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Health status of MB detains

In response to the reports issued by the Amnesty International and by some of the Egyptian newspapers on the health status Mr. Khairat Elshater, one of the detainees tried before a military court, we present the following brief report on the health status of Mr. khairat and the whole group

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In response to the reports issued by the Amnesty International and by some of the Egyptian newspapers on the health status Mr. Khairat Elshater, one of the detainees tried before a military court, we present the following brief report on the health status of Mr. khairat and the whole group:

A – Mr. khairat Elshater health status:

He complains of:

Diabetes Mellitus: that goes frequently out of control and that was complicated by microbial foot infection that resulted in ulcerations on the dorsum of the foot, the sole and in between the toes. The condition was associated with severe pain and was treated with antibiotics and twice daily dressings. The condition is about to heal after more than 3 weeks of treatment.
Severe diabetic neuropathy.
Hypertension that goes out of control in relation to stress. Blood pressures up to 180/110 have been recorded in prison.
Chronic asthmatic bronchitis with occasional acute exacerbations causing respiratory distress and necessitating urgent therapy.
Hypothyroidism necessitating life-long thyroid hormonotheropy.
Renal calculi with history of passing stones. In prison he developed an attack of severe renal colic.
Hyperlipidemia for which he is receiving medical treatment.

B- Health status of the group in general:

More than half of the detainees are above 50 (17/33). And only 2 of them are below 40. Consequently, the age-related diseases are widely prevalent among the group:
Hypertension: 21 of them are hypertensive, and despite being on regular medications. Many of them frequently have their blood pressure out of control.
Diabetes Mellitus: 7 of the group are diabetics. Besides difficulties in control of the diabetes 4 of them have diabetes related problems. These include: severe diabetic neuropathy, diabetic foot infection, neuropathic ulcer and diabetic retinopathy.
Ischemic heart disease: 6 of the detainees are known cardiac patients. Five of the 6 have undergone cardiac catheterization. One of them had undergone stent placement and another is awaiting coronary bypass surgery.
Prostate problems: 4 patients.
Other prevalent diseases include: hepatitis C viral infection and liver cirrhosis (2 patients) disc prolapse lumbar or cervical (6 patients). Peptic ulcer disease complicated in prison by bleeding (1 patient), vertigo (1 patient), glaucoma (1 patient), renal calculi (1 patient).chronic asthmatic bronchitis (patient).

C- More detailed comments on some of the critical cases:

1- Mohamed Ali Bishr (56 years)

Complains of active viral hepatitis and liver cirrhosis. Liver enzymes are elevated (more than double normal levels). Consulted hepatologist stressed the need for therapy with interferons.

2- Hassan Malek (49 years) complains of:

Hypertension: uncontrollable
Ischemic heart disease for which he has undergone cardiac catheterization. He is currently on medical treatment.
Hyperlipidemia for which he is receiving medical treatment.

3- Essam Hashish (58 yrs) complains of:

Ischemic heart disease following a period of unstable angina cardiac catheterization revealed the presence of 3 lesions in the coronary arteries, each causing more than 90% stenosis. Dilatation and stenting was performed on 26 /6/2007 for one of these lesions and currently he is on medical treatment.
Bleeding peptic ulcer disease: following peptic ulcer disease: following an attack of melena. Upper GIT endoscopy revealed the presence of bleeding attack – which occurred in prison – was medically controlled.

4- Hassan Zalat (55 years) complains of:

Diabetes Mellitus and hypertension.
Ischemic heart disease: few days after his detainment he developed a severe anginal attack. Cardiac catheterization revealed the urgent need for coronary bypass surgery. The surgery has not yet been done despite the lapse of months since the decision was taken.

 
5- Fathy ElBoghdadi (53 years) complains of:

Diabetes mellitus and hypertension: frequently out of control
Severe diabetic neuropathy.
Diabetic retinopathy and glaucoma.
Diabetic foot infection that developed in prison and that took 6 months to resolve, with residual neuropathic ulcer that heals to reulcerate within a short period of time.
Ischemic heart disease: for which he has undergone cardiac catheterization. He is currently on medical treatment.
Hyperlipidemia.

6- Amir Bassam (43 years) complains of:

Diabetes mellitus and hypertension. Echocardiography revealed left ventricular hypertrophy as a complication of hypertension.
Ischemic heart disease: for which he has undergone cardiac catheterization. He is currently on medical treatment.
Hyperlipidemia.
Lumbar disease prolapse.

7- Saud saad (50 years) complains of:

Chronic active hepatitis (Virus C)

D- Unfavorable Circumstances:

In addition to their suffering from the above-mentioned diseases, the detainees face several unfavorable circumstances that have negative impact on their health status. These are:

1- There is usually a long delay from the time the detainee asks for any form of medical care to the time of provision of this care. It took Dr Essam Hashish 5 days to go to hospital when he was in an extremely critical case complaining of unstable angina pectoris and repeated chest pains. The doctor’s reluctance to send him to hospital was not justified, since upon his arrival to the Manial University Hospital – 5 days following his examination, Dr Essam was immediately admitted to the Intensive Care Unit and underwent "URGENT" cardiac catheterization and coronary stent placement. Another extreme example for this delay is the case of Mr. khairt Elshater who has been promised by the examining doctor to undergo a "plain X ray" and an "abdominal vltronography" to investigate his urinary tract following an attack of renal colic. Three months have passed and Mr. Elshater is still awaiting the appointment. Most probably the doctor has forgotten the whole thing but this event gives an idea about the quality of the provided medical care.

2- On duty doctors are very hesitant in referring emergency cases to the Manial University Hospital. Unless the case is a typical one with definite clinical diagnosis they always try to postpone the decision for referral to be taken in the next morning by the "senior" doctor. It seems they would be "blamed" if the referred case proves to be negative. Adopting this policy of referring only "definite cases" will surely result in missing many emergency cases that do not present in a typical picture. Failure to refer an emergency case in due time may have catastrophic consequences. An illustrative example in this respect is the case of Dr Essom Hashish who has severe melena (bleeding per rectum) as a complication of his peptic ulcer disease that needed urgent upper gastrointestinal tract endoscopy. Despite the presence of a typical history of melena, and severe pallor denoting major blood loss the examining doctor was refusing to transfer him to hospital. The only way to convince him was to ask Dr Essam to pass stools to "show" his melena! But what if Dr. Essam was not able to pass stools after that time? He would have been left with his bleeding the next morning.

3- The truck trip to the courtroom and the 8-hour stay in the courtroom twice weekly are a real threat to the health of many of the sick detainees. The hours spent in the truck metal seats are real suffering for the patients with disc problems. The courtroom paibd with more than 200 persons is not ventilated at all. There is no air-conditioning, no ceiling fans and the very highly placed windows are always kept closed allowing only the sun to further heat the place. The detainees are kept for around 8 hrs in narrow cages (80 cms width) when sitting in the cage a tall person have his knees hitting against the metal bars in front of him. There is no place for standing comfortably, so many of the detainees tired of several hours of sitting stand "on" their chairs. This 8 hours confinement in narrow cages that do not even meet "animal rights requirements" is very hazardous to the health of many the detainees especially those with cardiac diseases.

4- The stressful living and trial conditions and the unfavorable hygienic standards in the prison add to the health problems of detainees. Its is not astonishing that two thirds of them are hypertensive, and that many of the cardiac patients developed anginal attacks in prison.