muhammad back to Al-Hadra hospital. In this hospital, the uncle found no way out but to put his signature in the endorsement sheet that certifies carrying an amputation surgery to save Muhammad's life. "I signed the certificate that certifies the ever disability of my nephew!" Muhammad's uncle said. "This is a crime! But full-fledged crimes with no punishment although its fatal results are clear like a nose in face!". If we go to the administrative level, the head of Muharram Bey Prosecution talked with the head of emergency morgue in Kom Ad-Dikka, and he called for keeping the amputated part in the emergency morgue until the doctor responsible for autopsy arrives. The real defamation for Egyptian medicine is the silence against these crimes and that leads to maintaining them. Another case, for a girl called Sabbah Muhammad `Abd Al-Hamid Al-Yamani, 30years old, she became a victim for anesthesia injection before undergoing an operation, she became sick with quadriplegia as a result of an acute heart failure. Sabah went to Al-Hussein hospital on 5 November 2002 to make a surgery for treating squinting in her eyes. She requested two days vacation from work as the surgery is a simple one. Unfortunatlly, she went out of the operation unconscious since the anesthesiologist gave her a big injection that caused her a coma for 3 months. Head of defending victims of medical negligence society, Ayman Rabih said that he was following the case since the beginning and the case is still kept in the office of General Deputy and since it is kept, that means a misdemeanor will be filed against the charged doctor who caused her misery. Rabih pointed that law will make nothing as Article 244 from penal code stipulates that in case any doctor caused a grievous mistake to any patient, shall be detained for a duration of one month and not more and shall pay a fine about 200 EGYP, however, if the doctor was responsible for the death of the patient, he shall be punished in accordance to article 238 from penal code by imprisonment not less that one year and shall pay a fine of 200 EGYP and shall not exceed 500 EGYP. Another case about a newly born 40-day old child, she went to children hospital affiliated to Al-Mansura University to be treated from diarrhea and dryness, and in the department of malnutrition in the hospital, there was a fatal mistake in fitting the bandage round her hand . The color of her hand changed to blue and the result was the amputation of her left hand. A message sent to the editor at Al-Ahram newspaper among many messages that express the very bitter reality of medical negligence and the administrative heedlessness, the message says: "The negligence of doctors and nurses working at the Specialized Hospital in Demyat caused my little son who is 9 months old to be carried off. During the checkup, the doctor left him to make a phone call outside the hospital, although he did not come except after calling him several times and we waited a lot for his arrival. When he came back, he jotted down several medications and examinations that nurses failed to abide by. The nurses tried several times to call him but he was not replying even the head of the department was unable to save us or even the head of the hospital….. No body has shown any heed, until my son passed away. Who is going to punished those who caused his death with their nigligence?".

Qadry Muhammad Al-Matuli-As-Swalim –Demyat

The above incidents were for ordinary mortals, so not to speak about a great catastrophe that afflicted many and resulted in death casualties of 52 people. This accident stunned Egypt for weeks and left many repercussions among which was the attempt of the ministry of culture to resign, it was the blast of Culture Palace Theatre in Beni Sweif. It was expected that the injured people at the accident would have received a good medical care; however, what happened was the contrary. There were many cases whose injury was about to heal, yet they died due to the grave negligence in many medical domains in the hospitals affiliating to the ministry of health. Unfortunately, the scenario is still on. One of the patients who died although his burn was about to heal was Dr. Salih Saad. Although, his injuries were not serious, yet negligence caused his death. Same patients of the same accident who were transferred to different hospitals to be treated died due to medical negligence in these hospitals, like Alaa Al-Misry who died two weeks after the accident in Al-Asr Al-Eini Hospital and Mu'min Abdu who died in Helmiya Military hospital while he was expected to leave it within a few days and Asmaa Mhamed Al-Saiyyed who died after recovery in mid February. Beside the deceased cases, there were other cases who suffer negligence and medical faults. There are many victims of the blast are still alive but are motionless due to medical negligence. Al-Ahali newspaper made an interview with some of the injured people; one of the victims called Hamdi Tolba said "I went out of Al-Hilmiyyah Hospital suffering from microbe pus that leads to the erosion of the pelvic joints. Doctors decided that I must undergo a surgery to replace joints and up till now I am motionless. I can not afford my medications because since I fell sick I spent all what I have on medications and medical requirements. I want to ask; where is the role of the state and the statements that assure medical insurances?" In Al-Hilmiyyah military Hospital, here lies Muhammad Samir Uways, he refused to speak due to his poor and serious conditions. His doctor, in an interview said that his conditions are extremely serious and show no signs of good news. After several operations, he responds no more to anesthetic and as a result his spirits are low. His father spoke to the press and complained that there are no officials inquire about his son's health "because he's not a popular guy.!" . Muhammad is a student at the faculty of medicine and is a clever student and he is a champion in track and field, now he became deformed and most of his body became worn out due to negligence and random treatment. And although there are people who were responsible for this misery yet they refuse to treat his son on their expenses. Hosam Abd Al-Azim is another case; he was transferred from Al-Salam Hospital to Al-Demerdash Hospital to undergo a surgery in chest due to a medical fault of one of the doctors at Al-Salam Hospital that caused a perforation in his larynx. After being transferred to Al-Demerdash Hospital they refused him until he continues the treatment from burns, but due to his serious conditions he remained at the hospital to be treated fro burns firstly although there is no department for treating burns. His mother said that they had to summon a doctor from outside the hospital to treat him and all this is on their own expenses. These are clear evidences against the medical negligence followed by administrative heedlessness. All these faults give bad images about medicine that is not in favor for this domain especially with the problem of non-attendance of many doctors to their work. Osim Public Hospital punished 26 doctors for not showing up in their work, were there will be cuts from their salaries for 5 days. Governor of Giza, Consultant Mahmud Abu Al-Lail, in one of his sudden rounds at public hospitals and medical units, decided to stop the administrative director for Osim Hospital for his negligence, bad performance in his job, and not discarding the serious medical refuse away from the other uses of the Hospital in accordance to the state and environment rules that regulate this issues. He ordered for 15 days cuts from the salaries of doctors who wrote down medicine tickets without stating the instructions for usages. Then he decided to replace that director with another qualified one. He ordered the concerned bodies for health facilities in Osim to increase their efforts in cleaning services and removing refuses regularly. The governor ordered Giza Health Directorate and concerned bodies of medical insurance to form a committee to revise the clients of medical insurance to solve the problem of overcrowdness and to organize the methods for working doctors there. He also charged the directorate to put a chronological schedule for finishing the new building in Osim Public Hospital and providing it with the up dated equipments; the governered ordered paying an immediate cash grant to bone section pathients due to their conditions. All these orders by Giza Governorate were on March 2004 and after nearly seven months; in October 2004 there was a governors' reshuffle. The new governor of Giza made a round at hospitals and he decided to send all absent doctors at Al-Hawamdiyyah hospital, AL-Badrashin hospital, Jazirat Ad-Dahab clinic, and the center for birth spacing affiliate to the clinic to investigation. Fathi Saad, Governor of Giza decided in his sudden visit at the cities and centers of Al-Hawamdiyyah, Abu Al-Nomros, Giza and Badrashin center to cut 3 days from the salary of the administrative director of the medical insurance unit in Jazirat Ad-Dahab and ordered for sending the head of the center to investigation due to bad disciplinary. While at Al-Hawamdiyah Public Hospital, he visited the rooms for patients, kitchens and the works of maintenance, He promised to contact the medical insurance for paying the dues to the hospital that estimated one million pound. Had it not been for the reshuffling of governors, and the different visits of the governors to different places, the condition would have remained as it is even if there were procedures for cutting salaries or sending to investigations since these punishing procedures are directed for media propagandas and not for reformation of a corrupted administration that takes everything but gives nothing. Corruption forced one of doctors in one of the hospitals to decide hunger strike against the financial and administrative corruption of the hospital and that made his colleagues join him in a sit in. This incident took place at Zagazig Public Hospital as a complaint for the presence of Dr.Yehia Al-Fallah who continued to be the general director of hospital although many doctors send many complaints against him to all administrative and supervising bodies, all this with many documents put as evidences for the administrative and financial corruption besides the bad level that the medical service in hospital attained. However, the Governor of Sharqiyyah, Consultant Yehia Abd Al-Hamid had brushed away all these complaints. The strangest thing is that when the general secretariat of the governorate Muhammad Mwafi met the striking doctors, he expressed his wonder as no body informed him of what was going on, and as a result of this, he renewed the decision of keeping the general director in his position. Striking doctors have sent many letters to all concerned bodies and annexed the declaration issued from them on all these cards, where they assured their hunger strike and they called all honest and faithful people to join them for the sake of patients and need people. Noteworthy, a second officer at Zagazig police station had threatened the doctors and told that they would be tried according to Emergency laws for blocking work inside one of the important utilities which in reality did not take place, on contrary they were doing their jobs during strike since they bear the sense of responsibility and that some of them were consultants in key specializations. Doctors' strike and sit in are not all means to express discontent; there is another mean that is committing suicide. It is a case of one of the patients who decided to commit suicide as a reaction to negligence, bad medical services, and poor resources. This is what happened to a citizen called Atif Abd Al-Mun'im. The head of the general authority for medical insurance Dr. Mustapha Abd –Al-Atty, declared in a statement: " In accordance to what was issued in Al-Masaa newspaper, dated on 10/1/2006, and today is 11/1/2006. Relating to the patient/ Atif Mahmud Abd Al-Mon'im , 33 years old who is working as a print worker in the company of Dyeing and Textiles; His address is Aghur As-Sughra- Al-Qanatir Al-Khayriyah, medical insurance number is 300/32078424/861. He went to Al-Nil Hospital on 14/1/2006 to undergo a surgery for umbilical hernia. The patient was prepared on the same day to undergo the surgery on Thursday morning in 5/1/2006. He entered the room for surgery but suddenly there was a heart failure so anesthetization was stopped, necessary aids were done and the heart responded quickly, then an artificial respiration device was fitted to the patient. The patient after that was transferred to intensive care near surgery room in the first floor in the hospital around 11: am to continue treatment in such cases. This medication continued to Friday morning 6/1/2006 and the patient showed positive signs for better conditions. Then the artificaial respiration device was removed at the morning in the same day about 10:30 am. The condition of the patient was normal. It was discovered, during an interview with his wife and one of his relatives, that the patient suffered previously psychological disturbance, and they said that he was not used to taking any treatment for this case just only the recitation of Koran. They also added that he used to suffer state of disorientation after a state of neurospasm. In the morning of Saturday 7/1/2006 the patient became afflicted with a state of intensive spasm and he kept saying that he wants to see his children, then he removed away the monitor connections fitted in his body and rushed away from the bed, went to the neighboring room, jumped to the balcony and threw himself out of the window. He fell on the floor immediately. Security men took him back to the hospital and laid him on his bed again.

Chiropodists and neurologists checked him up in the intensive care then they made the necessary x-rays for him that indicated later that there is a blood pool, and a potential fracture in the lumbar vertebrae. The patient is still kept in the intensive care under a high medical supervision and good care. A notice was sent to Shubra Al-Kkaimah police station about the accident shortly after it occurred. Then precautions were taken by sending a guard to the room where the patient lies to prevent repeating of the accident. Hatem Al-Gabali, minister of health designated a higher medical committee to checkup the patient Atif Mahmoud Abd Al-Mun'im who tried to commit suicide. Dr, Ahmad Magdi Ahmad Rashad, consultant neurologist have checked up the patient and said that he is currently a normal person, but he stated that the patient was previously suffering from epileptic attacks the come in the form of spasms and cause involuntary urination, all this was in 1991, and he was not treated at all. The patient's family used to believe that the patient was controlled by evil supernatural spirits. Dr. Rashad added that any attempt to commit suicide is done under an extremely psychological disturbance and is a serious reckless behavior. At the same time of the accident that occurred at An-Nil Hospital in Shubra, The governor of Ismailia exempted the head of the public hospital from his position. Al-Ahram newspaper covered this event in the front page and said that the president himself is following what happened. Al Ahram said ,"Soliman Awad, spokesmen of the Rebublic's presidency has stated that the President Hosni Mubarak is following what was published that there are deficiencies in the performance of some medical insurance hospitals in the greater bairam. His Excellency had ordered updating him with the latest results of the ongoing investigations." The spokesman said that Mubarak stressed on the importance the responsibilities assigned to the ministry of health and the domestic bodies. These responsibilities are embodied in assuring the providing with medical facilities for citizens and combating all forms of deficiencies with inhibiting measures. Amr Ghunayma from Ismailia said that the Governor of Ismailia Abd Al-Galil Al-Fakhrani, in a sudden visit to the Hospital, has decided to exempt the director of the Public Hospital Dr. Muhmmad Naguib from his position and to appoint Dr. Muhammad Wasfi instead of him temporarily to re-maintain disciplinary and ameliorate the medical services provided to the citizens. Noteworthy many citizens have sent complains expressing their dissatisfaction from the provided medical services.

Minister of health and Population, Dr. Hatem Al-Gabli formed a committee that includes leaders from the ministry to investigate the accident of the patient Atif Mahmoud Abd Al-Mun'im who tried committing suicide by throwing himself out of a window in Al-Nil medical insurance hospital. The commissioned committee has gone to the hospital to carry out investigation. The head of An-Nil Hospital for medical insurance, Dr. Suhair Abd Al-Hamid told Hossam Zaid the reporter from Al-Ahram newspaper that a notice was sent to the police station to relate the accident of committing suicide. The patient was sent back to the hospital and all necessary aid were given to him. X-rays showed that the patient suffers fracture in the second vertebrae and the patient will undergo a surgery for fixing the vertebrae on Saturday. There is an important problem deserves paying attention to it which is the problem of the poor salaries given to doctors. Salaries are inadequate for the prestige of doctors in society. Although the Ministry of Health always says that there shall be incentives for doctors and presents the draft law to the People's Assembly, yet the draft sinks in oblivion as the Ministry of finance always replies that there are no financial specializations now for this problem. Is it credible that the Doctor's salary for the one shift does not exceed 50piasters? This is the facts related by Samih Samir Salam, a doctor practicing medicine for the first year in the Chest Department said that his monthly salary is 157 pounds only! While the salary of the deputy in the hospital does not exceed 450 pounds. Another doctor takes a monthly salary of 120 pounds during the years of training, and after she had made her Masters, the salary became 140!! She said that the problem lies in the places they are commissioned to. They are many doctors whose grades were very good yet they were commissioned to go Suhag and Assiut!! She wonders; how can this be the beginning for a beginning doctor beside the financial obstacles that stand in the face of future doctors? These are the conditions of the beginning doctors; however, the teaching staff in the faculties of medicine rarely enjoy better condition, yet they complain the inadequate salaries. A teacher at the faculty of Medicine, Asiout University, Ahmad Ar-Rashidi says, "I work in the academic field since 1990, which means for approximately 15 years, yet my monthly salary does not exceed 1200 pounds!! And from the University Hospital, I take only a percent from the price of the ticket which costs 1 pound! Although I am married and a family provider and all these salaries are not sufficient for meeting the necessities of life. I sometimes feel that I stat from the point where others end." He strikes an example that he can not dare to establish a private laboratory for him until he attains the age of 40 years old. The other problem is that there is no budget for researches in the University, and that forces him to afford the exorbitant fees for the single research needed for promotion, knowing that the fees necessary for one research estimates 2000 or 3000 pounds as the raw material required for testing the cancerous tumor estimates 2500 pounds. Sometimes, doctors carry out a common research to lessen fees, "yet other times, it becomes inevitably that you carry out the research by your own".

Selling Human Organs

Corruption or Abject poverty

What is the persistent matter that forces a man to sell his body for a trivial amount of money? It is a painful question, yet the answer is more painful because it is penury and unemployment that turns man to a cheap commodity. All these ills spread as a result of corruption prevailing in the society and the censorship. A member in People's Assembly, Dr.Shahinaz Al-Naggar has submitted an urgent report that shows that selling the human organs became a widespread phenomenon among poor classes in order to obtain trivial amount of money in order to support their families. She pointed that the reason behind selling organs, especially the kidneys, was the abject poverty among needy people. The matter was not an individual case, yet over the recent years it became organized operations and there is secret mafia that stands behind this and practices its activities with the help of other private hospitals. There are international reports expressing fears that Egypt may turn to be another Brazil of the Mediterranean due to the growing rate of selling organs. From several years, the issue of selling organs was restricted to some African countries yet Egypt joined them lately. There is a case that stunned the public opinion. It was about a man who decided to sell his kidneys for 12,000 in order to buy the trousseau of his sister. When he refused to share that amount of money with brokers, they killed him and threw his body in the desert. 6TH of October general prosecution has decided to imprison a carpenter and a jobless as they killed a man, known for committing crimes, in order to steal 12,000 pounds from selling his kidneys.() The father of the victim assured that his son told his father that he intend to sell his kidneys in order to help his sister in her marriage. The father tried to dissuade his son from this decision but in vain. The two suspects said that they wanted to have their share in the commission of selling the kidneys, yet he refused, so the decided to kill him. Mail and Guardian, a British newspaper, said in a report that there is a secret mafia flourishing in Egypt and attempts to change the country to a regional center for human organs trade, due to the abject poverty and the deficiencies in law. The newspaper pointed that there are no available statistics about this matter. It concluded that many Egyptians will fall as preys in this trap due to the social injustice and about quarter of the population is living under the poverty line. Then the newspaper investigated about those who sell the kidneys, it discovered that all were poor people and they are looking for better life and not as volunteers. These people relate terrifying stories about selling their kidneys. All these cases defame the face of Egypt making it the Middle East Brazil.