في أماكن الخدمة الطبية... العنف والوصاية يلاحقان النساء
“She comes up to me from the reception — a woman that has been injured by the gas cooker and had her finger cut open at the knuckle. She’s dragging her husband behind her to get it stitched up, and her husband is telling me ‘I swear (wallah) it's not worth it, but she insisted on coming to the hospital and wants you to check on her’. I saw the wound, and I found it just a small scratch and it really was not worth it. So, I told her ‘No, we do need stitches, and we’ll take 3 stitches.’ I did them without any anesthesia so that she will learn her lesson.”
With these words, an Egyptian doctor on his Twitter account boasted about the unjustified violence he had committed against an injured woman who had wanted to merely reassure herself on a wound she had. Even though her husband was accompanying her to check on her, the doctor volunteered himself to exact revenge on his patient by “disciplining” her, as he had described it.
This tweet, which a number of activists and women’s rights defenders shared and circulated a while ago, was able to shed light on the violence that women are subjected to in medical service and health care facilities (examination rooms) — whether they were public or private hospitals or medical clinics.
The many forms of violence that women are subjected to in these places vary, from outright abuse such as harassment and sexual manipulation that some doctors carry out against patients, to the hidden abuse that is practiced by some doctors against their patients without their realization, as was in the previous case.
Virginity Tests Without Permission
Fatima, a young woman in her thirties, recounts the details of the abuse she was subjected to in a private hospital. She tells Raseef22, “I am a single young woman (I have never been married or had any sexual relations) and I have been suffering from frequent infections in the vagina. I’ve had my condition previously examined several times by gynecologists, and their diagnoses varied between allergies to certain foods or infections in the urinary tract.”
She adds, “In previous times, I would pay for all the costs of the treatment, but this time I went to an insured doctor, so that the examination and medication would be at the expense of the insurance provided by my workplace.”
During each of the previous times, she explains, “The doctor or physician would always ask for my permission in order to conduct the examination, and if I refused, they respected my wishes. The first question they would ask was: ‘Was I a virgin or was I married?’ The conversation regarding this specific point would usually end with the response that I am a virgin and I have never been married or had any sexual relations.”
But things went much more differently with the last doctor she visited. “This time, I explained to the doctor the infections I suffer from and the secretions that take place, and I told him about my medical history. I also gave him the results of a swab analysis that I had previously taken in order to find out the causes of my infections. The test results showed that there wasn’t any of the infections that are transmitted through sex. He asked me if I was married and I answered him with no. He then reverted to asking about my sexual relations, and I answered again in the negative.”
The 30-year-old continues her story, “He asked me whether he could take a swab to analyze it himself, indicating that he did not trust the results of the old analysis. I agreed and he began to take the swab within the first few seconds of the examination. But I was surprised that even though he was done with taking the swab he needed, he did not stop and continued to examine my vagina, and his fingers began to reach my vagina in strange touches that I had not experienced with any doctor I had visited before. I grew nervous and asked him what he was doing. His short answer came in the form of asking me not to move, and the situation continued like this for several minutes. The swab had turned into a full vaginal examination without any permission or consent.”
The story did not end here. “After he finished my examination, I asked him why the examination had taken so long, and he told me that he had conducted a virginity test on me! He then started to ask questions about my sexual relations again, saying that he suspects that I have an STD (sexually transmitted disease). Even though I continued to reaffirm my previous statement that I was a virgin and had never had any sexual relations, he insisted on his diagnosis that my illness was caused by an STD, even hinting several times that I was lying to him.”
“After he finished my exam, I asked him why it had taken this long, and he told me that he had conducted a virginity test on me! He then began to ask questions about my sexual relations again, saying he suspects I have an STD, even though I reiterated that I was a virgin”
“I went into a state of shock for days,” she continues recounting her story, “I was not treated properly (medically), which prompted me to visit another doctor who assured me that the issue is a simple one and does not require a vaginal examination, and that the diagnosis is allergic and its treatment simple.”
What Fatima was subjected to is not any different from what Salwa (pseudonym) was subjected to at the hands of a surgeon in a university hospital.
She recounts to Raseef22 the details of what she had been exposed to, “I went to a surgeon to check on an abscess in the lower part of the abdomen, under the navel but above the pubic hair area. There was no nurse throughout the examination, and during, the doctor touched my vagina with his fingers without wearing any medical gloves.”
“I felt both shock and embarrassment at the same time, and I did not make any reaction,” she adds, following up with, “I waited until the exam was over, received the prescription, and left the examination room.”
“The state of shock and denial went on until I began to suffer from extreme anxiety, accompanied by nightmares, screaming, as well as a state of guilt because of my silence about what I had been subjected to and for not exposing the doctor for what he had done,” she continues.
The girl — who is in her late twenties — goes on, “I told my friend, and through her, I was introduced to a lawyer who I contacted in order to take legal action, but I could not follow through with the process because I found it difficult to prove the incident.”
The human rights lawyer Aya Hamdy was the one who took the case. She tells Raseef22, “I received this case and provided some legal advice to her, but she did not complete the procedures and withdrew after that.”
She points out that fear and suspicion play a strong role when it comes to women who back down from reporting and submitting complaints as well as taking legal action.
Hamdy explains that there are two different kinds of measures that a woman can take if she is exposed to any type of abuse in a health care setting, “First, she may file an administrative complaint within the hospital itself and another one to the medical association. Second, she may file a legal complaint by filing out an official police report at the nearest police station.”
“The forms of abuse that women are subjected to within medical care facilities vary — some of which are easy to detect, such as verbal or sexual abuse, while some of them not many realize or are aware of”
She points out that the first paragraph of Article 306 of the Penal Code stipulates a penalty of imprisonment for a period of no less than a year and a fine of not less than five thousand pounds for anyone that subjects others to suggestions or hints in a public or private place. It also stipulates that when it comes to doctors, a union punishment also applies alongside the penalty — sometimes even amounting to banning the perpetrator from practicing his profession.
“Verbal, Sexual, and Other Forms”
Entisar Elsaeed, director of an Egyptian, feminist-oriented non-governmental organization called the Cairo Foundation for Development and Law, says, “Many women are subject to abuse within a medical care setting, but most of them do not take any legal actions for fear of backlash or negative reactions,” assuring Raseef22 that “the institute has received some complaints in this regard.”
Elsaeed notes that the forms of abuse that women are subjected to within medical care facilities vary — some of which are easy to detect, such as verbal or sexual abuse like harassment and rape, while some types of violence not many women realize or are aware of, such as obstetrical abuse. Many are subjected to verbal or physical abuse at the hands of a number of doctors — whether through a clinical examination or while giving birth. This is what “some of them think is a normal occurrence due to how common it is,” in addition to the use of unjustified medical treatments or surgeries such as cesarean section.
She goes on to add that “there are other types of abuse that go unnoticed and are practiced against women in medical and health care facilities. These forms of abuse include neglect, disregarding a patient’s pain and/or needs, and violating privacy and confidentiality, in addition to failing to adhere to professional standards while providing health care, such as vaginal examinations without any justification or medical need.”
“I went to a surgeon to check on an abscess in the lower part of the abdomen, under the navel but above the pubic hair area. There was no nurse throughout the examination, the doctor touched my vagina with his fingers without wearing any medical gloves”
The Cairo Foundation for Development and Law is holding a series of events and training courses for health care providers on how to deal professionally with women, as part of the program dubbed “Safe Health Care Centers for Women”.
Imposing Tutelage and Verbal Abuse!
Hanan (pseudonym) was subjected to an incident of psychological intimidation and verbal abuse while receiving medical service in a government hospital. The 30-year-old tells Raseef22, “I was in my late twenties and my marriage certificate was finalized, but the wedding had not taken place due to financial circumstances. I had sexual intercourse with my husband at that time that resulted in pregnancy, but I did not know that I was pregnant. I was feeling very tired, which prompted me to go to the nearest government hospital accompanied by my mother.”
She recounts, “During the examination, the doctor asked me if I was married, and I informed him that my marriage has been officially contracted and finalized. After the exam was over, he informed me that I was pregnant.”
She adds, “My mother was waiting outside and was not aware of what had happened between me and my husband. I was afraid and felt terrified, so I asked the doctor to refrain from informing my mother of anything. However, he surprised me by reprimanding, taunting, and mocking me. He even went as far as to insult me and make wild and abusive accusations against me. He also quickly informed my mother of what happened despite my repeated requests and insistence on him not to, causing a major crisis for me at the family level. Whereas on the psychological level, it has caused me to lose all faith and confidence in doctors and refrain from visiting them except during urgent and critical cases.”
Cases of abuse against women in places that provide health care services are not a rarity. Some of them have even come out into the open and made their way into the courts. Last April, the Zagazig Criminal Court sentenced a doctor to one year in prison with manual labor. The doctor had been accused of indecent assault on one of his patients while she was undergoing a medical exam within a charity clinic in the city. Also, last January, the Minya Criminal Court decided to enforce a penalty of three years in prison on a doctor after he was accused of an attempted indecent assault on a patient while examining her.
Last March, human rights activists and defenders launched an online petition to collect signatures and to be presented to the medical association under the title, “Petition to the Egyptian Medical Syndicate EMS... Stop sexual violence”. It also called on the syndicate to disown any doctor in the event a final judgment proving his involvement in such acts is passed, in compliance with regulations on professional ethics.
Member of the Egyptian Medical Syndicate (EMS) Dr. Najwa el-Shafei affirms that there are two committees within the EMS specialized in receiving citizens’ complaints and investigating all incidents of violation against any doctor. The two bodies operate under the titles of the Investigation Committee and the Ethics Committee.
She adds to Raseef22 that in the event that any citizen is subjected to any abuse or violation at the hands of a doctor, he/she can file a complaint with the Ethics Committee, while the Investigation Committee summons the doctor and all parties involved. If the doctor is proven wrong, he is penalized — with penalties ranging from accusation and reproach to renouncing and banishment, according to the scale of the violation that’s been committed.