Youssef Mohammad’s diagnosis came four months too late. The seven-year-old boy inherited congenital deafness and mutism from his parents, but due to the absence of sign language interpreters in the hospitals he was admitted to, he also developed glaucoma. As a result of the delayed diagnosis, Youssef lost his vision.
A series of disappointing visits to government hospitals in Beheira and Alexandria governorates; an agitated child; and a mother and father desperately trying to explain their situation with hand gestures. The three of them are deaf and mute; they cannot hear, nor speak, and as a result, cannot tell their story.
The absence of sign language interpreters at government hospitals impeded Youssef’s treatment, but he is not the only one. Over three million deaf people struggle on a daily basis at government institutions in Egypt.
In 2014, Egypt ratified a new constitution “[guaranteeing] the rights of persons with disabilities and dwarfism; to make public facilities and spaces more accessible; and to mainstream disabilities.” Additionally, a 2018 law obligates that governmental bodies ensure that their employees are able to deal with people with disabilities. This led several government institutions to announce new sign language training programmes for their employees.
This investigation documents 15 problematic cases as a direct result of “the communication disconnect” with public officials, and monitors the suffering of deaf persons and their families at government departments and hospitals. We accompanied three deaf persons and their families on a tour of government institutions in three Egyptian governorates: Cairo, Bani Suef in Upper Egypt, and Beheira in the Nile Delta.
Hearing loss is the result of complications at birth, certain infectious diseases, some types of chronic ear infections, use of certain drugs, exposure to excessive noise and aging.
Ophthalmologist Sharif Jamal told us that a delayed diagnosis of glaucoma can lead to a variety of complications, including the destruction of the optic nerve and vision loss. He explained that cases of glaucoma, especially among children, need rapid and decisive intervention to save the child's eyesight.
Unfortunately, this did not happen to Youssef four years ago, according to his deaf father, Mohammad Habashi. When his parents could not find a way to treat their son at government hospitals due to the absence of sign language interpreters, they had to turn to the child’s 53-year old grandmother, Asrar al-Saadawi, to speak to the doctors on their behalf. Through this improvised method of communication, Asrar was able to start a dialogue and arrive at an accurate diagnosis, which needed urgent surgery. Youseff was admitted to the operating room, and despite the success of the drainage surgery, it was too late to save his sight.
The Ministry of Health and other relevant ministries are legally obligated to make medical services available to people with disabilities, and the law recognises sign language as an official language for people with hearing disabilities.
A number of governmental institutions in Egypt announced that they are training their employees on sign language, which the Egyptian Institution for the Rights of the Deaf helped in organising.
Unfortunately, the training was in vain and did not have any positive effects on these institutions. A researcher from Deaf Affairs, Mona Safwat, identifies some of the reasons based on her experience in organising an initiative to train a number of government institutions’ employees on sign language in 2015 in the Qaliubiya Governorate, in cooperation with Egypt’s State Information Service. She says that the training did not make a difference, as the experiment was not generalised to all government institutions, and that over time, some employees forgot what they had learnt.
Youssef and his family live in the Beheira governorate, and in 2019, we documented through video and audio footage what Youssef and his mother had to go through during a field visit to a government hospital. That day, Youssef’s mother, Hanan, accompanied her child to Damanhour General Hospital, which is the largest government hospital in the Beheira Governorate (population: 6.5 million), approximately 175km from Cairo.
Youssef and his mother were received by an employee who was not aware of their disabilities at first and who kept repeating the same question: "What do you want?" After a little while of this, the employee realised their disability and wrote a random name on the check-up sheet, pushed it to the mother and pointed her toward the doctor's room.
Inside the examination room, the nursing staff stood helplessly in front of Youssef. They tried to decipher what the child was complaining about from his deaf mother, but no one understood their gestures or sign language. The doctor came in and was also unable to diagnose the condition, so, once again, Hanan left the hospital disappointed.
Mohammad and Mahmoud are two deaf brothers who live in the Bani Suef governorate to the south of Egypt. They come from a middle-income family; their father, Yasser Fathi, works as a tuk-tuk (auto rickshaw) driver. According to their parents, Mohammad, 19, became deaf and mute after a number of surgeries, and Mahmoud, 16, was born deaf.
Mahmoud went to Bani Suef University Hospital, which was the first hospital to announce the use of a certified sign language interpreter in the emergency department, according to its administration. Mahmoud was received by a nurse who denied that the hospital had a sign language interpreter or a specialist doctor. She asked Mahmoud to return the following day for an examination with a doctor who would try to diagnose him through gestures.
Mahmoud tried again at the Bani Suef General Hospital – the governorate’s largest hospital. The situation there was not better. Mahmoud asked the receptionist for the sign language interpreter, but, again, the receptionist denied having one, and directed him towards the examination room. Inside, a female doctor tried to understand the 16-year old, but her attempts did not succeed, and after she eventually concluded that the pain was in his stomach, prescribed some analgesics.
ARIJ contacted the Ministry of Health via email on May 7, 2020, but to date, has not received a response, despite several follow up attempts through the Ministry's press office.
Haitham Sam, 37, works for a pharmaceutical company, and spent a whole day running around the Ministry of Supply and Internal Trading, going from one office to the next, and being referred from one employee to the next, as no one could understand him, nor cared to listen.
He eventually found an employee who cared enough to try to understand his hand gestures, but to no avail. The employee thought he was requesting a new supply card, while all he wanted was to add a new beneficiary to the one he has. Haitham eventually left the ministry with his request unheard, and unanswered.
ARIJ contacted the Ministry of Supply and Internal Trading via an official email, on May 7 2020, but to date, has not received a response.
After a visit to the Ministry of Supply, we headed to a Banque Misr branch in Cairo, where Haitham wanted to make adjustments to his bank account. The situation there was no different to that of the Ministry of Supply, as, again, Haitham could not find anyone who understood him. Eventually, the bank’s solution was that Haitham submit his request in writing, but he refused, on the principle that a large number of those with hearing impairments are illiterate and cannot read or write.
the listed education percentages among the deaf and hearing impaired, are according to the Egyptian Central Agency for Public Mobilisation and Statistics published in 2017.
Najla Mohammad, a sign language interpreter at the Qualitative Federation of the Deaf, attributed the illiteracy of more than 60% of the deaf to the relatively inadequate number of schools for the deaf, and noted that the majority of teachers in these schools are not fluent in sign language and need further training themselves. First Undersecretary of the Ministry of Education for Special Education Affairs, Hala Abdel Salam, stated that the number of schools for the deaf in Egypt nationwide is only 193, and only three schools for the hard of hearing.
Researcher at the deaf affairs, Mona Safwat, says that schools for the deaf pay more attention to vocational education, such as carpentry, decoration and sewing, than to teaching students reading and writing skills.
of people with disabilities were unable to learn due to their disabilities
In November 2018, a member of the Education Committee in the Egyptian Parliament, Fayez Barakat, requested a briefing to the Minister of Education, Tariq Shawqi, to improve the conditions of schools for the deaf and hard of hearing, which he described as "poor”.
In March 2020, the Minister announced that sign language should be taught to all students to facilitate communication between them and their deaf and hard-of-hearing peers, and that this will take effect at the beginning of the 2020/2021academic year.
In 2017, hundreds of deaf people demonstrated in front of the Egyptian Radio and Television Union building (known as the Maspero building), demanding access to accurate news reporting using a unified and standardised sign language. Hundreds of demonstrators protested that sign language interpreters on television screens use an uncommon language, leaving them unable to understand what is being said.
"Three years have passed and nothing has changed," said Osama Mohammad, a participant in the protests that demanded the establishment of a unified sign language dictionary for public use nationwide, whether on television channels or among sign language interpreters in general. Osama also called for a larger sign language interpreter screen, which usually appears at the bottom of the TV, impeding their ability to follow-up of events, adding that sign language is not always available for all programmes and newscasts.
All demands are legitimate and considered an inherent right, according to Egyptian law which stipulates: “The commitment of all national and private media outlets to provide the necessary languages; to enable persons with disabilities to have access to and to comprehend media content, and to further facilitate communication and allow them to engage with media.”
However, head of the Egyptian Television Broadcasting Sector, Naela Farouk, responded that Maspero relies on certified translators from civil society organisations serving persons with disabilities, and they are well trained on sign language.
In ARIJ’s exchanges with the deaf, hard of hearing, hearing impairsed and sign language interpreters, the majority all insisted that a standardised sign language dictionary needs to be widely circulated. The former director of Auditory Education at the Ministry of Education, Dr. Hanan Mohsen, explains that sign language, like any other spoken language, is regulated by grammar and has standards, and the dialects vary across the country all the way from Upper Egypt, down to Alexandria’s coast.
This is despite the launch of a unified sign language dictionary by the Ministry of Communications and Information Technology in 2015, which was then described as "the first of its kind”, and distributed among schools for the deaf and hard of hearing.
In 2019, and within the framework of a cooperation protocol with the Ministry of Education, the Coptic Church presented a sign language dictionary to the Egyptian Ministry of Education, also describing it as "the first of its kind" in the Middle East. However, none of these attempts solved the problem, which is extremely apparent at government institutions when delivering a message across the deaf, the hearing impaired, hard of hearing, and their accompanying sign language interpreters.
I feel that I am not even human, everyone treats me and the deaf as if we are animals.
I feel that I am not even human, everyone treats me and the deaf as if we are animals.
This is the literal translation of what Hanan Mohsen, 57, said in sign language. In 2018, she spent over three hours inside a Real Estate Registry Office in Abdin, in an attempt to persuade the office employees to issue a general power of attorney to her only son, so that he could manage her bank account, to pay his university fees, but her attempts were unsuccessful as they refused to conduct any formal transaction with her without a certified sign language interpreter, which she in turn refused due to her lack of confidence in them.
Accredited translator Sharif Adam, empathises with this lack of confidence among the deaf and hard of hearing in sign language translators, due to various disputes he has witnessed. These disputes were mainly due to errors in the translation of the demands of the deaf to officials in government institutions. This is a direct result of the lack of a unified dictionary of sign language, which resulted not only in deepening the difficulties of the deaf but also in hindering the fulfilment of their needs. Adam defends his colleagues saying that there are clear differences between deaf and hard-of-hearing signals and their translation is mastered by most sign language interpreters.
Prior to 2012, the Ministry of Justice required that the deaf bring a judicial assistant before conducting any governmental transactions at the Real Estate Registry Office. According to the Head of the Egyptian Institution for the Rights of the Deaf, Nadia Abdullah, the deaf need to submit a request to the court to appoint a relative of theirs as an aide or judicial assistant and attach to it a medical report of their health status. They would then wait for a hearing for a judge to approve this request.
The Egyptian Institution for the Rights of the Deaf obtained a judicial ruling from the Administrative Judicial Court in June 2012, obliging the Minister of Justice and the Real Estate Registration Authority to put multiple options in real estate registry transactions with the deaf, according to Nadia Abdullah. She noted that the ruling permits the educated deaf to use writing to express their demands, and to complete their own procedures without a judicial assistant or translator. The ruling also allowed the use of an accredited sign language interpreter by organisations or associations for the deaf.
However, some employees of the Real Estate Registry Offices were intransigent in implementing the ruling, while others were unaware of it, particularly the item allowing "educated" deaf people to follow up their transactions in writing, according to what Abdullah and some of the deaf reported.
This was evident with 40-year old Ali Khalifa, an employee at Cairo’s Diwan Citizens Service Centre, who three years ago suffered greatly just to issue a general power of attorney for his sister in the Real Estate Registry Office of Shubra al-Khaimah, enabling her to handle the sale or purchase transactions of his apartment. The staff at the registration office refused to issue the power of attorney based on a written request, and required him to bring an accredited sign language interpreter to finalise the issue.
The same incident occurred with Hanan Mohsen again in May 2020, where an employee at the Abdin Real Estate Registry Office was intransigent in finalising a written request to issue a contract for an NGO for the deaf which is still in the process of establishment. She informed the employee that she was a university professor and could express her demands clearly and without a sign language interpreter, but the employee refused.
ARIJ sent an official letter to the Ministry of Justice via email, on May 7 2020, but have not received a response to date.
Counselor Majed Abu Bakr, a member of the technical office in the Real Estate Registration Department of the Egyptian Ministry of Justice, responded saying that a newsletter was sent to all real estate registry offices informing them to complete the transactions of the educated deaf in writing. Abu Bakr asked the affected people to submit official memorandums and pledged to deliver them to relevant parties for further examination specifically the investigation authorities, adding that there is periodic monitoring and follow-up on the Real Estate Registry Offices.
We also tried to communicate with the National Council for Disability Affairs more than once over the phone, to present the findings of the investigation, but could not make contact. However, the former secretary general of the National Council for Disability Affairs and member of the House of Representatives, Heba Hajras, justifies the deaf and hard of hearing crisis due to the fact that the human rights movement for people with hearing disabilities falls behind, as it moves at a slower pace than movements of other disabilities.
She attributes this to the fact that the deaf and hard of hearing deny that they are people with disabilities, but rather believe that they have a different language, which is an issue prevalent not only in Egypt but also globally.
She added that the sign language crisis is a global one and teaching deaf people to read and write would solve up to 70% of their issues. In addition, there is the need for government institutions to use advanced technology to provide sign language translation programmes on mobile phones and a hotline with a video call feature for on demand access to sign language interpreters.