A Deep Wound On the physical and psychological consequences of torture, prolonged solitary confinement and deliberate medical neglect on prisoners

Contents

1. Executive summary
2. Introduction
3. Report Methodology
4. Legal framework

4-1- The crime of torture and other forms of maltreatment in international law 

4-2- Crime of torture and other forms of maltreatment in Egyptian constitution and law

1. Prolonged solitary confinement

5-1- Legal framework of the solitary confinement 

5-2- the use of solitary confinement as a method of punishment and maltreatment of prisoners

1. Deliberate medical neglect

6-1- Legal framework of providing health care to prisoners

6-2- Use of medical neglect as a method of maltreatment of political opponents in prison

6-3- Death as a result of medical neglect in prisons

1. Physical and psychological consequences of torture and prolonged solitary confinement

7-1- Physical consequences of torture and other forms of maltreatment

7-2- Psychological consequences of torture and other forms of maltreatment

7-3- Psychological consequences of Solitary confinement

7-4- Suicide in Egyptian prisons as a result of torture and maltreatment

7-5- Death as a result of torture in Egyptian prisons

1. Harassment by authorities of those providing support to victims of torture
2. Recommendations

Annexes

 

• Executive summary

Torture and other cruel, inhuman or degrading treatment is a prohibited act in accordance with the Egyptian Constitution of 2014 and in accordance with international human rights law. Torture is also a crime against humanity when practiced systematically or broadly, according to the Rome Statute of the International Criminal Court, as is genocide, slavery, forced displacement and other similar inhumane acts that intentionally cause severe suffering or serious harm to the body or mental health, and the perpetrator should be held accountable before the law. The Convention Against Torture and Other Cruel or Inhuman Treatment of 1984 absolutely prohibited torture and specified that no exceptional or emergency circumstances whatsoever, whether it be a state of war or internal instability at the political level of the state, should be invoked, and that orders issued by higher officials of whatever rank or any official authority should not be invoked to justify it. This is on the international level. As for the domestic level, the Egyptian constitution explicitly criminalized torture and stated that it has no statute of limitations. However, Egyptian legislation faces a failure to meet international and constitutional standards. The Penal Code, in its Article No. 126, limits the criminalization of torture to cases where it targets confessions, while neglecting to criminalize any of the other causes surrounding the occurrence of the crime of torture, such as punishment and intimidation. Article 129 of the Penal Code came – as a gap – to establish mitigating penalties for the perpetrators of the crime of torture, by using the term “the use of cruelty” instead of torture – and using cruelty with people violating their honor or inflicting physical pain on them – and considered it a misdemeanor, not a felony in spite of the elements of the crime of torture in terms of intentional infliction of bodily and psychological harm according to the international definition. It sanctioned imprisonment for a period not exceeding a year or a fine of no more than 200 pounds, which reflects a state of acceptance to use torture policies and an opportunity for perpetrators to escape punishment.

The report focuses on two main types of torture and ill-treatment that are practiced in Egyptian prisons repeatedly and systematically as punishment methods for prisoners and as a means of revenge against political opponents:

The first pattern: solitary confinement, prolonged solitary confinement, or indefinite solitary confinement, which is used by the Egyptian authorities in dealing with political opponents and activists in their custody.

In this regard, President Abdel-Fattah El-Sisi ratified the amendment of Law 106 of 2015 regarding amending some provisions of Law No. 396 of 1956 on the organization of prisons, Article 43, on October 20, 2015, which granted broad powers to prison officials regarding the penalties that may be imposed on prisoners including solitary imprisonment for a period not exceeding 30 days – it was 15 days before the amendment – or the convict can be placed in a high security room for a period not exceeding 6 months.

In 2011, the United Nations Special Rapporteur on Torture called for the prohibition of solitary confinement for prisoners except in exceptional circumstances and for the shortest possible period with an absolute ban on its use against minors, children, women and persons with mental disabilities in addition to criminalizing solitary confinement of more than 15 days considering it to be torture since it may cause some permanent mental damage after a few days in social isolation/solitary confinement according to scientific studies used by the Special Rapporteur. The Standard Minimum Rules for the Treatment of Prisoners have also stipulated that in no case may disciplinary restrictions or sanctions amount to torture or other cruel, inhuman or degrading treatment or punishment, and stipulated that a set of practices, including indefinite solitary confinement, must be prohibited as well as prolonged solitary confinement. Moreover, the punishment of solitary confinement should not be used except in very exceptional cases and for the shortest possible period of time, and must be subject to legal regulation and judicial supervision. Also, even if the penalty for solitary confinement is applied, a minimum of contact and human contact must be allowed, family visits permitted, and access to mental health services provided.

Solitary confinement in Egyptian prisons is used as punishment against activists and political opponents with the aim of punishing and abusing them. This violation continues for months or years without regard to what the law and constitution stipulated. For example, former President Mohamed Morsi was held incommunicado for 6 years, during which he was allowed 3 family visits only until he passed away in June 2019; also activist Ahmed Doma was arrested on December 3, 2013 and was kept in a solitary cell and until to date, despite submitting complaints about the deterioration of his health and psychological condition.

The second type of torture or ill-treatment is intentional medical negligence and prevention of medical care, as the report monitors medical neglect in two aspects. The first concerns legislation governing the provision of health care for detainees in terms of international and domestic law, in which the Nelson Mandela Rules, the Standard Minimum Rules for the Treatment of Prisoners, state that the state is fully responsible for providing health care to prisoners in its custody that are at the same level of quality as health care available in society. It set a set of basic conditions and controls for the provision of health care to prisoners. However, the national legislation failed to achieve these conditions and controls. Health care was mentioned in 4 articles of Law No. 396 of 1956 regarding the organization of prisons and included several brief points regarding health care, the most prominent of which is that in every prison there should be a doctor as well as in every central prison. If no doctor is available, the government should delegate a doctor from government hospitals to undertake the responsibilities of prison doctors. The Prison Regulation Regulations in Article 33 granted the prison warden the right to observe the doctor’s recommendations regarding providing health care to a prisoner as required by his health condition and in this case the matter is submitted to the Medical Services Department to form a committee to consider the prison doctor’s decision, which constitutes a risk to the lives of detainees who need urgent health care.

The second aspect relates to the spread of the phenomenon of medical negligence in Egyptian prisons, where Egyptian authorities deliberately use medical negligence as a means of abuse of detainees, which leads to an increase in the number of deaths, as happened to Shadi Habash, who died in Tora prison in southern Cairo, on May 2, 2020, after exceeding the period of pre-trial detention permitted by law (two years) pending state security case no.  480/2018. Shady suffered alcohol poisoning, drinking methyl alcohol thinking it was water. His condition deteriorated for days and was only given colic treatment and medicine for the vomiting. He died in the prison clinic.

Another example of abuse of political opponents and leaving them in a state of pain and suffering is the case of former presidential candidate Dr. Abdel Moneim Abu El Fotouh, who was placed in solitary confinement for two years, despite his deteriorating health condition in a way that directly endangers his life. Abu Al-Fotouh is 69 years old, and suffers from several chronic diseases, including diabetes and hypertension. He also suffers from serious health problems in the spine and inflammation of the vertebrae. He suffers from severe prostatic hyperplasia that requires urgent surgical intervention, in addition to suffering cardiac problems. He also suffers from angina, having had attacks on two consecutive days on June 29, 2019 and June 30, 2019, and was not provided with any health care by the authorities.

The report discusses the effects and consequences of torture or other forms of ill-treatment, which begins with the physical effects that differ according to the type of torture used. Torture, with severe beating, whether by hands, legs, or with sticks, causes severe bruising and cuts, and sometimes even fractures. Torture by suspension, whether from hands or feet, usually causes problems in the nerve plexuses above the arms or feet, and sometimes these problems become permanent depending on the duration of the suspension. In addition, electrocution causes burns in places where the electrical wires are placed. Even just blindfolding for long periods of time can lead to problems in the retina and disorientation regarding time and space. In addition, food and water deprivation affects the vital organs of the body. Even short periods of water deprivation could lead to a sharp drop in blood circulation, which leads to kidney and hepatic failure, and accumulation of toxins in the blood, which may eventually lead to circulatory failure and death. In some cases, torture has led to permanent physical effects, such as the occurrence of direct permanent disabilities as a result of torture, as in the case of Munir Yusri, 28, who was subjected to torture and severe beatings, which led to blindness in his left eye while he was being held in the May 15 prison south of Cairo in 2017.

Torture exposes the victims to intense psychological violence, to the extent that is defined as one of the extraordinary traumas in view of the major mental effects it has on the victims. Those effects may last for a long period after being subjected to torture, the most important of which is Post-Traumatic Stress Disorder – PTSD, which is a psychological condition resulting from the exposure to a severe trauma such death threats, sexual violence, repeated physical violence, severe physical harm, such as the case in torture where the victim has no ability to defend him/herself. This fear, helplessness and horror during the incident may accompany the victims for long periods of time.

One of the distinguishing features of this disorder is that those who suffer from it recover events as if they were really happening again (Flashbacks), where the victim is exposed to repeated compelling memories, in which the victim feels that he is experiencing the trauma again and brings back feelings of impotence or intense fear. Sometimes he can retrieve the sounds accompanying that shock – such as screaming sounds in cases of torture or odors such as the smell of a narrow cell, the smell of sweat and blood or the smell of burning flesh – which causes the victim to become confused and may become unaware of his current surroundings. This is in addition to severe depression, which causes feelings of despair from life, suicidal thoughts, and possibly actual acts of attempted or committed suicide. 

The report reviews the psychological and mental effects of those who have experienced solitary confinement, especially prolonged or unlimited prolonged solitary confinement, and the possibility of them being exposed to severe mental disorders such as psychotic disorders including schizophrenia and audiovisual hallucinations, and visual illusions. Depriving the prisoner of external influences such as communicating with others, carrying out social activities, reading books, magazines and other external stimuli that are essential to the process of cognition, is destructive to the mental health. After some time, the brain is forced to create stimuli for itself, as the absence of any external influences begins, the brain begins to make its own efforts, so the concerns, thoughts, ideas, and memories of the person begin to express themselves in the form of hallucinations, to compensate for the loss of perception that occurred as a result of solitary confinement. These symptoms may persist after his release from solitary confinement.

In addition, suicide attempts are one of the consequences of the widespread methods of torture and other forms of ill-treatment in Egyptian prisons, such as the case of Osama Murad, who committed suicide by slitting his throat after he was subjected to ill-treatment and beatings in prison the day before his suicide. Torture may also lead to instances of death directly due to the effects of physical torture, and the report reviews some cases that died as a result of torture in Egyptian prisons in 2019-2020.

The report concluded with a set of recommendations, the most important of which are:

• Ordering the immediate cessation of the policy of torture and ill-treatment in Egyptian prisons for any purpose, whether extracting confessions or using them as a means to punish detainees, and bringing the perpetrators to justice to hold them accountable for their crimes.
• Amending the current domestic legislation related to the crime of torture and ill-treatment in line with the agreements signed and ratified by Egypt and the Egyptian constitution, by amending Articles 126 and 129 and article 162 of the law of criminal procedures.
• Immediate cessation of using the prolonged solitary confinement punishment as a method of abusing political opponents as a form of torture and ill-treatment in local laws and legislation as stipulated in the Nelson Mandela Rules.
• Allow the International Committee of the Red Cross to inspect prison conditions in Egypt, as well as allow specialized national and international NGOs to visit all places of detention and allow United Nations experts, especially the Special Rapporteur on torture, to visit Egypt.
• The formation of a national preventive mechanism from independent human rights organizations that organize unannounced visits to places of detention to inspect their conditions in cooperation with the National Council for Human Rights and the Public Prosecution specializing in the periodic follow-up of prisons, especially solitary cells and cases of disease to monitor the two phenomena and provide reports on them to the relevant authorities.
• Immediate cessation of using medical negligence policy to abuse detainees, especially political opponents, and provide urgent medical care for detainees with chronic health problems or requiring transfer to a specialized hospital, and refer those who violate or prevent medical care for a sick detainee to legal accountability.
• Formation of an independent judicial committee to undertake an urgent and impartial investigation of cases of death as a result of medical neglect in Egyptian prisons. Results of such investigations should be made public and those responsible held legally accountable 

• Introduction

Torture and other forms of ill-treatment are among the most prominent violations that prisoners face in places of detention in Egypt on an ongoing basis. Torture crimes are an essential tool for police officers to extract confessions from suspects in legal places of detention, such as police stations, prisons, and illegal ones such as national security headquarters. It is a tool of the police force to impose control and punishment on prisoners and detainees, and to abuse political opponents held in state prisons. With regard to torture practices in Egyptian prisons during the past years, according to the report submitted to the United Nations for the universal periodic review process during the period between 2014 and the end of 2018, 446 prisoners died in places of detention, including 85 as a result of torture, in addition to death as a result of deliberate medical negligence.

In addition, Egyptian laws and legislation criminalizing crimes of torture and ill-treatment are punctuated by a legislative failure to hold perpetrators of torture crimes accountable, and some articles, such as Article No. 129 of the Penal Code, which allows the description of torture as a use of cruelty to turn into a misdemeanor instead of a felony and consequently, issue reduced sentences to a period of 6 months or a fine of 200 pounds. This results in the majority of perpetrators enjoying effective immunity from prosecution and accountability in light of the complicity of the police investigation authorities to repel any reports of torture. Prosecutors fail in most cases to verify complaints of torture and ill-treatment, and if the prosecution calls for investigating the complaint and referring the victim to forensic medicine, the prison administration was intransigent in sending the forensic doctor until the injury is healed, and in many cases the judges ignored the complaints and allegations of torture by defendants. For example, the case of the Attorney General, in which death sentences were imposed against the accused. All these points sound a warning bell about the use of policies of torture and ill-treatment and the tacit approval of them by prosecutors and judges, and even on the basis of confessions extracted under torture in issuing life sentences and executions, despite the law stipulating that confessions extracted under torture may not be used in any way in courts.

This report aims to highlight the patterns of crimes of torture and ill-treatment, especially solitary confinement, which is practiced against activists and political opponents as a means of punishment and abuse, and often amounts to torture in cases of prolonged or indefinite solitary confinement, as happened with former President Morsi, who spent 6 years in solitary confinement; or the cases of political activist Ahmed Doma, who spent about 5 years in solitary confinement, and the prosecution is still postponing the consideration of the lawsuit to abolish the solitary confinement penalty since 2017 until now. In addition, the report aims to reveal the prevalence of medical neglect in Egyptian prisons, on the one hand, and the use of deliberate medical neglect and the prevention of providing urgent health care to patients who are being held as a punitive and reprisal method from political prisoners. For example, Dr. Abdel Moneim Abu El Fotouh, whose health condition has deteriorated greatly during two years in solitary confinement so far, to the extent of suffering two angina attacks on two consecutive days on 29 and 30 June 2019 and the authorities did not provide him with any medical care.

Essentially, the report aims to shed light on the effects of the crime of torture and ill-treatment from temporary and permanent physical effects such as permanent disabilities, in addition to the psychological and mental effects on victims of torture and ill-treatment that amount to attempted suicide or death as a result of torture.

There is a danger that threatens the lives of detainees in Egyptian prisons every day whether from medical negligence or the effects of torture or in the simplest of cases threatens their physical, psychological and mental integrity to dangerous levels to the extent that might hinder them from practicing their lives after their release from prison because of their inability to recover from their experience of torture and ill-treatment, because of its devastating effects on mental and mental health as well as physical well-being. In order to prevent torture and ill-treatment, real changes must occur in the local legislative structure governing the crime of torture including increased penalties for its perpetrators, while supporting this by state policies represented in the Egyptian government and through cooperation with semi-governmental bodies, civil society, prosecutors and the role of judges to reduce torture and ill-treatment in Egyptian places of detention.

• Report Methodology

The report takes reference from international human rights law in legal matters related to the subject of the report – specifically torture in the form of prolonged solitary confinement and deliberate medical neglect – and foremost the International Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment of 1984 and the United Nations Minimum Standards for Treatment of Prisoners (Nelson Mandela Rules). As for the Egyptian legislation, the report examined the Egyptian constitution, the penal code, the criminal procedure law, the prison organization law and its internal regulations, in addition to reviewing previous literature on torture crimes and other forms of ill-treatment.

The report uses a number of psychological references in parts of the report related to mental disorders such as the statistical diagnostic manual for mental disorders, in addition to a research interview with the Nadim Center for Rehabilitation of Psychological Victims and its publications in this regard. The report also uses testimonies of victims and torture cases documented by the Egyptian Commission for Rights and Freedoms and other Egyptian organizations to determine the physical and psychological effects of prolonged solitary confinement and deliberate medical neglect.

• Legal framework

The Universal Declaration of Human Rights of 1948 – which, despite being an international declaration that is not binding on states, is seen as a codification of a human rights reference internationally – begins with a preamble that ” Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world”. Article 5 reaffirms that “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.”

Article 56 of the Egyptian constitution states, “Prison is a house for reform and rehabilitation. Prisons and detention centers shall be subject to judicial oversight. All that which

violates the dignity of the person and or endangers health is forbidden.” Article 56 of the constitution lays down the foundations for the concept and definition of a prison sentence as it defined it as a “house” and therefore an indication of the place where a person resides for a period – for community reform and rehabilitation, in which everything that contradicts or opposes the preservation of human dignity is prohibited as a basic human right as well as everything that endangers the physical health and safety of the detainee; prisons and places of detention are subject to judicial supervision to ensure this. 

With regard to the first part of the concept of incarceration/imprisonment, the United Nations Standard Minimum Rules for the Treatment of Prisoners stipulated in Rule No. (3) that imprisonment and other measures of isolation of persons from the outside world are painful measures in themselves as they deprive the individual of the right to decide his fate by depriving him of his freedom, and for this reason the prison system should not exacerbate that suffering with additional measures except in special cases. It added in Rule No. (4) that the penalty of imprisonment and other measures to deprive people of their liberty are mainly aimed at protecting society from crime and limiting cases of re-criminality, and there is no way of this unless the period of imprisonment is used to ensure the reintegration of those persons into society after their release. To achieve this, prison departments should provide education, vocational training and various forms of assistance of a correctional, ethical, spiritual, social, health and athletic nature. In addition to the clarification in the rules of the concept of the prison sentence and its main goal as a nucleus for the interpretation and organization of the prison sentence, the first rule of the Nelson Mandela Rules stipulated that all prisoners be treated with due respect for their human dignity, and no prisoner may be subjected to torture or cruel, inhuman or degrading treatment, providing all prisoners with protection therefrom, and no circumstance may be invoked as a justification therefor. The safety and security of prisoners must be guaranteed.

From this philosophical, legal and humanitarian pespective, it is not permissible for prison inmates to be subjected to torture or other forms of ill-treatment, including prolonged solitary confinement or deliberate medical neglect. In this chapter, we review the general legal frameworks that prohibit torture or other forms of ill-treatment in general. In chapters five and six, the report reviews legal frameworks that specifically concern solitary confinement and deliberate medical neglect.

4-1- The crime of torture and other forms of maltreatment in international law 

The International Covenant on Civil Rights of 1966 laid the foundation for the criminalization of torture, stating in its seventh article that “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment”, which Egypt ratified in 1982. Thus the text mentioned in The Universal Declaration of Human Rights above is binding under an international agreement.

Then in 1984 the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, which Egypt joined with no reservations on June 25, 1986, defined torture as follows: “Torture For the purposes of this Convention, the term “torture” means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions. ” 

Given the gravity of the crime of torture, the Rome Statute of the International Criminal Court defined torture, in its seventh article, as a crime against humanity when committed in the context of a widespread, systematic, or directed attack against a group of the civilian population, in addition to other inhumane acts of a similar nature intentionally causing suffering, severe or serious harm to the body or mental or physical health, that clarifies the concept of ill-treatment or cruel or human treatment. The definition in paragraph e) clarifies that torture is ” means the intentional infliction of severe pain or suffering, whether physical or mental, upon a person in the custody or under the control of the accused ” The definition clarified that the concept of torture does not include pain or suffering arising only from, inherent in or incidental to, lawful sanctions

The Convention against Torture and Other Cruel or Inhumane Treatment prohibited torture absolutely, and specified in its second article that it is not permissible to invoke any exceptional or emergency circumstances, whether it is a state of war or internal instability at the political level of the state, and added that it is not permissible to invoke orders issued from higher-ranking officials or any higher authority as justification for torture at the level of individuals. The Convention obliges each State party to take legislative, administrative, judicial, and other measures to prevent acts of torture and hold perpetrators accountable.

In addition, the convention has specified that each state party has a responsibility to prevent the crime of torture, including rules for the arrest and detention of persons in its custody, and to establish interrogation rules, methods, and practices, and that each state party must ensure that its competent authorities conduct an impartial and prompt investigation in the event that there are compelling reasons to believe in the commission of any acts of torture; each country guarantees the right of any person who claims to have been tortured to look into his complaint and to conduct the necessary investigations promptly and to take all necessary steps to protect the complainant and witnesses from all types of ill-treatment such as intimidation and threats as a result of the victim’s complaint.

4-2- Crime of torture and other forms of maltreatment in Egyptian constitution and law

The Egyptian constitution of 2014 came to lay down the constitutional legitimacy of categorically criminalizing torture, as it explicitly stipulated the criminalization of torture and considered it a crime that does not fall under the statute of limitations in its article No. 52, which states that “torture in all its forms and types is a crime that does not cease by statute of limitations.” “Anyone who is arrested, imprisoned, or whose freedom is restricted must be treated in a manner that preserves his dignity, and it is not permissible to torture him, nor intimidate him, nor force him, nor harm him physically or morally, and his detention or imprisonment is only in designated places and shall be humane and healthy. The state is obliged to provide means of access to persons with disabilities. Violating something of that is a crime, and the perpetrator will be punished according to the law. The accused has the right to silence. Any statement that proves to have been issued by a detainee under the weight of any of the foregoing, or threatening with any of it, will be ignored and is not reliable.” 

This is a progress towards imposing legal protection on the right of individuals not to be subjected to torture and punishment for perpetrators who enjoy authority, at least at the constitutional level. In addition, in its Article 99, the 2014 constitution guaranteed the right of the aggrieved to file a criminal lawsuit and the right to compensation for the infringement on his rights and freedoms guaranteed by law and the constitution. In addition to that the constitution gave the right to intervene to semi-governmental bodies such as the National Council for Human Rights to inform the Public Prosecution of any violation of these rights. Article 93 of the constitution also stipulates that ” The state is committed to the agreements, covenants, and international conventions of human rights that were ratified by Egypt. They have the force of law after publication in accordance with the specified circumstances”. Chapter Four: Rule of Law. This gives a strong constitutional basis for legal and judicial compliance with the international agreements mentioned above.

As for the level of Egyptian laws and regulations, the texts are still far from what was stated in the constitution and have not been modified to be consistent with its text of, but rather the opposite in some cases.

Egyptian law engaged with the crime of torture and ill-treatment in the Penal Code criminalizing torture and determining its punishment without adequately defining it, and in the Criminal Procedure Law through the right of the victim to obtain redress from the perpetrator and his collaborator and to receive reparation and compensation for the damage suffered.

The Penal Code defines torture in Article No. 126, which stipulates that every public official who ordered the torture of a defendant or did so himself to make him confess is punished with imprisonment or hard labor from three to ten years, but in the event of the death of the victim as a result of torture, he is sentenced to the penalty prescribed for intentional murder. It is noted here that the definition limits the concept of torture to extracting confessions, and it appears that the legislator has inserted this text in consideration of the legal consequences of relying on confessions extracted under torture in obstructing justice, and thus limited the punishment to torture to extract confessions, while omitting other causes of the crime of torture such as intimidating or abusing the victim, and directly punishing him, whether by physical or psychological abuse by security men, which violates not only the rights of the victim, but also is a grave breach of the role of law enforcement officials entrusted with protecting rights.

In addition, the definition limited the responsibility for the crime of torture to the public official who ordered the torture of a defendant or did it himself, at a time when the definition of torture in the Convention against Torture and all forms of cruel, inhuman or degrading treatment stipulated that the punishment of torture extends to all who incited the torture, approved, or tolerated it by officials, or anyone acting in an official capacity, which calls for amending the definition of torture contained in the Penal Code in line with the definition in the Convention against Torture.

In addition, Article No. 129 of the Penal Code defined a punishment of a maximum of one-year prison sentence or a fine of a maximum of 200 Egyptian pounds for every public official and every person assigned to a public service who relied on his job to use cruelty with people, in violating their honor or inflicting physical pain on them. 

The definition outlined the criteria for this crime, firstly the act committed be a public official using his authority, and the term “public employee” came to identify any public employee who has authority over citizens of all job ranks, and his reliance on this authority to use cruelty and direct harm to his victim/defendant in his custody, especially because the victim is in no position defend himself since he is physically and psychologically the weaker party facing the oppression of power. Any response may expose him to a greater assault or expose him to fabricated charges against him. Moreover, the state official is in a spcyholgocially stronger position in view of his enjoyment of power, which drives him to commit torture, especially when he knows that he will enjoy impunity.

Two points are noted in that article. The first is concerned with the concept of “the use of cruelty” instead of the use of the word “torture” in the imposition of the punishment, because this crime – the use of cruelty – constitutes a misdemeanor and has a statute of limitations – i.e. the case is dropped after a certain time has passed since the incident occurred. Torture, on the other hand and according to article 126 constitutes a felony and is considered a crime that with no statute of limitations according to the Egyptian constitution. The second point relates to the punishment of the use of cruelty, which is imprisonment for a year or a fine of no more than two hundred pounds, and this punishment is not proportionate to the severity of the crime in view of its psychological damage to the individual and society if it is systematically committed, which is the case in Egypt. Thus, the punishment does not constitute a strong deterrent to the perpetrators of this crime. Rather, it may constitute an opportunity to escape the punishment of torture by turning it into an act of cruelty. In addition, there is the insignificant amount of the fine on the one hand, and the possibility of reducing the prison sentence on the other.

Article 99 of the constitution states that “Any assault on the personal freedoms or sanctity of the life of citizens, along with other general rights and freedoms guaranteed by the Constitution and the law, is a crime with no statute of limitations for both civil and criminal proceedings. The injured party may file a criminal suit directly.  The state guarantees just compensation for those who have been assaulted. The National Council for Human Rights possesses the right to enter into an ancillary civil lawsuit on the side of the injured party at his request”

However, none of this is permitted in the Criminal Procedure Law. Article 162 of the Criminal Procedure Law established that the civil rights claimant could appeal the decision issued by the investigating judge that the case is not open for prosecution – unless the complaint is against a state employee, public servant, or one of the law enforcement officers investigating a crime that occurred during or because of his the performance of his work; in this case there is no appeal of the decision of the investigating judge if he finds that there is no reason to file a criminal case. The article exempted from this provision the crimes mentioned in article 123 of the Penal Code which is limited to refusing to enforce judicial rulings, and therefore, under these provisions, the torture victim does not have a way to appeal in the event that the investigating judge’s decision is that there is no ground for filing a lawsuit accusing a public official of committing the crime of torture. This leads to the closure of dozens of torture cases by a decision of the Public Prosecution based on these Article, and widens the gap between the rights established by the constitution and its remedies, and between legislation and the means of their enforcement established by laws.

• Prolonged solitary confinement

Solitary confinement is one of the harshest penalties that can be applied to a prisoner and amounts to a form of torture or cruel and inhuman treatment, especially in the case of prolonged solitary confinement because of the complete isolation in a narrow cell that may cause severe psychological effects. Preventing a prisoner from human contact with other prisoners or with the family for long periods of time may cause serious mental and psychiatric disorders such as acute anxiety, depression, post-traumatic stress and personality breakdown. In 2011 the UN Special Rapporteur on torture called for the necessity of imposing an absolute ban on prolonged solitary confinement for more than 15 days, considering it an act of torture.

5-1- Legal framework of the solitary confinement 

The United Nations Minimum Standard Rules for the Treatment of Prisoners consider that solitary confinement is the incarceration of prisoners for 22 hours or more per day without any means of making meaningful contact with others. It recognized that the concept of prolonged solitary confinement is solitary confinement for more than 15 days. In addition, in a 2007 Istanbul statement on the use of solitary confinement and its effects, it was stated that “complete isolation of the senses, in conjunction with complete physical isolation, can destroy the personality and constitute a form of inhuman treatment that cannot be justified by security requirements or any other reasons” (published in the report of the Secretary-General of the United Nations addressed to the General Assembly on August 8, 2011,). The statement recommended that the penalty of solitary confinement should be used only in very exceptional cases and for the shortest possible period, and should be subject to legal regulation and judicial supervision. It also recommended that even in the case of the application of the penalty of solitary confinement, minimal human contact and communication must be permitted, by allowing access to social activities with other prisoners, or allowing family visits, and providing access to mental health services.

In addition, the Standard Minimum Rules for the Treatment of Prisoners stipulated in its rule No. (43) that in no case may disciplinary restrictions or punishments amount to torture or other cruel, inhuman or degrading treatment or punishment, and included a list of practices that should be prohibited including indefinite or prolonged solitary confinement. It stated that disciplinary punishments or restrictions may not include preventing prisoners from communicating with their families.

Rule No. (45) stipulated that solitary confinement should not be used except in exceptional cases or as a last resort and for the shortest possible period, and upon authorization by a competent authority, and prohibited the imposition of solitary confinement on prisoners with mental or physical disabilities, on women or children as referred to in the United Nations standards.

On the other hand, the Committee against Torture, the United Nations committee mandated to interpret the provisions of the Convention against Torture, recognized the violent psychological effects of the prolonged solitary confinement penalty and expressed its concern for its use even as a preventive measure during pre-trial detention as a disciplinary measure also aimed at punishment. The committee recommended abolishing the penalty of solitary confinement, or imposing strict, clear and well-defined legal oversight, such as setting the time and maximum period and subject to judicial supervision and used only in exceptional circumstances, for example when it comes to the safety of persons and property. The United Nations Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment recommended that the prison doctor visit prisoners in solitary confinement every day, that detainees could spend at least an hour in the open air and be provided with adequate beds and mattresses, and indicated that prolonged solitary confinement was equivalent to acts of torture and other inhuman treatment, and prohibited its use for minors or those with mental problems or disorders.

 In 2011, the United Nations Special Rapporteur on Torture called for the prohibition of solitary confinement of prisoners except in very exceptional circumstances and for the shortest possible period with an absolute ban in the event of juveniles – minors – and persons with mental disabilities or people with psychological problems or disturbances, due to the seriousness of this procedure and because it directly contradicts the idea of ​​rehabilitation, which is the main goal of the prison system. In addition to criminalizing solitary confinement if it exceeds 15 days as torture, as published scientific studies have conclusively demonstrated the occurrence of some permanent mental damage after a few days in social isolation/solitary confinement.

However, despite this, at the local level, President Abdel Fattah El-Sisi ratified the amendment of the Egyptian Prison Regulation Law No. 396 of 1956 on October 20, 2015, which granted broad powers to prison officials to apply the penalty of solitary confinement, in addition to extending the maximum limit of the penalty for solitary confinement to 30 days instead of 15 days or the confinement of those convicted in a high security room for 6 months.

5-2- The use of solitary confinement as a method of punishment and maltreatment of prisoners

On the ground, many prisoners are held in solitary for indefinite period of time and for prolonged periods extending sometimes to years. It is extremely difficult to obtain accurate estimates about the numbers of detainees incarcerated, and in the absence of any supervision of any kind on Egyptian prisons, the penalty of solitary confinement is used arbitrarily in disciplining prisoners, both criminal and political, and is used systematically to retaliate, abuse and punish political opponents without deterrent or control. In the Amnesty International report “Crushing Humanity, Misuse of Solitary Confinement in Egypt”, the organization stated that “Egyptian authorities regularly classify detainees and prisoners for political reasons as dangerous and use national security as an excuse to put them in solitary confinement, and among the apparent objectives of solitary confinement is revenge, punishment and intimidation”, where the penalty of solitary confinement in Egyptian prisons is used against activists and political opponents with the aim of punishing and abusing them, and this violation continues for months or years without regard to what the law and constitution stipulated.

In the case of the late President Mohamed Morsi, he was held incommunicado for more than six years until his death on 17 June 2019, and he was also deprived of communication with others and of books, newspapers, paper, pen, and radio. Amnesty International has demanded an investigation into the death of Mohamed Morsi, who has been forcibly disappeared for several months, in addition to his solitary confinement for 6 years, which put tremendous pressure on his psychological and physical health in clear violation of the prohibition of torture and other cruel or inhuman or degrading treatment. During these six years, he was completely cut off from the outside world and allowed only three family visits and prevented from contacting his lawyer or his doctor despite his deteriorating health. According to Amnesty International, he was suffering from diabetes and was taking insulin, and his blood sugar level decreased during sleep causing several incidences of hypoglycemic coma, a condition that may lead to death. His sense of vision deteriorated as a result of an impairment of his sugar level, in addition to severe pain in the back, bones and neck, and he asked to consult an orthopedic doctor but received no response to his request. He requested medical care through the court, so the court agreed, but the prison authorities did not implement the court order. Egyptian authorities also prevented Morsi from receiving medicine and appropriate food from outside prison for the duration of his imprisonment while permitted it in other prisons. Morsi continued in solitary confinement and medical negligence until he died in June 2019.

The penalty of prolonged or unlimited solitary confinement was used against Ola al-Qaradawi, daughter of Sheikh Yusuf al-Qaradawi, former president of the International Union of Muslim Scholars, who spent two years in solitary confinement after arresting her and her husband from her summer home in the North Coast on June 30, 2017 on charges of belonging to a group founded against the law. Since her arrest, the State Security Prosecution ordered her and her husband’s solitary confinement, in a cell that does not exceed two square meters, without windows or ventilation for 24 hours a day. She was prevented from receiving visits even from her lawyer without giving reasons for that. On July 3, 2019, the Cairo Criminal Court issued a decision to release Ola al-Qaradawi with precautionary measures, two years after being held in pre-trial and solitary confinement in Al-Qanater prison, only to be charged in a new case on July 4, 2019 and re-imprisoned by the State Security Prosecution on charges of joining and financing a terrorist group by exploiting her relations in prison, all while still in solitary.

In the case of activist Ahmed Doma, who was sentenced in April 2014 and was held in a solitary cell by a decision of the Prison Authority of the Ministry of the Interior, which led to the deterioration of his physical health and severe psychological damage, while ignoring the complaints submitted by his lawyer regarding the deterioration of his condition. The Egyptian Center for Economic and Social Rights filed a lawsuit No. 32866 of 71 judicial cases against the Public Prosecutor and the Minister of Interior to cancel the decision of his incommunicado detention for violating the constitution and the law that states that the maximum period of solitary confinement is 30 days because of its violent negative effects on the prisoner, both physically and psychologically as well as its breach of prison regulations. The Administrative Judicial Court adjourned the consideration of the case several times over several years since the case was filed in 2017 until now, and Duma is still in solitary confinement.

• Deliberate medical neglect

Deliberate medical negligence in prisons is a form of ill-treatment and a form of cruel and inhuman treatment, which implies the prevention of the right to provide health care to prisoners causing severe physical and psychological suffering for patients who cannot obtain the necessary health care themselves as a result of their imprisonment, which endangers their lives, and in many cases resulted in their death, while it was possible to save their lives with simple medical procedures.

6-1- Legal framework of providing health care to prisoners

According to the minimum standards for the treatment of prisoners, incarceration is not an excuse for violating any of the basic human rights or failure to perform or violate them for the purpose of punishment, foremost of which is the right to physical integrity and the right to health, and the state is obliged to do so since the state is fully responsible for providing health care to prisoners in its custody. The Standard Minimum Rules for the Health Care Services for Prisoners – starting from Rule 24 to Rule 35 – have established that the state is responsible for providing health care to prisoners of the same quality like that available in society and that this right to access of necessary health services should be provided free of charge and without discrimination based on the prisoners’ legal status. Health services should be organized in a way that ensures the continuity of treatment and care. It also stipulates that every prison should have a health care services department consisting of a multidisciplinary team including psychiatry, and be charged with assessing, strengthening, protecting, and improving the physical and mental health of prisoners, and that the health care services department should prepare individual medical files for all prisoners and ensure that all prisons have immediate access to medical care in urgent cases. In the case of prisoners whose conditions require specialized care or surgery they should be transferred to specialized institutions or to civilian hospitals; there must be sufficient staff and equipment in the prison hospital facilities to provide appropriate treatment and care services to the prisoners referred to it. It recognized that only health care professionals responsible for making clinical decisions may be permitted to make such decisions, and non-medical prison staff may not cancel or ignore these decisions.

In the case of women’s prisons, they should be provided with the special facilities necessary to provide prenatal and postnatal care and treatment, make wherever possible arrangements for the birth of children in a hospital outside the prison, and be provided with the necessary facilities if the children are kept with their imprisoned mothers. Children should not be treated as prisoners. The prison doctor must examine each prisoner after entering prison to determine his health care needs and to identify any mistreatment of prisoners before entering prison, and to indicate any signs of psychological pressure due to the prison incident that may lead to suicide risks or self-harm.  The doctor must have daily access to all prisoners who complain of physical or mental health problems to conduct medical examinations, and to submit a report to the prison director in the event that he considers that the physical or mental health of a prisoner has been or will be affected by the conditions of his imprisonment. If health care professionals find during the examination of a prisoner or the provision of medical care any signs of torture or other cruel, inhuman or degrading treatment, they must document these cases and inform the relevant medical, administrative or judicial authority.

As for the national legislation related to providing health care to prisoners, they are vague and unspecified and only requires the lowest health standards that cannot be ignored – such as the presence of a general practitioner in every prison – and even those standards are ignored and violated on the ground. Law No. 396 of 1956 regarding the organization of prisons stipulated several summary points related to health care. 

In its articles No. 33 to 37, every prison must have one or more doctors, one of whom is a resident entrusted with health work in accordance with the prison’s internal regulations; a central prison shall have a doctor, and if a doctor is not appointed, a government doctor shall be assigned to perform the duties assigned to the prison doctor. The law also obligated governmental and university medical facilities to treat prisoners referred to them from prisons and to treat them according to the standards of the Ministry of Health and the Ministry of the Interior. 

It also entitled every convicted prisoner to request release for health reasons, in which case the matter is presented to the department of prison medical services to assess the health condition and issue a decision accordingly.  It also stated that if the prison doctor identified that the prisoner suffers a mental disorder, he should present the matter to the director of the prison medical department and to refer the prisoner to a mental hospital if the condition is confirmed, in which case the prisoner is kept in the hospital until recovery and is then returned to prison. The time spent at hospital is then deducted from his prison term. Also, if the prison doctor identified that a prisoner is suffering a life threatening illness or an illness that could cause him permanent disability, he may present the matter to the director of the medical department and the forensic doctor for examination and their decision is implemented upon agreement of the public prosecutor. The director of the prison medical department and the forensic doctor may be authorized to examine and report on the health condition. The released prisoner may be returned to prison to continue the prison sentence if re-examination reveals that the condition calling for the release has been cured or if he changes the address of his residence without informing the respective administrative authority. 

It is noted that the national legislation has omitted many of the principles of providing medical care to prisoners that are included in international legislation, and in reality the Prison Regulation Law did not set any real conditions or rules for providing medical care other than what was stipulated in the presence of a doctor who is constantly in prison, nor has it any provisions related to providing medications and medical tools necessary to provide health care for prisoners, or to provide doctors in various specialties or the right to refer the sick prisoner quickly and without delay to the doctor and not to leave him suffering from severe pain for long periods of time and transfer him to the hospital if necessary, especially in critical cases. It did not lay down any rules related to providing medical care for prisoners with chronic diseases or the elderly or keeping medical reports about prisoner cases. Rather, in the Prison Regulations the first point in Article No. 33, it was stated that the prison warden must implement what the prison doctor recommends with regard changing the treatment of a prisoner according to what his health condition calls for. The second point in the same article then he gives the right to the prison warden to make reservations on the doctor’s recommendations, in which case the matter is submitted to the prison medical services department to form a committee to consider what the prison doctor decided, which takes long periods of time that can pose a serious danger to the health of prisoners. This is what happens as dozens of people lose their lives as a result of medical negligence in Egyptian prisons.

6-2- Use of medical neglect as a method of maltreatment of political opponents in prison

Many prisoners of conscience in prisons still do not receive the health care required to protect their health from deterioration as they suffer from chronic diseases such as diabetes, hypertension, heart disease, respiratory disease, and others. This comes at a time when the Coruna virus has spread in Egypt and the world, and Corona cases have started to appear in some prisons in Egypt. ECRF has appealed to Egyptian authorities over the years to provide appropriate medical care for prisoners, the last of which was concerning many political prisoners between human rights defenders and political activists. The Adalah Center for Rights and Freedoms has monitored 828 cases of medical negligence in places of detention from June 30, 2013 to June 2017. Prison authorities often carry out medical negligence at the instigation of the National Security Sector, as the authorities deliberately use the prevention of medical care as a means of punishment and abuse of prisoners, especially to exact revenge on their political opponents.

Among the cases of medical negligence documented by ECRF is the case of former political and parliamentary activist, lawyer Ziad Al-Alimi, who suffers from breathing crises as a result of a rare immune disease (Sarcoidosis), and pericardial effusion, which exposes him to a risk due to his continued detention. Ziyad’s family has filed a lawsuit to demand that he be transferred to an external hospital at the expense of his family to provide the necessary health care. Al-Alimi continues to be held in pretrial detention at the time of writing this report pending state security case 930 of 2019, known in the media as the “Alliance of Hope” case in which he is accused of joining a terrorist group. 

Also, Aisha Khairat Al-Shater, a member of the Egyptian Coordination for Rights and Freedoms, suffers from aplastic anemia, which contributed to the deterioration of her health. She was transferred to Al-Kasr Al-Aini Hospital for her need of medical care due to severe bleeding. However, her condition requires specialized, intensive and continuous treatment in a properly equipped medical facility. In her current condition, her life is still at great risk due to sepsis or bleeding. She also suffers from bone marrow failure, unable to manufacture the blood cells needed to carry oxygen to her body’s tissues (red blood cells) or defend her body in the event of any infection or bacterial which may lead to septicemia, an urgent medical condition that may lead to death. Security forces had arrested Aisha Al-Shater from her home on November 1, 2018, and she was subjected to enforced disappearance. She then appeared on November 25, 2018, a state security suspect in case no. 1552/2018, accused of joining a group founded in violation of the provisions of the law and the constitution appeared on November 25, 2018.

As for the former presidential candidate, Dr. Abdel Moneim Abu El Fotouh, who was arrested on February 15, 2018, he was placed in a solitary cell in the Mazraa Prison in the Tora Prison Area, south of Cairo, pending the investigations conducted by the Public Prosecution in state security case No. 440 of 2018. So far, he has been held in solitary confinement for over two years and has been included in a new case, No. 1781 of 2019, despite his deteriorating health condition in a way that directly endangers his life. Abu Al-Fotouh is 69 years old, and suffers from a group of chronic diseases such as diabetes and high blood pressure. He also suffers from problems in the spine and inflammation of the vertebrae. The heart has been subjected to several angina attacks, the last of which was a heart attack two days in a row on 29 and 30 June 2019. The refusal of the authorities to provide him with the necessary health care, especially in light of the successive health crises that almost caused him to die, is nothing but slow killing, especially in view of his old age. Also, his incommunicado detention and his total isolation from the outside world for a period of approximately two years is considered an explicit crime of torture causing severe physical and psychological harm and a deliberate violation of the law and the constitution.

Likewise, the case of Ibrahim Abdel Moneim Mitwalli, lawyer and founder of the Association of the Families of the Disappeared, 57 old, who was arrested from Cairo International Airport on September 10, 2017, where he was forcibly disappeared for two days, during which he was subjected to torture before appearing in state security case 900/2017 and was held in Tora Prison, a highly-guarded prison known as Scorpion Prison. On October 9, 2017, during his hearing at the State Security Prosecution, Ibrahim Mitwalli accused the administration of Tora Prison of slowly killing him as a result of intentional medical negligence and mistreatment by the prison administration that endangers his life. He was kept in solitary confinement for more than two years in a narrow cell with a single toilet not fit for human use; in the absence of any medical care for him of any kind, his health condition deteriorated sharply. ECRF has documented, citing the testimony of his relatives that he suffers from persistent hand tremors as a result of a nerve injury caused by torture by electrocution. He also suffers severe visual impairment as a result of being deprived of sunlight and the intent of the prison administration to make the lighting of the room in which he was held individually very dim. He has a prostatic tumor affecting his ability to urinate normally. His family requested that he be seen by a prison doctor, but the prison administration did not respond to their request. The prison administration also prevented his family from delivering the medications and vitamins they brought at their own expense and did not provide him with any alternative medications or medical care, which puts his life at great risk. The ECRF lawyer submitted a communication to Maadi Prosecution, No. 26 of 2019, on March 12, 2019 to request his transfer to the hospital to provide the necessary medical care to him. He also called for an investigation into the intentional medical neglect suffered by Ibrahim. His son submitted a complaint to the National Council for Human Rights holding the prison administration responsible for exposing his father’s life to danger and slowly exposing him to the possibility of death in view of his deprivation of medical care despite the major deterioration in his health condition. It is noteworthy that Ibrahim received a release order in case no. 700 but it was not implemented and he was added to a new state security case, no. 1470/2019 and is now being held in Tora high security prison 2 of the Tora prison complex. 

A lawsuit no. 41553/74 Judicial year has been filed by his son before the State Council, an administrative judiciary, against the Minister of the Interior and the President of the National Council for Human Rights, by requesting the formation of a committee of members of the National Council for Human Rights and medical professors to inspect the Tora Prison Complex, and request a halt to the implementation of the decision by the minister of interior to withhold information regarding the safety measures taken to protect the remanded prisoners and the officers and workers in these prisons, especially about the preventive measures taken by the prison administration that provide protection for prisoners, especially in Tora Prison, and about the availability of good hygiene and ventilation, and the empowerment of the committee to inspect and confirm whether or not preventive and medical measures are taken within the prison.

 6-3- Death due to the effects of medical negligence

In the past years, prison deaths have increased due to medical negligence. In January 2020, in one week, Egyptian human rights organizations documented the death of at least 3 detainees as a result of medical negligence, including Mustafa Qasim, the Egyptian American, who died in Tora Liman Prison while he was serving a 15-year prison sentence, known in the media as the Rabaa dispersion case. Mustafa Qassem was suffering from diabetes and then his health deteriorated as a result of his hunger strike to protest the deteriorating conditions of his prison. He was transferred to Manial Hospital two days before his death. A joint statement by Egyptian organizations stated that, “According to a joint human rights report published at the end of last year, 449 prisoners died in places of detention during the period between June 2014 and the end of 2018, and this number increased to 917 prisoners (between June 2013 and November 2019), with an excessive increase during 2019, according to the latest human rights update, including 677 as a result of medical negligence, and 136 as a result of torture”.

On May 2, 2020, film maker Shadi Habash, 22 years, died in Tora prison as a result of medical negligence, after he exceeded the legally allowed period of pre-trial detention pending state security case no. 480/2018. of 2018 restricting state security. Egyptian human rights organizations said in a joint statement, “The case of methyl alcohol poisoning that Shadi Habash suffered had to be dealt with as a medical emergency tht required immediate hospitalization to put him under constant medical observation, follow up of vital signs and perform the necessary analyzes and checks while giving him solutions and tablets that treat symptoms of poisoning and possibly do a gastric wash, rather than frequenting the prison doctor three times – as happened according to the public prosecutor’s statement – and giving him an antiemetic and then returning him to his cell, especially since he had shown symptoms of alcohol intoxication with repeated vomiting, poor vision and mental confusion”. The general prosecution issued a statement saying that Shadi was very exhausted, which prompted him to notify the prison administration and he told the doctor that he had drunk medical alcohol by mistake and was suffering severe pain. The doctor gave him an intestinal antiseptic and returned him to his cell. On the following morning, his condition continued to deteriorate, so the prison doctor consistently reported his fatigue and severe vomiting, and injected him with an anti-emetic and returned him to cell. On the afternoon of the same day Shady’s condition continued to deteriorate. In addition, he complained of deterioration of his vision. He was injected with anti-colic medication and dismissed. He collapsed upon his arrival in his cell, according to the testimony of his cell mates – his eyes rolled up and he continued to vomit violently. He became delirious and then lost consciousness. He was again taken to the prison clinic and upon examination was found that his consciousness was disturbed as well as his vital signs (blood pressure and pulse) he was provided with first aid (intravenous fluids). Cardia resuscitation was attempted and failed. He died. 

It is worth noting that ECRF obtained information that the prison clinic had only a plastic surgeon, a dentist and an ophthalmologist, specialties that are not essential in prisons compared to the need for a general or internal physician. in addition to the prison administration’s neglect of the deterioration of the condition of Shadi’s health and of his colleagues’ requests to transfer him to hospital in view of their recognition of the clear effects of alcohol poisoning that could lead to his death. They continued to prescribe colic medication until he died.

Shadi Habash’s death as a result of medical negligence is not an individual case. On March 19, 2020, three detainees died of medical negligence, Subhi Fathi Abdul Samad died in Zagazig general prison, where the prison administration was intransigent in providing health care in addition to not agreeing to allow him to perform urgent surgery on his own expense; Hamdi Muhammad Hashem Abd al-Barr died in his prison in Borg al-Arab Prison on the 19th of March 2020, as a result of the prison administration’s refusal to allow him to have a necessary surgery or release him for health conditions until he died in prison. In addition to Samir Rushdi Qenawi, 55 years, who died in Minya General Prison. 

Less than 24 hours later on March 20, 2020 the death of detainee Tony Hassan was announced in Asyut General Prison, as a result of medical negligence. It was reported by the Al-Shehab Center said that his family remained throughout his 4-year detention period demanding medical examination and urgent medical care as he was suffering – when arrested – from circulatory disorders, severe ulcers in the stomach and abdomen, and he was unable to move due to severe arthritis. He was suffering from a double fracture and a tumor in his left leg and in need of urgent surgery, but the prison administration did not respond to them, and even the necessary medical care was not provided to him in terms of attending the foot, despite the submission of his family’s requests and petitions to all the competent authorities. His family held the administration of Asyut General Prison, Menya General Prison, and the Attorney General responsible for his death.

Detainee Muhammad Kabkab also died in El Dekheila Police Station in Alexandria on April 7, 2020, as he was suffering from high blood pressure and shortness of breath, which greatly affected his health, being held in nonhumane conditions in crowded badly ventilated cells full of smoking inmate. He died without ever receiving any medical attention. 

• Physical and psychological consequences of torture and prolonged solitary confinement

The effects and consequences of torture and other ill-treatment vary, individually with each case of torture or ill-treatment, according to the severity and violence of the crime, as well as the health and psychological state of the victim and the medical or health care he received. The effects and consequences of torture include:

• Temporary physical effects (bruises, burns, fractures and disability)
• Psychological effects such as PTSD, anxiety and acute depression.
• Psychological and mental conditions as a result of solitary confinement
• Suicide and death

7-1- Physical effects of torture and other forms of maltreatment

Inflicting severe physical pain with the aim of obtaining information or punishment or maltreatment of the victim causes several physical consequences depending on the method used. Forms of torture range from blindfolding, beating with hands or feet, slapping, electrocution, suspension of body in painful positions, flogging, beating with sticks, belts, pipes or hoses, just to give a few examples.

In its report 2017 “Media archive of oppression” report and based on victim testimonies, El Nadim Center mentioned a number of torture methods used, including:

• Suspension from both hands without feet touching the ground
• Suspension from one hand or both feet for long periods of tie
• Breaking fingers
• Standing on top of the victim’s stomach and jumping on it
• Putting corrosive substances on the back of the victim
• Grabbing the victim by the hair and pushing his head forcefully against a wall
• Food and water deprivation for 4 days
• Depriving the victim of using the toilet for 7 days
• Suspending a victim for 15 days from his hands, with consequent welling of both hands and nervous injury
• Forcing victims to soak in sewage water wearing only their underwear and severe beating if they resist. Victims are then left for 10 days without a wash
• Forcing victims to strip and lie on hot sand and putting heavy stones on their chests
• Electrocution in genital area
• Anal rape with an object stick
• Burning with cigarettes
• Use of police dogs, tasers and tear gas inside cells
• Threats of raping wife or daughters

Through the previous methods of torture, the physical effects of the method and type of torture vary. Torture with severe beating, whether by hands, legs, or with sticks, causes severe bruising and cuts, and sometimes it may cause fractures in the case of severe beating. Torture by suspension, whether from hands or feet, usually causes problems in the nerve plexuses above the arms or feet, and these problems often become permanent depending on the duration of the suspension.

In addition, electricity causes burn in the places where the stun wire was placed, and it affects the body’s electricity in addition to causing excruciating pain. Even just blindfolding for long periods of time can lead to retinal problems and confusion regarding time and space, which may continue for a period even after the blindfold is removed. The deprivation from eating or drinking affects the vital organs of the body, as the blood becomes more viscous, less vital and more susceptible to clots, and the cells of the body are exposed to dehydration due to the disruption of their vital functions, especially the brain. Within a few days the water deprivation causes drop in blood circulation as a result of a lack of blood volume, and thus a lack of blood nutrition of vital systems, which may lead to kidney and hepatic failure, and accumulation of toxins in the body, causing further drop in blood circulation, and the body enters into a vicious cycle of collapse and death. 

In addition, prohibition of using the toilet may cause bladder problems and may lead to kidney failure if urine has been retained for long periods in the bladder and kidney pelvis, which causes significant and high pressure on both the kidneys and bladder, urine reflux to the kidneys, damage to kidney cells and may lead to death as a result of chronic kidney failure.  

In some cases, torture led to permanent disabilities as a direct result of torture, as in the case of Munir Yusri, 28, whose testimony was documented by ECRF, where he was subjected to torture and severe beatings, which led to loss of his left eye during his detention in the 15-May prison, south of Cairo on August 26. 2017. The incident began with a routine search of the victim’s cell. The officer started insulting and humiliating the detainees – as is customary in prisons – so the victim turned away his face, indicating his resentment of what is being said. This seems to have angered the officer. He dragged the victim out of the cell into the outside corridor of the cells and used an iron water- pipe to beat the victim all over his body. The victim was using his hands to shield his body, so the officer aimed the pipe towards his eyes and hit him, which led to the explosion of his left eyeball according to the forensic report.

Munir also stated that the officer transferred him to another room and deprived him of medical care and refused to show him to a doctor until he signed the police report, in which he stated that he was injured because of the fall of a plastic bag in which the prisoners kept their property. Munir signed to be presented to any doctor where his eye was severely hurting. He was transferred to an Eye Center in the Shubra district – at his own expense – to conduct a medical examination. This reflects the extent of the severity not only of torture, but also the deliberate medical neglect, as torture victims do not even receive adequate medical care for what they have suffered. The ECRF lawyer submitted a communication to the Public Prosecutor on September 17, 2017 and the communication was filed at the Rawd Al Faraj Prosecution; then the communication was transferred to the competent Prosecution, and a communication was submitted to the Helwan Prosecution until the investigation was opened again on November 3, 2017 and the Public Prosecution accused the officer of using cruelty and causing permanent disability. The forensic report stated that there was an explosion in the left eyeball that led to a loss of vision in the left eye, and the case was referred to the Helwan Criminal Court, case No. 2/2019.  The prosecution decided to release the defendant until the time of the verdict, and on March 5, 2019 the officer received a sentence of 6 months, suspended until exhaustion of all levels of litigation.

7-2- Psychological consequences of torture and other forms of maltreatment

Torture is described as an extraordinary trauma, because of its violent and devastating psychological effects on the victim that extend beyond the time of torture and may continue with the victims for long periods and sometimes for the remainder of their lives. To explain the psychological effects of torture victims, some psychological references were used in addition to a research interview with Dr. Aida Seif Al-Dawla, Professor of Psychiatry and one of the founders of the Al-Nadim Center for Rehabilitation of Victims of Violence and Torture.

Victims of torture usually suffer from post-traumatic stress disorder – PTSD, which is defined as a psychological disorder that arises after experiencing a traumatic or overwhelming event – such as exposure to an actual death threat, sexual violence, repeated physical violence, kidnapping, harm or assault incidents such as torture, especially since the victim is unable to defend himself – the intense fear, helplessness, or terror that the victim suffers during the traumatic event can haunt him for long periods of time.

• Intrusive symptoms

Where the victim has frequent unwanted memories, in which he feels that he is experiencing the trauma again, whether while awake or in nightmares. One of the main features of PTSD is that patients retrieve events as if they were actually occurring again (Flashbacks) and bring back feelings of impotence or intense fear, and sometimes patients retrieve accompanying sounds – such as screaming sounds in cases of torture, for example, or smells like the smell of a narrow cell odor or the smell of sweat and blood, or the smell of burning flesh resulting from electricity – which causes confusion and the victim may become unaware of his surroundings.

• Continuous sense of danger and alertness

People with post-traumatic stress disorder suffer from a permanent feeling of danger, so the person always feels alert to face this permanent danger. In addition to this the patient suffers from sleep difficulties and a constant feeling of severe anxiety.

• Other symptoms

Most people with PTSD experience feelings of panic and fear, as well as severe depression. Depression is defined as a mood disorder that causes persistent feelings of sadness, loss of pleasure, inattention to usual things, and lack of focus. It may be accompanied by feelings of guilt, lack of importance, and a lack of self-esteem. The disease affects feelings, thinking, and behavior. This causes many emotional and physical problems, which in turn affect the performance of daily activities. It may cause a feeling of hopelessness in life, thinking about suicide, and perhaps attempting it in advanced cases. In addition, sufferers from post-traumatic stress disorder show increasing rates of addiction, whether to alcohol or drugs or sedatives and tranquillizers to overcome or forget that trauma. This may continue for very long periods.

According to Dr. Seif al-Dawla, the detainees who were subjected to abuse or torture suffer from a deep feeling of anger and of extreme humiliation on the psychological level, and this is mainly the goal of torture – trying to break the detainees and humiliate them and give them a sense of powerlessness, and that they have no way out of what they are in, where all decisions belong to the perpetrator of torture and the entire destiny is in the hands of this executioner, who has the right to deprive them and has the power to grant them and decide whether or not to continue to torture them; and it is he who decides when the torture ends or if it will end in the end – while they continue to be deprived of their freedom to act or respond, in addition to the fact that the victims are often restrained by blindfolds and handcuffs, which makes them feel even more helpless.

That is why when detainees are released from prison, especially after being subjected to torture and other cruel or inhuman treatment, which is described as a supernatural trauma such as earthquakes, fires and volcanoes, they have many questions (Why is this happening? How can I forget what happened? How did this happen with me? Was it possible to do anything? Was it possible to stop it … etc?). There is a state of recall of everything that happened, whether in dreams or awake; the victim has horrific nightmares in which he is tortured again. Upon his exposure to any stimulus that may remind him of the torture incident, the same feelings he had then are revived, and sometimes even the same sounds, smells, and faces that he saw during the trauma.

All of this often leads the person to a state of anxiety and severe depression that may affect his physiological functions, such as his ability to sleep. Some survivors suffer from insomnia and difficulties in sleeping because of their fear of nightmares, especially if the torture happened during sleeping, like beating or electrocution whenever he fell asleep in the torture chamber.

In addition, the victim pursues feelings of intense fear, as prisons are places of extreme darkness, and some even describe their feelings towards spending their period in prison – by feeling that they were buried alive or that they are in graves – and for this, the victim, even after leaving prison, is in a state of intense fear and panic. All of this may lead in many cases to unbalanced behaviors, ranging from extreme fear and panic – such as if the victim hears the sound of a regular scream and is frightened and enters into a state of shock or screaming – or violent outbursts of anger that are not explained by anything except within the victim’s mind itself, like something that provoked him or targeted his trauma feelings, and in many cases this is not understood by his surroundings, nor even by people closest to him.

After a torture victim is released from prison to return to his community there is usually a huge gap between him and those around him, so a state of tension occurs between the victim and the people closest to him as well as the community. The person often feels very alienated from the people and places he was used to previously. Dr. Aida explains: “A person feels as if he has come out of a huge maze and is required to stand steadily on the ground. This feeling of steadiness is not always immediate and may need time.” In addition, there are many things that happen during torture, which the victim may not be able to share due to his sense of shame and the victims of torture often feel very guilty as a result of their questions about “Was it possible to do something, to defend myself? Could I have hit him like he hit me? Was it possible to respond to him, could I have fought more? ” All of these questions are self-flogging, because the position of the detainee held in torture is one in which his will is stolen, especially his physical will. These effects often persist for a long time. After a medical or psychological assistance, a person may be able to control them somewhat, but the experience of torture and ill-treatment is unforgettable.

The psychological and mental disorders caused by the trauma of torture and other forms of ill-treatment affect a person’s interaction with society. Those most affected by these disorders are young people who have a problem in re-identifying society, and often cannot find a place for themselves as a result of their absence for periods that may be long or short, as a result of prison trauma, torture or ill-treatment, and as a result of their feeling of things having changed from what they used to be. Some go out to find they had lost their jobs, or have been expelled from university, some are affected by their marital or family relationship or have lost some of their friends, and as a result there is a period of extreme confusion and a feeling of anger and the search for a place in the community that he knew and could identify with before prison. But after experiencing a violent trauma such as torture, some victims feel suspicious of all those around them, and misinterpret the simplest gestures as rejections or condemnations for having been in prison. This magnifies both the anger and the feelings of loss of self-worth.

Those who have experienced torture try to find themselves again and reconfigure their lives in a way that has some logic, because torture is an irrational experience, which the human mind cannot deal with logically because it cannot absorb it. In addition, it breaks down all the standards and criteria in the victim’s mind, leaving endless questions and perceptions about justice, cruelty, evil, and human beings. All of this definitely affects a person’s interaction with society, and in the event that he was fortunate and found another job or did not lose his work, he may still experience a period of a sense of alienation, which may affect his productivity and his communication with his colleagues.

7-3- Psychological consequences of solitary confinement

Solitary confinement is one of the forms of torture due to its major effects on the psyche, mind, and subsequently the body. An essential element of ​​human existence relates is the relation to the external world, in addition to the fact that a person needs another in order to realize himself. According to Dr. Seif Al-Dawla, Professor of Psychiatry, a person can live and find his place in life based on his reception of external stimuli, whether from other human beings, different life situations, newspapers and books that a person reads, general news and so on. Thus, in the absence of these external stimuli, a feeling prevails of severe loneliness, loss of hope and despair, but also after some time the brain is forced to create stimulation for itself from within, because the brain needs them to be aware, to think. In the absence of these the brain may create its own stimuli with no contact to reality. Thus, the concerns, fears, thoughts, and memories of a person held in solitary confinement begin to express themselves in the form of hallucinations, meaning that the person begins to realize, hear, smell, see, feel things that are not present to compensate for the loss of perception resulting from solitary confinement.

7-4- Suicide in Egyptian prisons as a result of torture and maltreatment

Victims of torture and ill-treatment experience a number of major psychological disorders following the trauma, in addition to the severe depression that usually affects them and which is known as major affective disorder that causes a continuous feeling of sadness, emptiness and extreme despair. Many who experience depression suffer from symptoms of anxiety, sleep disturbances and loss of appetite, and they have a sense of guilt or lack of self-esteem and poor concentration, and even physical symptoms without medical explanation such as back pains or headaches. During an acute depression, it is very unlikely that those who suffer can continue their usual activities, whether socially, at work, or at home, except to a very limited extent.

Sense of loss of self-significance, guilt and lack of self-esteem, which clinically affects emotions, thinking and behavior, may cause a feeling of despair in life accompanied by repeated or persistent thoughts of death, of suicide, suicide attempts, or actual suicide in advanced cases.

Most of the time, the victims experience these symptoms while in prison, especially those in solitary confinement, where the slow, deliberate and cruel punishment may drive prisoners to feel they are slowly losing their sanity, which often leads to the exacerbation of symptoms that may lead to death wishes or suicide attempts. 

In fact, there are no statistics on suicide rates or attempted suicide in Egyptian prisons. To demonstrate approximate statistics, in the book “Insanity in the depths of Prisons: The Mental Health Crisis Behind Bars and Our Role in Confronting It (in the Prisons of the United States of America) by Terry Coopers, a psychiatrist and Fellow of the American Psychiatric Association and President of the East Bay Psychiatric Association – explained that “the suicide rate in prisons is twice the suicide rate among the population in general, and about 9 times more in pretrial detention than it is among the population in general, or five times higher than in prisons. This is an approximate estimate, as the rate varies greatly from state to state; however, these figures indicate that suicide represents a major health risk within penal institutions.” This approximate percentage does not in any way reflect the situation in Egyptian prisons, as a result of the poor conditions of detention and the deteriorating living conditions of detainees to a terrible extent, in addition to torture – which is almost a culture in places of detention starting from the moment of entry to disciplinary measures against inmates – and the prevalence of ill-treatment, medical negligence, and prisoner distress continuously being subjected to insults and humiliation and exercising power and authority over them.

For example, the case of Osama Murad, who was arrested by security forces on May 27, 2015 while he was at his workplace in the Al-Azhari Institute where he worked as a teacher of the Holy Quran, in the village of Menouf in Tanta Governorate. He disappeared for 10 days, then appeared at the State Security Prosecution in Cairo, and the case was referred to the circuit 23 of the North Cairo criminal court. He was accused by the prosecution of joining a terrorist group. He was detained in connection with case No. 186 of 2014, and was sentenced to ten years in prison on September 4, 2016. On April 22, 2019, Osama Murad committed suicide by slitting his throat in ward (A) in Tora reception prison during the noon prayer. His cell mates had gone to attend the noon prayer while Osama went to the bathroom to end his life in a desire to get rid of the agony and the severe depression that he suffered in prison.

According to Osama’s wife he was not suffering any psychological disorders before his imprisonment and had never thought about suicide. The physical and psychological harm he suffered drove him into a psychological breakdown. Osama had moved between more than 5 prisons during his period of detention. In the beginning he spent 7 months in Tanta police station, then for 9 months in Tora reception prison. During that time, he had a relatively stable psychological condition. He was giving literacy classes to his cell mates. Then he was transferred to Menya prison, where the deterioration began as a result of physical and psychological maltreatment. He and six other defendants were held in a separate place from the rest of the prisoners. They were continuously monitored by cameras and headsets all the time, and they were continuously intimidated, searched, stripped of their belongings. He was subjected to ill-treatment and arbitrary restrictions during family visits, as he was receiving visits from his family in the death row cell, and the visit was monitored through cameras in addition to the constant presence of security personnel. According to his wife he was silent most of the duration of the visit, fearfully looking around himself. After spending months in Menya prison he began to show evidence of psychological distress. He became severely depressed and then would develop episodes of excitement and screaming. He was examined by a doctor who prescribed anti-depressants and tranquillizers. He was regular in taking his medication until the management of Tora prison prevented his family from bringing him his psychiatric medication, a short time before his suicide. 

The ECRF lawyer had filed a complaint no. 44/2019 with the Maadi prosecution to investigate his deprivation of his medicines which might cause him harm. A day before his suicide he developed convulsions, after which he was beaten by the head of the Tora investigation officer and his assistants, and accused him of pretending to be insane, enacting a nervous breakdown. They beat him severely and handcuffed him. The following day Osama went to the toilet during the noon prayers and slit his throat from the right to the left side causing a transverse cut wound of his throat and trachea, then tried to expand the opening of the wound using his hands until he lost consciousness and was transferred to hospital in a near death condition. His rescue was an unexpected miracle. We are not sure he welcomed it.

7-5- Death as a result of torture in Egyptian prisons

The effects and consequences of the crime of torture may cause the death of the victim, which occurs repeatedly as a result of the widespread use of torture in Egyptian prisons in dealing with prisoners or suspects.

Walid Muhammad Fathi, who is 26 years old, died as a result of brain hemorrhage, pneumonia and broken ribs, according to the forensic report, after he was held for two days without charge in the Al-Muski police station, where witnesses said that the citizen was on his way to a pharmacy when an investigation officer from the police station asked him about the address of someone wanted by the police. He showed them. However, they returned and arrested him after they realized he had erred regarding the number of the apartment. They took him to the police station where he was subjected to severe torture until he died. On the following day, Walid’s father received a call from Al-Moski Police Department to come to the police station to fetch the body of his son. The father formally charged the officers of the department and filed against them case No. 456 of 2020, Al-Moski administrator. The forensic report has been viewed.

ECRF documented the death of Walid Abdel Azim, who works as a driver for the Public Transportation Authority, as a result of torture in the Helwan police station, who died 3 days after his detention after being taken due to an argument with a police officer then the latter abused his mother. He was taken to the police station where his family said he was beaten. ”The victim was going to the investigation officer while he was being beaten in his head with the boots, and another hit him in the stomach to the extent that he began to vomit blood. He bled to death. Before his death he was screaming that this was unfair and that he was human like them not some kind of heretic.

The ECRF lawyer, representing Walid’s family, who died after being tortured at the Helwan Police Department, submitted a request to the head of the main Helwan Prosecution to enable him to extract an official copy of the papers or access them. However, the Public Prosecution did not grant him access. According to the lawyer, the brothers of the victim in their statements to the prosecution accused both the Chief of Investigation and his assistant of the Helwan police station of torturing their brother until his death. The Public Prosecution office has so far declined to give them any information on the course of the investigation.

Also, ECRF documented the death of Raafat Ahmed in Dekheila police station in Alexandria on February 4, 2020 as a result of torture, after two months of forced disappearance. The victim had been subjected during his disappearance to various forms of torture including beatings, electrocution and suspension from his feet for four days, during which he was electrocuted, in addition to food deprivation. This resulted in paralysis of the left side of his body, and fracture of the vertebrae of the neck and the jaw. The victim’s jaw was twisted and he was continuously vomiting blood and was telling his cell mates “I am slowly dying. Every part of me is broken”. He was put in that condition in the Dekheila police station and when he was transferred to prison, the prison refused to receive him in this condition. So he was returned to the police station. The family’s request to transfer him to hospital was rejected. He was last seen three days before his death, when his condition had deteriorated very much according to his cellmates. His moaning was being heard all over the station on the 4th of February 2020. He died and was buried on evening of the 5th of February. His family said that the policemen responsible for his death attended the burial.

Omar Ahmed had also died on October 28, 2019, in the custody of Shubra al-Khaima’s second district police station, Qaliubiya, as a result of the torture he was subjected to. According to the Egyptian Coordination for Rights and Freedoms, the prosecution was supposed to investigate him in one of the criminal cases, but his injury and health condition prevented him from presenting to the prosecution, since he was denied medical care by the Shubra Al-Khaima Investigation until he died. 

In addition, citizen Youssef Salah El-Din Abdel-Qader died in Banha general prison. He was forced to swallow large pieces of hallawa until he almost lost consciousness, and then the police officers beat him until he lost his consciousness. After he regained consciousness he was put on the “Falaqa” and was beaten again, until he died on October 12, 2019.

• Harassment by authorities of those providing support to victims of torture

Not only did Egyptian authorities allow the continued use of torture and ill-treatment in Egyptian prisons, and promote the impunity of the perpetrators with reduced penalties, but the Egyptian authorities are pursuing a policy of obstructing human rights centers in general, including the Nadim Center, which is one of the few specialized in rehabilitating victims of torture and ill-treatment and the only one providing this service free of charge to torture victims. In February 2016, security forces stormed the Al-Nadim Center and presented the workers with an order to close the place and stop its activities, and the Center filed a legal challenge regarding the closure of the center since the center has a license from the Medical Syndicate, and a license to operate a medical facility from the Ministry of Health. Egyptian authorities closed the clinic on February 9, 2017 before a decision was issued regarding the appeal submitted to court.

The harassment of the Nadeem Center and its workers is part of the blockade of all centers or institutions that highlight human rights violations, if they are different from what the state wants to talk about, which it considers “spreading false news” which is entrenched by a set of legal and legislative amendments. Through it, the state traps and closes any institution that disagrees with it. However, despite the closure of the clinic, the center is still able to provide psychological support to survivors of torture and ill-treatment as much as possible. But the harassment that the center was exposed to raises fear among some survivors, because they are originally coming to the center to avoid traumas caused by security. At the same time the services provided by the Nadim Center or other rehabilitation clinics are not luxury or luxuries or can be dispensed with in any way. Dr. Seif El Dawla says, “I wish we could do without it; I wish there would be no need for El Nadim center, if the state would stop practicing torture as a systematic policy with its opponents and non-opponents, or, more accurately, against any person who falls into their hands.”

• Recommendations

The report makes the following recommendations to relevant authorities

At the level of state policies:

• Ordering the immediate cessation of the policy of torture and ill-treatment in Egyptian prisons for any purpose, whether extracting confessions or using them as a means to punish detainees, and bringing the perpetrators to justice to hold them accountable for their crimes.
• Immediate cessation of using the prolonged solitary confinement penalty as a method of abusing political opponents mentioned in this report and others, and prohibiting prolonged solitary confinement or indefinite solitary confinement, as a form of torture and ill-treatment in local laws and legislation as stipulated in the Nelson Mandela Rules.
• Immediate cessation of using medical negligence policy to abuse detainees, especially political opponents, and provide urgent medical care for detainees with chronic health problems or requiring transfer to a specialized hospital, and refer those who violate or prevent medical care for a sick detainee to legal accountability.

At the level of oversight

• Allow the International Committee of the Red Cross to inspect prison conditions in Egypt, as well as allow specialized national and international NGOs to visit all places of detention and allow United Nations experts, especially the Special Rapporteur on torture, to visit Egypt.
• The formation of a national preventive mechanism from independent human rights organizations that organize unannounced visits to places of detention to inspect their conditions in cooperation with the National Council for Human Rights and the Public Prosecution specializing in the periodic follow-up of prisons, especially solitary cells and cases of disease to monitor the two phenomena and provide reports on them to the relevant authorities.

At the level of legislative reform 

• Amending the current domestic legislation related to the crime of torture and ill-treatment in line with the agreements signed and ratified by Egypt and the Egyptian constitution, by amending Article 126 of the Penal Code to adopt the definition of torture issued in the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment, and amend the article 129 of the Penal Code with regard to the use of the term “cruelty” and with regard to amending the punishment resulting from the use of cruelty to be considered a felony.
• Amending Article 162 of the Code of related Criminal Procedure to allow a victim of the crime of torture or one of his family members, if he died as a result of torture, to prosecute the perpetrator of this crime, and to appeal if a decision is issued by the investigating judge that there is no ground to file a lawsuit in case the perpetrator is a public official.
• Amending the Egyptian Prisons Organization Law and Prison Internal Regulations to restrict and monitor the powers of prison officials in the penalty of solitary confinement, in accordance with the Mandela Rules so that it is used only in exceptional cases and by a decision of a competent judicial authority and not exceeding 15 days while allowing the detainee to receive family visits. In the event of a violation, disciplinary penalties will be imposed on the perpetrator of the violation.

• Amending the Prisons Organization Law and Prison Internal Regulations, in accordance with the provisions of the Constitution and in accordance with the Standard Minimum Rules for Prisoners in relation to providing medical care to prisoners, so that health care services guarantee all prisoners could have immediate access to medical care in urgent cases, both within the prison or in a public hospital, as well as amendment of Article 33 of the Prison Regulations, which gives prison wards the right not to take into account the recommendations of the prison doctor.

At the judicial level:

• Independent and impartial investigation of crimes of torture and maltreatment and holding perpetrators accountable through the formation of a special prosecution in every court of first instance to investigate complaints of torture as well as inspection of places of detention in its jurisdiction.
• Formation of an independent judicial committee to undertake an urgent and impartial investigation of cases of death as a result of medical neglect in Egyptian prisons. Results of such investigations should be made public and those responsible held legally accountable 

 

Annexes

Forensic report in the case of Mounir Yusry