About two years ago around this time, crowds of protest movements were enveloping the Middle East and North Africa. Protestors were coming together to work towards better representation of people that had the capacity to serve the larger population, rather than the upper elite. In Egypt, particularly about two years ago around this time, the former President of Egypt of 30 years, Hosni Mubarak, was forced to step down.
The Middle East region includes about 20 countries, with almost 400 million people living within its span. Of this population, about 65 million people live on less than $2 US dollars a day. Egypt has the largest number of people living in poverty in the Middle East, with 18 percent out of 80.4 million living on less than US$2 per day. Loose labor laws, a lack of strong physical infrastructure and a weakened sense of social justice amounted to an overwhelming amount of unsatisfied civilians that took to Tahrir Square in 2011 and have since been fighting for their just representation by government officials.
Economic burdens and restraints, like those that have affected a large portion of Egypt’s population, not only lead to inequality of employment, resources and infrastructure, but they can also eventually lead to the regression of physical health. When you have such a large population living in under-privileged circumstances, people walk a very thin line of safety when it comes to health services. It may not have stood out as a single issue that raised headlines during the protests, but the lack of policy that suppressed the spread of diseases is also a result of government neglect.
According to the World Health Organization profile on Egypt, lymphatic filariasis (elephantiasis) and schistosomiasis (snail fever) have been largely eliminated in most areas due to sustained mass drug administration activities. However, last year Sabin President, Dr. Peter Hotez, and his co-authors published a paper that states that among the Middle Eastern countries, Egypt leads in the number of ascariasis and hookworm infections. Ascariasis, better known as roundworm, is the most common human worm infection and is most commonly found in areas with poor sanitation or where crops are irrigated by improperly treated waste water. Ascariasis is usually transmitted by accidental ingestion of ascaris eggs through contaminated food, water or soil and once the eggs are swallowed, they are passed into the intestine where they hatch into larvae. Larvae travel through the body and can cause pulmonary symptoms such as coughing and wheezing. Once the larvae settle in the small intestine, they feed on food from the human host, sometimes leading to malnutrition, and can live for up to two years.
Similarly hookworm was also reported to have a high rate of exposure, as a result of poor sanitation. Hookworm larvae are found in human feces and transmitted to humans from contaminated soil through the skin, usually due to walking barefoot, or by accidentally ingesting contaminated soil. Hookworm larvae enter the body through the skin and find their way to the small intestine. There, they mature into adult worms by attaching themselves to the intestinal wall and feeding on human blood. As the worms feed, they cause severe internal bleeding, leading to abdominal pain and diarrhea, anemia and eventual malnutrition. Hookworm is a serious global concern contributing to an estimated 43 percent reduction in future wage earnings in affected areas.
As the country with the largest population living under poverty in a region with such volatile political and social conditions, those in power would heavily bear an advantage from addressing preventable diseases as a national health, social and economic concern. While there are a range of vital interests regarding fair and just representation of the Egyptian people, attending to poverty-stricken communities and combating NTDs will also have an impact on those broader issues. The inclusion of poor communities (which often have high exposure to NTDs due to low sanitation and little access to sufficient resources) in the discussion of government activity would empower individuals with the ability to improve social standards and economic opportunity. This inclusion would build support for the government through recognition of their impoverished state and help to slowly transition out of the protest state of Egypt.
Two years after the initial start of the uprisings, Egyptians are continuing to take to the streets and invoke pressure to a newly elected government so that they can be represented justly. With the Egyptian Parliamentary elections coming up, it’s important to include the conversation of preventable diseases to the progression of national activities. Supplementation of activities that prevent these treatable diseases is a significant issue that can be addressed more easily and take a step forward to progress as the country continues to develop.