Annual Report of The National Council for Human Rights

Chapter Five - Cont.
Human Rights Practices in Egypt For 2004

Health :

Health care is regarded as one of the fundamental human rights. The constitution guarantees this right in articles 16 and 17. It is also guaranteed by the country's legal liabilities emanating from joining the concerned international conventions, especially the International Covenant on Economic, Social and Cultural Rights (articles 9,12.)

A study prepared by the National Council for Human Rights pointed to "the right of citizens to adequate health care". However, such right should depend on the citizens' needs and not on their ability to pay the costs of this care.)⁽¹³⁾

The World Health Organization defines the term "health" as being the physical, mental and social well being, and not merely the existence of a disease or disability. Hence, health becomes the result of overlapped socio-economic factors concerned with a certain society, and involve several environmental, educational and economic conditions. Therefore, obtaining better health results is associated with multiple factors.

The health system in Egypt comprises more than 29 various public authorities operating in the health services field. The Ministry of Health and Population is responsible for all the health and population policies. Other public authorities contribute in offering direct health care services, the most prominent of which is the Public Authority for Health Insurance, The Educational Hospitals Authority and Treatment Institute. The private sector offers private health services. The country has a wide network of public services for basic health care which allows all the population to be near to the health services centers.

The extensive health care system was assisted to achieve health gains nationwide over the past two decades, the effect of which was manifested in the decline in mortality rates of children below the age of 5 yeas, enhancement of nutritional indications and drop in the mortality rates of mothers. However, the same report records the continued existence of an apparent gap between the regions and the various economic and social categories. It records - as well - that the use of such services is weak in all the geographical areas, with patients preferring to use private health services over government or public health services )⁽¹⁴⁾

According to the report of the People's Assembly Committee on Health and Environmental Affairs )⁽¹⁵⁾, the Assembly held sessions to hear the concerned officials in the Ministry of Health for this purpose. However, despite the achievements made and the increase in the number of beneficiaries of the health insurance system to almost 35 million beneficiaries since the inception of this system in 1964, nevertheless the Public Authority for Health Insurance is confronting problems and hurdles. These problems, raised by the Committee, may be summarized in the following points:

·  Increase in the number of beneficiaries and increase of the cost of service, without increasing the health insurance resources with the same percentage, which affected the level of service offered, and became a source of permanent complaint from beneficiaries. This is in addition to limiting the State's ability to extend the insurance umbrella to large categories who are currently uncovered by the insurance system.

·  The Authority has not developed and expanded the control system of performance and the implementation of the quality criteria, as the Authority plays the role of service provider and financer at the same time, knowing that modern insurance systems dictate the necessity of segregating between financing and providing the service.

·  Low wages, incentives and rewards to the staff, including physicians and support staff, in addition to not developing the training systems and upgrading efficiency, which led to the weak level of the service offered.

·  As a result of the health insurance's default in absorbing new categories and the inability of free treatment to provide a suitable service to the citizens, big sectors of beneficiaries of the health insurance system resorted to treatment at the State's cost, which amounted to one billion and three hundred million pounds annually. This has led to the occurrence of great distortion and confusion in the treatment system.

·  The multiplicity of laws governing the health insurance system led to the diversity and difference of the discount rates determined for beneficiaries and their contributions in the treatment costs, which casts doubts on the constitutionality of such laws as a result of the inequality in the burdens among beneficiaries. Further, the non contribution of beneficiaries of the law No.79 for 1975 in the medications fees led to the abuse and unjustified increase in the use of medicines.

On the other hand, several other factors affect the health care efforts. Their effects do not end at hindering development only, but endangers the achievements accomplished in the health field.

The poor sewerage facilities and disposal of human wastes come at the forefront of these factors, which implies the contamination of fresh water and ground water, as well as the creation of an environment infested with flies and other disease-carrying insects, in addition to the impact of pollution on the food chain.

In this context, the studies pointed to the persistent need to take immediate action to stop the continuous pollution of water and soil, as the damages caused are irreparable. Further, it exposes the living standard of the next generation to danger.

The year has also witnessed several discussions as a result of the continuation of the black cloud in the sky of Cairo for the sixth consecutive year, as well as the overall air pollution problems. The Peoples' Assembly's Committee on Health and Environmental Affairs prepared a comprehensive report on the phenomenon of the black cloud, which concluded that the responsibility lies with all sectors of society, government and non government institutions, as they should all work seriously in order to create a clean health environment, free from such a black cloud.)⁽¹⁶⁾

The Ministry of Environment's report to the NCHR reflects a deep awareness of the dimensions of the environmental problem faced by the country, and its programs in connection with the management of hazardous materials and hazardous wastes. The report details the Ministry's efforts in connection with the environmental inspection and the achievements accomplished. This is in addition to the government's program to control harmful emissions by using natural gas, controlling the emissions of cement factories, preparing plans and policies for enhancing the quality of air, protection against noise and the Ministry's efforts in connection with the enhancement of the quality of water.

Further, the MoI initiated the implementation of a program to detect the percentage of lead and carbon dioxide emitted from car exhaust systems, in order to prevent granting licenses to them in a number of governorates.

However- as expected in the environmental work field- the Ministry is facing numerous challenges and difficulties, the most significant of which is the difficulty of conformity between the development plans requirements and compliance with the environmental criteria determined to maintain human rights, as well as poor cooperation and coordination with the institutional structures in the country to implement the environmental policy and not effecting the incentives system for companies and factories to dispose of wastes and fumes.

Housing :

Housing is considered one of the important social rights, yet it is not only linked to the construction of building, but rather the politics of planning the residing process. It includes the structure of the physical infrastructure of water passages, sewerage systems and electricity for housing and everything relating to needs of social life.

The politics of housing in Egypt has gone through two phases. The first phase began from 1952 and ended in 1975. The main incentive behind the politics of this phase was to provide for the social and economical life for the many. However what came as a result was pulling out of the private sectors from this project, due to the decrease of rental payment, and the rejection of residents to join in paying for maintenance fees. Another main reason was the increasing of the poor overcrowded cities and the creation of slums that was a result of the exploiting of construction planning of the overall structure of the cities. The second phase began from 1976 till this day. In this phase there has been many achievements accomplished in the context of economical growth. The states addressed new laws regarding the rental methods based on administrative law number 193 for the year 1977 in a plane for promoting the private sectors, and re-supporting the housing progress. Through this phase new cities were built outside the main civilized cities. New law as well, were made to satisfy the house lords and their renters.

The new laws had different effect. A law which was passed preventing land lords to raise the rent supported the owners of complexes to sell their apartments rather than renting it, which was an overloading on the expenses of the poor unable to buy these complex. Another law that required owners of private buildings to sell no more than third of their units caused the owners to leave their apartments uninhibited rather than renting it. These laws have caused the increased spreading in the overcrowded cities and slums.

The effects of the increased slums had profound negative effects. Some of those slums were built on agricultural land. Some studies revealed that the space slum areas extended to in greater Cairo. Increased by 3.4% on a yearly basses. And the number of population increased by 3.2 percent yearly, meaning the increase of 200 thousand individuals yearly.)⁽¹⁷⁾

Due to the failure in ending the expansion of slum cities the results were negative. In and the report on human rights development in Egypt for the year 2004 it reported that control of the government of these slum cites led to the building on improper lands for living and . Choosing places not suitable to build on

According to a report from the ministry of housing to national council on human rights the ministry has planed fulfilling the construction of building 250 thousand unites in urban areas yearly. In which 50 of these units will constructed by the governmental sector, and 200 will be constructed by private sector. 72% of these units will offered as economical housing, while 22% will be offered as medium and above medium standard housing where as the remaining 6% will be for high standard housing. In terms of the rural areas a study has been made reflecting the need of 293530 housing units, which the ministry for domestic development well be held responsible for fulfilling. According of the ministry for domestic development it stated that it is providing loans worth 625 million Egyptian pounds yearly in providing for living in built units which will be paid back over 40 years with 5% interest and a financing it in a payment of 73 Egyptian pounds monthly. The state on its part provides for the cost of the land and infrastructures for the units.

Women Rights :

In terms of the rights of Women, the Egyptian constitution has provided for the rights of equality between males and females in articles 8, 11, and 40. These articles revolved around the concepts of equality in employment, in front of law, as well as, the equality in the political, social, cultural and economical fields. In addition, Egypt has joined different international agreements regarding women rights, two of such agreements that Egypt has joined took place in the year 1981. The first international agreement was concerning the political role of women while the second was regarding the elimination of all types of discrimination against women.

In continuation of the Egyptian government's efforts to grant women their full rights, two significant rights for women were achieved in they year 2003. The first achievement was advanced by the instructions of the president of Egypt, this achievement was regarding the granting of citizenship status to those whose mothers are Egyptians with foreign fathers. Thus raising the status of women and granting them a form of equality in this respect. The second achievement-took place in the month of October and was regarding the building of a family court. The significance of this achievement is that this court was especially made for observing, reviewing and giving the final decision on the process of women to get divorced. It became the only court to look in such cases therefore giving this subject more attention and cutting short on the time span taken by other courts to finish this process. In the official quarterly statistics gathered about this court )⁽¹⁸⁾ the statistics illustrated that the court have succeeded in giving a final decision in 70% of all cases brought turned into it for hearing.

Another form of rights the government has placed important emphasis on is the right of education. In this respect, indications illustrating the gabs between males and females have proven that the government has launched massive efforts in lessening the gabs between males and female in schools. Starting from the years 1992 up to the year 2002 indications shows that ratio percentage of females to males in school was 80.4% to 107.1% respectively in the elementary schools, 79 to 93.3% in middle school, 86 to 95.4% in high school, and 52.3 to 90.0% in higher education. While enrolment in schools have also gone through phases of dramatic increase, given the percentages of 3.7%, 67.8, and 55% respectively to the primary stages, the secondary and higher education.

In spite of this improvement Egypt nevertheless was placed on a low rank between countries in terms of social participation. From 78 countries in the list of the Human Development report of the year 2004 )⁽¹⁹⁾, Egypt ranked the 75th due to measurements taken to measure the participation of women in the political life. Where women occupied only 3.6% of the seats in the parliament, 9% of the overall percentage of high positions and ranks, and granted 0.38% of income compared to that of men.

Although there are steps taken to decrease the government sector to give more freedom to the private sector and better shape the governmental structure there is nevertheless those who will be negatively affected by such action, which are the women. One of the reasons for which women will be effected is that in the private sector is in less need of women, due to the long types of breaks granted to them in the first years of motherhood and child bearing. The government has granted women all its rights yet many are uninformed and unaware of these rights.

In terms of the participation of women in the political process there has been two factors that illustrated the decrease rather than the increase of the political participation for women overtime. The first factor is seen through the weak women representatives while the second factor around the decreasing role of women in the political participation process. In terms of the latter, the decreasing process could be traced back to 1986 where the number of seats in the peoples assembly women occupied were 37 (34 of them were elected by the people were the remaining 3 were appointed by the president) which constitute 6.7% of the total representatives in the assembly. While in 1987 the number of women in the assembly was reduced to 18 (14 elected by the people and the remaining 4 were appointed by the president) which represented 4% of the total seats. The number decreased again in 1990 to 10 were 7 were elected by the people and 3 appointed by the president. Nevertheless this number was reduced one more time in 1995 to 9 occupied seats in the assembly by women, were 5 of the seats were elected by the people and the rest appointed by the president, marking 2.2% of the overall seats. Finally in the elections of the year 2000 this number increased to 11 women representatives of which 6 were elected by the people and 4 appointed by the president) )⁽²⁰⁾

On the other hand, Women's participation in the Shoura Council has not been any much different. In 1997 women's occupied only 5.7% of the overall seats. In the mid-elections of 2001 and the elections of 2004 women's failed to occupy any seats.

In this context it is necessary to address the need for specifying extra number of seats in the various branches of the Government, the People Assembly and the Shoura Council of the government by assigning no less then 10% of the seats for women participation it will help in promoting the rise of women's political participation.

The case of the violence against women remains a serious case in its size and contents. Especially that that the women health demographics for the year 1995 in Egypt was erased proving only the extent of violence against women , as well as the average violence taken upon girls such as the female genital cut and betting by husbands.)⁽²¹⁾ Due to these results the national council for women rights and the associations for human rights have requested the government take more effective steps and efforts in order to eliminate such a phenomena. While the committee for eliminating all kinds of discrimination against women, in its discussion in January 19 of 2002 called on the government to provide a case study by using government instruments in terms of violence against women in the rural and urban areas. )⁽²²⁾ However in reality the government it will take a long process for the government to take this call into consideration and to provide more effort to eliminate the violence against women. Yet the government has began in the process of reforming laws and rules affection women. For instance the government has deleted article 291 in 1999 which used to prevent punishment for those who rape women if they agree to marry who they raped. Nonetheless from the most significant violence occurring against women is the arresting of a female relative as a way to pressure a criminal suspect to release himself to the authorities and provide the courts with the truth. )⁽²³⁾