It was as though he were drawing back the curtain on a heavy chapter of his life, one to which he returns against his will whenever prisons are mentioned. Haitham Mohamedein, the human rights lawyer and former prisoner of conscience, began speaking about his period of detention. He says: “Prisons in Egypt are not at all suitable for people with illnesses, even if they are simple illnesses that can be controlled outside. Overcrowding, the absence of beds and the reliance on squat toilets are all factors that make the lives of the sick inside prisons extremely difficult. People with slipped discs or bone diseases suffer bitterly, not only from the absence of treatment, but from the structure of the facilities themselves.”
In his conversation with us, Mohamedein recounts how the simplest movements turned into a burden inside a narrow cell, where prisoners were forced to share limited medicines in desperate attempts to ease the pain. Despite his release more than three years ago from a pretrial detention that lasted three years, the details of those days have remained engraved in his memory, bearing witness to a reality that many are still living today.
Medical Negligence: A Crisis Complete in All Its Elements
Mohamedein’s testimony clearly reveals that medical negligence in prisons is not merely a shortfall in treatment, but an integrated system that begins with an inhumane detention environment, passes through weak medical equipment, and ends with the absence of medical competence and specialisation, which makes the simplest illnesses a serious threat to the lives of detainees.
Mohamedein describes the clinics inside prisons as confining themselves to painkillers for all cases, even emergencies, as summoning a doctor becomes almost impossible after the cells are locked at six in the evening, and the nurse is sometimes forced to borrow blood pressure monitors from prisoners because the official devices are unusable. As for the doctors’ periodic rounds, he regards them as a formality, as a single, non-specialist doctor follows up all illnesses, as was the case in Qanater Prison, where a dermatologist was responsible for diagnosis and dispensing medicines for all cases.
Human rights lawyer Haitham Mohamedein points out that the Egyptian Constitution stipulates in its Article (55): “Everyone who is arrested, detained or has their freedom restricted must be treated in a manner that preserves their dignity, and may not be tortured, intimidated, coerced or physically or morally harmed. Nor may they be held or detained except in places designated for that purpose that are humanely and hygienically fit, with the state committed to providing means of accessibility for persons with disabilities. Violating this is a crime whose perpetrator is punished” in accordance with the law.
In addition, Egypt, as a state party to the International Covenant on Civil and Political Rights, is obliged to apply Article (10), which stipulates that: “All persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person”. Alongside this, the “Nelson Mandela Rules“, adopted by the United Nations in 2015, set out the basic international standards for the treatment of prisoners, including the right to health care without any form of discrimination.
For her part, Samar El-Husseiny, executive director of the Egyptian Human Rights Forum, affirms to Zawia3 that the health care crisis in Egyptian prisons represents “one of the most egregious files”, pointing out that the matter does not concern only political prisoners but all detainees, whether those held on criminal charges or those of various backgrounds.
Samar explains that the aim must be to guarantee every prisoner’s right to obtain appropriate health care, in accordance with national regulations and international standards. She adds: “Health care does not mean merely transferring a prisoner to a hospital to receive emergency treatment and then returning him immediately to his cell; rather, it requires that he remain in hospital until full recovery and convalescence”, pointing out that “what is currently happening is the exact opposite, as patients are returned to unequipped cells, which leads to a further deterioration in their condition.”
Testimonies and human rights reports reveal that the reality inside Egyptian prisons is moving in the opposite direction, as deaths continue as a result of the absence of health care, which results in the deterioration of prisoners’ health because the necessary treatment and care are not available, amid detention conditions that local and international human rights organisations have described as “harsh and inhumane”.
Marwa Arafa and Hoda Abdel Moneim
Haitham Mohamedein’s testimony reveals a grim reality of health care in Egyptian prisons, and it is not an individual matter, as the accounts of other prisoners from Qanater, Tora, Borg El-Arab and the prisons of Upper Egypt intersect, all pointing to medical negligence, shortages of medicines, delays in responding to emergency cases, and inhumane detention conditions that make illness tantamount to a slow death sentence.
Translator Marwa Ashraf Mohamed Arafa, held in pretrial detention for more than five years, appeared at the session on Saturday 18 October 2025 in a state of severe exhaustion and difficulty breathing, according to what was announced by the Egyptian Initiative for Personal Rights. Marwa informed the court that she suffers from complications of a previous suspected pulmonary embolism, in addition to heart problems and high blood pressure, without having been seen by specialist doctors to receive the necessary treatment.
After the session, a number of human rights organisations, politicians and public figures submitted an urgent request to the National Council for Human Rights, calling for immediate intervention to save the life of Marwa, who has been held since April 2020 at the Tenth of Ramadan Reform and Rehabilitation Centre “Rehabilitation 4”, in connection with Case No. 570 of 2020 (Supreme State Security).
The applicants stated that Marwa was referred to trial in December 2024 along with 38 other defendants in Case No. 19857 of 2024, First Nasr City Felonies, on charges relating to “joining a terrorist group and financing a terrorist group”. However, her continued detention since 2020, as they affirmed, violates Article 143 of the Code of Criminal Procedure, which stipulates that pretrial detention in felony cases may not exceed two years, while Marwa has exceeded this period by more than three years.
The applicants also documented that she suffered, in August 2025, a serious health setback initially diagnosed as a clot in the pulmonary artery, which led to a deterioration in her ability to move and to her reliance on her fellow inmates inside the prison for help. Despite the seriousness of her condition, she received only one night of medical care before being returned to her place of detention, while the competent authorities ignored requests to transfer her to a specialised hospital, whether through the Badr Medical Complex or an outside hospital at the family’s expense. The applicants considered that her continued detention in this way constitutes a violation of Articles 55 and 56 of the Egyptian Constitution, in addition to contravening Egypt’s international obligations relating to the right to health, liberty and the safety of detainees.
The request indicated that Marwa Arafa is a translator, aged 32, and the mother of a young daughter living with autism spectrum disorder, who has been deprived of her mother’s care since her mother was arrested in front of her when she was two years old, which caused her psychological trauma whose effects continue to this day.
Human rights advocate Samar El-Husseiny cites the case of Marwa Arafa, who suffered a clot and received her intravenous fluids inside the cell instead of in a specialised hospital, asking: “What is the danger in a patient receiving his treatment in an equipped hospital?”. She points out that “deprivation of health care has become an additional means of punishment”.
El-Husseiny notes that human rights organisations are not demanding special treatment for political prisoners, but only the application of international rules, most notably: enabling detainees to receive treatment, informing their families of their medical files, and allowing families to deliver medicines to their relatives. However, she reveals testimonies confirming that medicines are prevented from entering some prisons, or are sold inside them at high prices that exceed their price outside by between 25% and 40%, which represents an additional burden on families.
Despite urgent human rights demands to save Marwa Arafa and put an end to her prolonged detention, her case is not an exception in the wider picture of deteriorating health conditions among female detainees. At present, human rights lawyer Hoda Abdel Moneim is suffering from a sharp deterioration in her health: she has suffered a clot in her left foot, failure of the left kidney and reflux in the right kidney, in addition to a heart attack and a severe loss of balance due to an inflammation of the middle ear. As she struggles with these heavy complications, her family received a new notification last August from the prison hospital stating that she had been diagnosed with diabetes, which aggravates the risks of her condition and increases the need for urgent and appropriate medical care.
This prompted her daughter Gehad Khaled to make an appeal addressed to the President of the Republic on 12 October last, calling for urgent intervention to release her mother, whether through a health pardon or as part of the presidential pardon decisions. Gehad explained, in a letter seen by Zawia3, that her 66-year-old mother is going through “extremely critical” health conditions, despite having completed her five-year prison sentence in October 2023, before being detained again in connection with two new cases on the same charges.
Hoda Abdel Moneim is a lawyer, human rights defender and former member of the National Council for Human Rights. She was arrested in November 2018 because of her human rights activity, and her name was included in Case No. 1552 of 2018 (Supreme State Security), known in the media as the “Egyptian Coordination for Rights and Freedoms case”. Since then, she remained in pretrial detention for more than four years, until the Emergency State Security Court, on 5 March 2023, issued a ruling sentencing her to five years in prison, on charges that human rights organisations said were fabricated.
Although her sentence ended on 31 October 2023, she was not released; and on 18 November 2024, she was brought again before the Supreme State Security Prosecution in connection with a third case, Case No. 800 of 2019, on the same charges she had faced in the previous cases.
A Crisis of a System
Continuing his account, human rights lawyer Haitham Mohamedein recalls the coronavirus crisis during his imprisonment, revealing that he received a vaccine completely different from the one he had expected, at a time when the virus was spreading among prisoners: “I did indeed receive the first dose, and after 21 days I went to receive the second dose. In good faith I asked the doctor about the type of vaccine: was it the English one or the Chinese one? He answered me: “This is virus (B)”. So I discovered that I had been receiving the virus (B) vaccine, not the coronavirus vaccine.”
Negligence appears even in the simplest medical details. Dental problems, as Mohamedein recounts, find only one solution: “extraction”. In the course of his account, Mohamedein sees that more dangerous than all of this is the delay in responding to critical cases at night. He points out that negligence in responding to emergencies inside prisons may lead to the deaths of prisoners, as the sergeant or the guards may be late in opening the doors, especially at night or in multi-storey buildings, as happens in Qanater Prison, where help takes a long time to reach detainees.
He notes that the health care crisis in Egyptian prisons has been rooted for many years, and became clearly apparent with the expansion of pretrial detention after the revolution. He believes that the problem goes beyond individual cases, as prisons lack a real treatment system.
Mohamedein adds that perfunctory treatment through prison doctors or prison hospitals is insufficient, given the lack of capabilities even in public hospitals outside prisons. He affirms that prisoners with chronic or serious illnesses suffer doubly, as they are not allowed access to the university hospitals that provide appropriate treatment, unlike ordinary citizens.
For its part, the “No Statute of Limitations” campaign released its new report “Health Release: The Squandered Right!”, documenting the conditions of health care in Egyptian prisons between September 2024 and September 2025, and revealed a large gap between legal obligations and reality, with continued medical negligence that led to 20 deaths and 12 cases of deliberate negligence, especially in the prisons of Badr 1, Tenth of Ramadan, Borg El-Arab and Qanater, where detainees were deprived of treatment and their transfers to hospitals were delayed, and deprivation of care was sometimes used as a tool of punishment.
Last July, the Egyptian Initiative for Personal Rights revealed a severe health crisis suffered by one of those held in pretrial detention in connection with Case No. 2025 of 2025, who belongs to the “Ahmadi Peace and Light” group. The Initiative’s lawyers submitted an urgent request to the Prisons Authority to have him undergo a medical examination and to provide the necessary health care immediately, but the administration of Tenth 6 Prison did not respond fully, and on two occasions in May 2025 merely fitted a catheter to treat urinary retention, while his health suffering continued.
The detainee is 64 years old, and needed eye surgery to treat cataracts and retinal diseases before his arrest; he also suffers from kidney disease, diabetes and liver infiltration, which worsened his condition inside prison, with swelling appearing in his legs and a severe deterioration in his eyesight, in addition to a diabetic coma as a result of not receiving his medicines.
The Initiative condemned the continued pretrial detention of at least 16 detainees in connection with this case, including 14 from the “Ahmadi Peace and Light” group, and called for their immediate release while providing them with urgent medical care, in line with constitutional and international obligations.
Abdel Moneim Aboul Fotouh: 4 Angina Attacks
The case of Dr Abdel Moneim Aboul Fotouh, the former presidential candidate, represents another extension of the picture of medical negligence inside Egyptian prisons. In May 2018, nine human rights organisations expressed, in a statement, their deep resentment and condemnation of the medical negligence (deliberate, as they described it) to which Dr Abdel Moneim Aboul Fotouh was being subjected, considering it an escalation of political hostility and of acts of revenge against political opponents.
The statement pointed to the insistence of the administration of Tora Farm Prison on not allowing Aboul Fotouh to be transferred to hospital despite his suffering four successive angina attacks in less than three months, its disregard for the deterioration of his health and his advanced age (67), and his continued solitary confinement in a cell lacking the most basic standards of prisoner care, which the organisations described as a crude and shameful example of the mechanisms of indirect torture in Egyptian prisons.
Aboul Fotouh suffers from chronic illnesses including diabetes, high blood pressure and an enlarged prostate, and his critical condition reached its peak on 5 May 2018, when he suffered his most severe angina attack. Despite his urgent need for immediate medical care and for the necessary tests in intensive care, the prison administration insists on preventing his transfer, while the prosecution has rejected his repeated requests to be examined by a specialised medical committee.
A detailed memorandum was submitted to the National Council for Human Rights on 22 April 2018 documenting all the violations and his inhumane detention conditions, but it did not result in any change, which the organisations considered a continuation of the policy of deliberate medical negligence against political prisoners inside Egyptian prisons.
El Nadeem Documents 77 Cases of Medical Negligence
Human rights advocate Haitham Mohamedein stresses that serious health cases inside prisons often require intervention in university hospitals, which have the equipment and specialist doctors to treat intractable diseases, but a prisoner’s access to them is almost impossible, and the administration often refers the patient only to the prison hospital, however serious his condition.
For its part, the El Nadeem Center Against Violence and Discrimination documented 77 cases of medical negligence inside places of detention during the first half of 2025, ranging from a lack of basic medical care to the deterioration of detainees’ conditions, pointing out that the actual number may be higher given the difficulty of reaching all prisons and detention centres. The centre affirmed that medical negligence constitutes a violation of the Egyptian Constitution (Articles 18, 55 and 56) and of international conventions, including the Convention against Torture (1986), which considers deliberate deprivation of health care a form of torture and inhuman treatment. May recorded the largest number of cases (22 cases), followed by April and June with 20 cases each.
In this context, human rights lawyer Haitham Mohamedein believes that the Public Prosecution bears direct responsibility for medical negligence in prisons, stressing that inspection must be periodic, comprehensive and unannounced, with prisoners taken out to be examined at genuinely equipped hospitals, instead of perfunctory procedures in prison hospitals or internal clinics.
For her part, human rights advocate Samar El-Husseiny affirms that the solution requires forming an urgent committee comprising independent doctors and human rights advocates, enabling human rights organisations to view medical records, and transferring prisoners to hospitals when needed, while granting the National Council for Human Rights real oversight powers instead of its current limited role.
During the preparation of this report, we contacted the National Council for Human Rights through the official means of communication available on its website, to request comment on the conditions of prisoners and health care inside places of detention, and on what is being raised regarding medical negligence. As of the time of publication of the investigation, we had not received a response.
The file of health care inside prisons and places of detention in Egypt remains suspended between clear constitutional and legal texts guaranteeing the right to treatment, and a reality revealed by testimonies and human rights reports, which suggests a wide gap between constitutional and legal commitment and practice on the ground. While sick prisoners remain stuck in this gap, demands are growing for the Public Prosecution and the competent authorities to shoulder their constitutional and legal responsibilities, by activating mechanisms of periodic and unannounced inspection and guaranteeing actual access to decent health care, considering this not a favour or an exception, but an inherent right that does not lapse even behind bars.
Editorial correction: The first version of the report stated that Marwa Arafa had exceeded the maximum period of pretrial detention (two years) by more than five years; the correct position is that she has exceeded it by more than three years, as she has been detained since April 2020, as stated in the report.
Editorial correction: The first version of the report stated that the statement by the nine human rights organisations regarding the medical negligence against Abdel Moneim Aboul Fotouh was issued during the past year, that his most severe angina attack occurred on 5 May of the current month, and that the memorandum submitted to the National Council for Human Rights was submitted on 22 April last; the correct position is that the statement was issued in May 2018, and that the two incidents date back to 5 May and 22 April 2018.
