“What you see in Egypt is typical of a health system that has been neglected by the government,” said Henk Bekedam, the World Health Organization's (WHO) representative in Egypt. “And this is not since yesterday or since the revolution. This has been happening for the last 20 or 30 years.” The Egyptian government plays a marginal role in the country’s public health care system despite Egypt having the highest prevalence of hepatitis C (14.7% of the population), high rates of obesity and hypertension (17.6% of the adult population) and endemic poverty.

The health care system recently came under scrutiny after images of run-down government hospitals went viral following visits by Prime Minister Ibrahim Mahlab to two government-run hospitals June 6. The events spurred doctors to share photos revealing the alarming conditions in hospitals throughout the country. Among the images were clogged squat toilets, warnings about poisoned water, cats wandering the halls, animal droppings on hospital paperwork and bloody bandages on the floor.

On average, Egypt, the most populous country in the Arab world, invests 1.5% of its gross domestic product (GDP) on health expenditures for its 82 million citizens, who are subjected to sometimes unsafe and low-quality services. When government fails to adequately invest in health care, the private sector and market step in to fill the void, alleviating problems while also creating new ones. “The market doesn’t invest in safety and quality unless it gets a return,” Bekedam told al-Monitor. 

Heba, a doctor doing her rounds at Demerdash Hospital, recalled instances where her colleagues had to act against hygiene protocols. “I’ve seen doctors treat HIV patients without gloves and deliver a baby with bare hands,” she revealed to Al-Monitor. “When there are not enough medical supplies, doctors buy them out of their own pockets.”