{"id":18337,"date":"2024-11-08T18:14:31","date_gmt":"2024-11-08T16:14:31","guid":{"rendered":"https:\/\/zawia3.com\/?p=18337"},"modified":"2026-10-08T23:01:22","modified_gmt":"2026-10-08T21:01:22","slug":"ambulance-workers","status":"publish","type":"post","link":"https:\/\/zawia3.com\/en\/ambulance-workers\/","title":{"rendered":"Ambulance Without Fairness: How Does the Egyptian Government Ignore Paramedics’ Rights?"},"content":{"rendered":"

Amid red lights and sirens, workers of the Egyptian Ambulance Organisation stand on the front lines, responding to distress calls and saving lives at the hardest and most dangerous moments. These paramedics, who devote their lives to serving others, endure long working hours and harsh conditions not free of danger, and await tangible support to help them keep up with the rising cost of living. But despite their continuous demands for years and promises to improve their conditions and allowances, reality is disappointing and does not match these aspirations.<\/p>\n

In January 2024, the board of directors of the Egyptian Ambulance Organisation met to discuss the areas of development the organisation had undergone, work challenges and the shortage of human resources, and the session included discussion of raising the prices of non-emergency ambulance services, in addition to talk of efforts to improve the wages<\/a> of workers. In October 2024, the Egyptian Ambulance Organisation did indeed raise the prices of non-emergency ambulance services by about 300%<\/a>, justifying this by the rise in fuel prices and operating costs, so that transport within governorates now costs between EGP 450 and EGP 3,775, and between governorates from EGP 550 to EGP 9,100.<\/p>\n

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Although this increase is the largest and the first increase<\/a> for these services since 2019, as ambulance service prices had been fixed since 2009, this latest increase has not yet been reflected in any way in improving workers’ conditions. While the organisation’s workers expected the latest increase to be part of a comprehensive improvement covering their salaries and allowances, their allowances remained unchanged and their demands to improve conditions and be treated equally with their colleagues outside the organisation continued to be ignored, but their voices have not stopped calling for their rights and speaking of their efforts and suffering.<\/p>\n<\/blockquote>\n

So what are their demands? What do they suffer from? And why have these demands not been met?<\/p>\n

Recommended reading:<\/strong> Child Labour in Egypt: Stolen Childhood and Deadly Accidents on Daily Work Trips<\/a><\/p>\n

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Disparity in Allowances<\/h3>\n

Ahmed<\/strong> (a pseudonym), a nurse who has worked at the Ambulance Organisation for nearly 25 years, explains to Zawia3 the reason for his and his colleagues’ complaint. He says: “The Egyptian Ambulance Organisation was established in 2008 with special regulations to distinguish workers because of the arduous working conditions and long working hours. But over time, these regulations turned into a curse on us, as they came to stand between us and the benefits our colleagues in the rest of the health sector receive.”<\/p>\n

The nurse points to the big difference between him and his colleagues outside the organisation. He says: “Our nursing colleagues working outside the Ambulance Organisation under Law 14 on the medical professions receive salaries and allowances far exceeding ours, even though their working hours are six hours a day, while we work 12 hours. The medical professions risk allowance, for example, rose for them until it reached EGP 1,350, but for us it is only EGP 500, and the night-shift and overnight allowance outside the organisation reaches EGP 190, while we receive EGP 100. Even an overtime hour for nursing in health insurance is paid EGP 35, while inside the organisation it is paid only EGP 8.”<\/p>\n

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As for the strangest point, and the one that most angers the Ambulance Organisation’s workers, it is the meal allowance. Ahmed says: “Our meal allowance does not exceed EGP 20 for every 24 hours of work, which is not enough to cover the cost of a single meal. This amount was set in 2008 and has not been increased to date. Is it reasonable for the meal allowance to remain fixed for 16 years while prices have multiplied?”<\/p>\n<\/blockquote>\n

Ahmed adds: “We are the only body in the state that works 12 hours a day. If I divided my salary by the actual working hours, it would turn out to be one of the lowest salaries in the state. We ask for nothing more than equality with our colleagues in the health sector.”<\/p>\n

Speaking of the nature of the work and the effort exerted by the Ambulance Organisation’s workers, Mamdouh, a paramedic at the organisation for 30 years, explains: “My colleagues and I at the organisation exert great effort at work. We are the first to respond to patients and the injured; we are their first rescue before they reach hospital, and we exert enormous effort to ensure their safety, and our work does not stop on any occasions or holidays.” He added: “Although the Labour Law sets weekly working hours at 36 to 40 hours, we work 48 hours, in addition to another working day to make up for the shortage of workers at the organisation.”<\/p>\n

He goes on: “Many of our colleagues have been forced to cancel their secondment and leave the organisation because of low wages compared with the effort.”<\/p>\n

The Ambulance Organisation’s workers do indeed exert great effort in their work, and this was clearly evident during the coronavirus crisis, when some paramedics fainted<\/a> as a result of severe exhaustion and long working hours.<\/p>\n

On the nature of his work, he explains: “My work is not limited to giving first aid to the sick and injured and being present at celebrations and events; among the tasks I perform is also cleaning the ambulance, which is sometimes contaminated with blood after transporting the injured from accidents. At these moments, we are exposed to the risk of infection, and yet we do not receive adequate allowances.”<\/p>\n

Mamdouh links the most controversial problem, the meal allowance, to the effort he exerts and its importance for the work, saying: “The organisation recently raised service prices because of rising fuel and spare parts costs, while food prices have also risen markedly: I used to buy a box of cheese for EGP 7, but it now costs EGP 22, an amount exceeding the meal allowance we receive from the organisation, which has not exceeded EGP 20 since 2008. In the past, there was a meal for ambulance workers containing protein such as chicken, until it was replaced by an inadequate cash allowance. At the same time, we need proper nutrition in return for the effort we exert, so that we can work efficiently, and this is a point that cannot be overlooked.”<\/p>\n

Recommended reading:<\/strong> Earning a Living Under the Sun: Unprotected Risks for Delivery Workers in Egypt<\/a><\/p>\n

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Meagre Salaries<\/h3>\n

As for salaries, Mamdouh says: “Salaries at the Ambulance Organisation barely keep up with inflation rates, and they are lower than the salaries of those working elsewhere and in the comprehensive health insurance system. For example, a nurse who has worked at the organisation for between four and six years receives a salary of about EGP 6,000, while their colleagues elsewhere receive double this amount. As for me, after 30 years in this field, I receive only EGP 11,000 including all allowances, whereas had I been working in comprehensive health insurance<\/a>, my salary would have reached EGP 16,000.”<\/p>\n

He continues: “Also, comparing today’s salary with the salary in 2014, we find that its real value has declined. In 2014, my salary was EGP 6,000, and now it is EGP 11,000 including all allowances and incentives, but this increase has not compensated for the decline in purchasing power, as the dollar price rose several times and prices multiplied significantly, which has eroded our salaries against inflation.”<\/p>\n

The paramedic adds: “Some may think this salary is reasonable compared with other low salaries, but looking at the nature of the work and its harsh conditions shows the scale of the effort we exert. We work long hours in a difficult work environment and deal with emergencies and serious accidents, and during the coronavirus pandemic we faced a severe risk of infection, at a time when some patients’ families avoided dealing with them for fear of infection, while we faced the dangers and did our duty, and we also lost some of our colleagues.” He went on: “End-of-service gratuity is also not available to us; a retiree or deceased member among us receives only a pension, which may be small depending on years of service and the Labour Law.”<\/p>\n

Mamdouh talks about the suffering of the organisation’s workers and their lack of the most basic elements of healthcare despite the efforts they exert daily. Although they belong to the health sector, the organisation does not provide them with a dedicated hospital for treating them or their families. Mamdouh recalls the death of his daughter, who suffered from cancer, without any support from the organisation to contribute to her treatment costs, which has left him burdened with debt to this day.<\/p>\n

He explains: “Workers at the organisation face additional challenges: a paramedic who suffers a slipped disc is transferred to administrative work, but in this case some allowances are removed from him, which means the loss of many financial benefits. These policies reinforce a sense of not being appreciated, and the failure to respond to our demands increases some people’s frustration.”<\/p>\n

The paramedic describes the growing frustration among workers because their demands for equality are ignored, saying: “This marginalisation directly affects their mental and physical health, reducing their ability to carry out their vital tasks.” He went on to liken the workers’ situation to a car that needs high-quality fuel but runs on less efficient fuel, which affects its condition and performance, in reference to the way everything they suffer is reflected in their health and their performance at work.<\/p>\n

Speaking of the solutions resorted to by workers worn out by the working conditions at the organisation, he says: “Because working hours extend to nearly 24 hours, we cannot find an opportunity to work in additional jobs to improve our income, but some colleagues resort to ending their secondment to the organisation and moving to other places that offer better conditions and fewer working hours, which contributes to a growing shortage of workers and doubles the burden on those who remain.”<\/p>\n

Recommended reading:<\/strong> Workers of the Holding Company for Drinking Water: Forced Labour and Wages Below the Minimum<\/a><\/p>\n

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Slow Increases<\/h3>\n
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To clarify how a distinction came to be made between the workers of the Ambulance Organisation and their colleagues working outside it, part of the organisation’s history must be highlighted. The story of ambulance services<\/a> in Egypt began with the founding of the Egyptian Ambulance Society in Alexandria in 1902, after which similar societies spread to several governorates to meet the growing need for ambulance services. Over time, the need emerged to organise this vital facility more comprehensively, which led to the establishment of the “Egyptian Ambulance Organisation” in 2009.<\/p>\n<\/blockquote>\n

But at first, the wording of the decision establishing the Ambulance Organisation indicated turning ambulance services from a free public service into a profit-making project, which sparked strong objections<\/a> from the State Council and civil society organisations, which demanded that ambulance services be guaranteed free of charge in emergencies. The government did respond to these objections and introduced fundamental amendments to the decision, according to the Egyptian Initiative for Personal Rights. On 3 May 2009, Presidential Decree No. 139 was issued announcing the establishment of the organisation, and the ambulance service thus became an independent public authority<\/a> with its own regulations, with an emphasis on its service character serving all citizens and residents in Egypt.<\/p>\n

After the organisation acquired its own regulations, all the allowances and increases paid to health sector workers covered by the Law Regulating the Affairs of Members of the Medical Professions No. 14 of<\/a> 2014 and its amendments issued by Presidential Decree No. 137 of 2014 did not apply<\/a> to the Ambulance Organisation’s workers. From then on, the allowances and salaries of those working inside the Ambulance Organisation differed from those working outside it, and the increases granted to workers under Law No. 14 on the medical professions were always met with demands for equality, not only from workers inside the organisation, but also from Parliament and the Ambulance Organisation Workers’ Syndicate.<\/p>\n

On 7 February 2014, workers in the medical professions were given some incentives<\/a> and allowances, including a professional risk allowance of EGP 200, while such incentives were not given to the Ambulance Organisation’s workers, which prompted the Ambulance Organisation Workers’ Syndicate to seek and demand similar allowances for the organisation’s workers. Indeed, on 16 February 2014, the organisation’s board of directors approved the payment of incentives and allowances<\/a>, including a medical professions allowance of EGP 150; the night-shift allowance was amended to EGP 10 and the overnight allowance to EGP 15, while the meal allowance became EGP 20 for a 24-hour work system. In the same year, President Abdel Fattah al-Sisi also amended Law 14 on the medical professions, and incentives<\/a> and allowances were increased so that the medical professions allowance ranged between EGP 400 and 700 depending on the position, but this time the Ambulance Organisation’s workers did not receive an increase and their allowances remained unchanged.<\/p>\n

In 2020, when medical teams, including ambulance workers, were on the front lines confronting the coronavirus, the President increased the medical professions allowance by 75%<\/a> for workers under Law 14 on the medical professions, while the Ambulance Organisation’s workers remained as they were. Their syndicate head<\/a>, Wael Sarhan, began demanding that the emergency allowance be raised to 400% and the medical professions allowance be increased to EGP 700 for all workers at the Ambulance Organisation, on a par with workers covered by Law 14 of 2014 and its amendments. MP Evelyn Matta Boutros, a member of the House of Representatives, also submitted a parliamentary proposal<\/a> to the Prime Minister and the Ministers of Health and Finance in April 2020, calling for the Egyptian Ambulance Organisation’s workers to be included in the increase of the medical professions allowance and highlighting the need to appreciate their important role during the coronavirus crisis, but the medical professions allowance was not amended for the Ambulance<\/a> Organisation’s workers. In 2022, incentive bonuses<\/a> were paid to the organisation’s workers who dealt with coronavirus cases.<\/p>\n

In tandem with rising prices, allowances for workers under Law 14 on the medical professions continued to increase and to greatly exceed those of the Ambulance Organisation’s workers, while the demands of the Ambulance Organisation’s workers and their syndicate for increases and equality did not stop. This is in addition to Parliament’s demands: MP Ayman Abul Ela, deputy head of the House of Representatives’ Human Rights Committee, submitted a briefing request to the Prime Minister and the Minister of Health calling for improved salaries<\/a> and allowances for paramedics at the Egyptian Ambulance Organisation, who suffer from low wages and inequality with their nursing colleagues. He explained that paramedics work 12 hours a day, compared with 6 hours for those working outside the organisation, yet their infection risk allowance has not changed since 2014 and stands at EGP 150, while for other workers it has risen to EGP 1,400. He also pointed to the very low night-shift and overnight allowances, and the meal allowance, which has not been amended since 2008.<\/p>\n

After the medical professions risk allowance<\/a> reached EGP 1,350 for workers under Law 14 on the medical professions holding technical diplomas, such as nursing technicians and health technicians, in February 2024 the President approved a proposal to improve<\/a> the wages of the Ambulance Organisation’s workers, and their allowances and incentives were increased<\/a> in March 2024, so that the medical professions incentive became EGP 500 for operating crews, supervisors, administrators and drivers, and EGP 750 for doctors, while the night-shift allowance became EGP 50 and the overnight allowance EGP 50.<\/p>\n

Recommended reading:<\/strong> Labour Protests in Egypt… Closing All Windows to Peaceful Negotiation<\/a><\/p>\n

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Absent Equality<\/h3>\n

Despite the latest increase, the demands of the Ambulance Organisation’s workers have not yet ended: the meal allowance has not been increased and is still EGP 20, their working hours are still longer than those of their colleagues outside the organisation, and the medical professions allowance and the overnight and night-shift allowances are still lower<\/a> than the allowance for workers under Law 14 on the medical professions, and the organisation’s workers still want equality with them. Ahmed says: “All we ask for is justice and equality. Is that too much?”<\/p>\n

For his part, MP Ayman Abul Ela<\/strong> explained to Zawia3 “that the medical cadre does not allow the inclusion of the Ambulance Organisation’s workers, because that would open the door to other groups joining, which would put pressure on the health budget.”<\/p>\n

Meanwhile, Amr Rashid, head of the Ambulance Organisation, said in previous press statements<\/a>: “Workers do receive their rights, and they cannot be diminished under any circumstances,” noting that all overtime work is compensated. He also said: “The ministry is making continuous efforts to solve the existing problems, while taking care not to impose any additional financial burdens on citizens.” This statement came before the increase in the prices of non-emergency ambulance services, the decision that prompted the organisation’s workers to demand their rights again after the last increases they received. The decision also prompted the head of the paramedics to call on the head of the General Syndicate of Egyptian Ambulance Organisation Workers to allocate part of the fees<\/a> for non-emergency services collected by the organisation to the workers who perform those services.<\/p>\n

Zawia3 tried to contact the head of the Ambulance Organisation Workers’ Syndicate by prior appointment to ask him about the latest developments regarding end-of-service gratuity for the organisation’s workers and the workers’ demands regarding healthcare for them and their families, but he had not responded by the time of writing.<\/p>\n

Meeting the demands of the Ambulance Organisation’s workers is proceeding slowly, and some of the demands they have been making for many years have still not been met, even after the increase in the prices of the organisation’s non-emergency services. For the workers, promises to improve working conditions seem out of step with their efforts and with the inflation and rising cost of living they face daily. As they continue to work under conditions requiring great effort and involving high health risks, their hopes remain pinned on achieving justice and equality with their colleagues in the health sector, so that they can perform their humanitarian duty, which always places them at the forefront of emergency lines.<\/p>\n","protected":false},"excerpt":{"rendered":"

Egypt’s paramedics endure low pay and gruelling conditions as the Egyptian Ambulance Organisation ignores their demands for better wages amid a severe economic crisis.<\/p>\n","protected":false},"author":11,"featured_media":10990,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[410,390],"tags":[19252,19258,19259,19250,19256,19253,19254,19255,19257,19251],"kateb":[18014],"class_list":["post-18337","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-investigations-en","category-human-rights","tag-ambulance-workers-allowances","tag-ayman-abul-ela","tag-covid-19-paramedics-egypt","tag-egyptian-ambulance-organisation","tag-health-workers-egypt","tag-meal-allowance-paramedics","tag-medical-professions-law-14-of-2014","tag-non-emergency-ambulance-fees","tag-paramedics-rights","tag-paramedics-wages-egypt","kateb-menna-sayed"],"jetpack_featured_media_url":"https:\/\/zawia3.com\/wp-content\/uploads\/2024\/11\/\u0627\u0633\u0639\u0627\u0641.png","_links":{"self":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/18337","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/comments?post=18337"}],"version-history":[{"count":1,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/18337\/revisions"}],"predecessor-version":[{"id":18338,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/18337\/revisions\/18338"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media\/10990"}],"wp:attachment":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media?parent=18337"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/categories?post=18337"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/tags?post=18337"},{"taxonomy":"kateb","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/kateb?post=18337"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}