State of the World's Minorities and Indigenous Peoples 2013 - Case study: Egypt: Nubian community health support systems

by Sarah el Ashmaouy

The opening of a new hospital in Aswan only underlines the government's long-term neglect of the health needs of Nubians.

In January 2011, then President Mubarak inaugurated the new Aswan hospital; Aswan is the capital of Nubia in Southern Egypt. Meanwhile, in Cairo, the Nubian community had organized a support system for members of their community who need to access health care that was not available in Aswan. Each of the 22 villages of the Nubian region collected money to rent or buy a modest space in Cairo where inhabitants of the same village could stay while receiving health care in Cairo. This was coordinated through the Nubian club, which was created to maintain the cohesion of the Nubian community in Cairo and has an apartment in Tahrir Square for Nubians to meet and seek support if facing any troubles. The Nubian club was thus at the heart of the self-created health care support system.

This self-support system is a symptom of the problem of health care in Egypt, particularly in the peripheries of the country like Nubia. Despite the efforts of the Nubian community in Cairo to help Nubians living elsewhere to access services, the quality of health care accessed in Cairo by Nubians depends on their income and resources, which are usually among the lowest in the country. To tackle this, Cairo Nubians have consolidated networks of individuals inside hospitals and medical centres who are willing to help Nubians in dire need of health care. But the problem remains bigger than the action of individuals.

There is a long history of government neglect of Nubians in Egypt. Many Nubians were forced to leave their land to make way for the construction of the Aswan Dam in the 1960s. The government promised compensation and shelter; however, the resettlement plan offered poorly designed buildings for Nubian families. There were very few employment opportunities in the urban 'new' Nubia, and as a result many Nubians moved to Cairo for better education and employment opportunities. Nubians had little or no access to basic services

The Aswan hospital is the only one in the new Nubia to serve the 22 villages of the Aswan governorate. The eight medical centres scattered around new Nubia are difficult to access, lack basic medical equipment and often have no personnel. In some places, Nubians have to travel 44 km to access their closest medical centre, some of which are not even equipped to treat injuries or deliver babies. The lack of the simplest equipment, such as antidotes for scorpion bites or dialysis machines, has led to deaths from diseases which are easily preventable. The Aswan hospital, for example, only has two dialysis machines, one of which is not functional.

This is not only due to the poor health care policies of the Egyptian government but also the lack of reliance on local resources. Doctors from Cairo who work in the hospital leave Nubia three days a week to go back home, while Nubian medical students pursue their careers in Cairo. Nubians have frequently addressed their local governor, demanding better social services, including health care. Each time, their demands have been met with a promise of policy change, followed by a 'bureaucratic' excuse that refers the action back to the Cairo cabinet.

Lost in the pile of files referred back to the Cairo cabinet, the lack of action on the issue of health care in Nubia has left Ahmad, an 11-year-old boy from Aswan who suffers from epilepsy, no choice but to travel to Cairo. Here he hopes to find an Egyptian doctor who will finally sign a form that will enable him to access health care in Cairo, rather than the Aswan hospital, which cannot provide him with the care he needs.