Egypt

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OVERVIEW

In Egypt, the health care landscape for women is rather complex. Contraceptives can be purchased at pharmacies without prescriptions. For emergency contraception, prescriptions are legally required but, in practicality, this is not always the case. There is strong social stigma against STIs/STDs, so, while testing facilities exist, there is limited public knowledge or monitoring of STIs. Abortion is illegal, yet an underground economy of abortions seems to be rather large. There is a prominent women's shelter, maintained by a women's group, and there are some notable feminist organizations to help women in need. Overall, Cairo is a place that can be difficult for female newcomers. If you have a health care need, it's recommended to tap into a network of already existing resources and progressive doctors.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Egypt, contraceptives are legal and require no prescription, as supported by the Ministry of Health. They can be purchased at local pharmacies. However, there is strong social stigma against purchasing birth control, especially for people perceived to be single. This leads to many Egyptians buying contraceptives from pharmacies outside their neighborhoods or even boyfriends or foreign friends to buy contraceptives for them. Read this article on these stigmas and how they are managed by Egyptians.

What to Get & Where to Get It

You should be able to buy contraceptives at most pharmacies. Brand name brands are often available at reduced prices. It's common for pharmacists in Cairo to speak some English. While almost all pharmacies will work, here are some bigger name pharmacies that you can trust:

• Seif Pharmacies
• Ezaby

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

Emergency contraception is available in Egypt by prescription only. Studies have shown that Egyptians are generally interested in EC yet lack proper education. According to one study, "There is a need for EC in Egypt. However, a big gap in knowledge leads to nonuse or incorrect use of EC and negative attitude toward it. If health service planners and policy makers could fill this gap, a considerable decline in the prevalence of unwanted pregnancy may be achieved by using EC."

According to another study in 2013, 75% of Egyptian women in Alexandria lacked knowledge of EC methods. Furthermore, 18.8% thought that EC and the abortion pill were the same thing. Many women did not know the legality of EC either, with 51% incorrectly thinking it was illegal and 38.4% not knowing at all. "Despite the fact that EC has been available and registered for a long time in Egypt and some other Middle Eastern countries as Algeria, Lebanon, Libya, Mauritania, Morocco, Tunisia, and Yemen," the study found "EC remains relatively unknown and is discussed controversially in such countries, and the problem of unintended pregnancy still exists."

For some thought around EC in Egypt, check out this blog post: "Why is there no official EC fatwa in Egypt?"

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne, which lasts up to 5 days (120 hours) after unprotected sex. Egypt doesn't carry ellaOne, but copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

This doctor prescribes EC for about ₫375835: Dr Magued Adel Aziz Mikhail: Address: 15 Charles De Gaulle Street opposite Giza Zoo, 5th floor flat 52 Above Ragab sons Supermarket, Giza. Phone: 00 20 122 444 0597.

Legally, you need a prescription to get dedicated EC in Egypt. But some pharmacists may give it out without a prescription.

Dedicated Products / Progestin Only Take 2 pills within 120 hours after unprotected sex:

• Contraplan II (this is a brand produced in Egypt by DKT Egypt)
• Postinor-2 (this is an international brand produced by many labs)

Oral Contraceptives used for EC / Progestin Only Take 50 pills within 120 hours after unprotected sex:

• Microlut

If you can't access an EC prescription, you can use the following regular contraceptives as replacement EC:

Oral Contraceptives used for EC / Progestin-Estrogen Combined Note: in 28-day packs, only the first 21 pills can be used Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later:

• Primovlar

Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later:

• Microvlar
• Nordette

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Egypt, STI testing is available at hospitals and clinics. If you're applying for an Egyptian residence or work permit, or if you're a foreign student, you are required to take an HIV test. The test must be performed at the Health Ministry's central labs -- all other lab results are not accepted. If you are diagnosed as HIV+, you will be expelled from the country.

Generally, Egyptian society is secretive and uncomfortable when discussing STIs. This is partially due to the criminalization of STIs, like HIV. There is also negative social stigma regarding STIs, which people connect with taboo and non-traditional sexual practices. Furthermore, STI clinics are difficult to reach, especially in rural or less developed areas. Meanwhile, on a government level, the response to STIs has been mixed. In 2005, the Egyptian government did increase its attention on HIV/AIDS, including HIV education in public schools, establishing nine mobile and 14 fixed centers around the country, conducting trainings for nurses and physicians and beginning to provide antiretroviral therapy (ART) for HIV/AIDS patients free of charge. However, the government has been criticized for neglecting the issue, as well as avoiding addressing high-risk populations, like men who have sex with men (MSM), female sex workers (FSW) or injection drug users (IDUs).

Statistically, Hepatitis C is the most prevalent STI/STD in Egypt with 14.7% of Egyptians testing positive for the HCV antibody. Egypt has the largest Hepatitis C epidemic in the world, and much of the transmission seems to come from informal dental and medical care. Read an online discussion here in which some researchers and academic discuss possible causes for the high rates.

Regarding HIV, Egypt has low overall prevalence with estimates between 1-3% for the population. However, according to one study, "Egypt was once considered to be an HIV/AIDS low-grade epidemic country, recent data indicated that Egypt is stepping toward a concentrated HIV epidemic with numerous challenges and barriers to prevent and control in the future." In 2013, it was found that 10% of Egyptian MSM (men who have sex with men) were HIV+. In Cairo, specifically, 5.7% of MSM were found to be HIV+ in 2010. Unfortunately, only 1 in 8 Egyptian people eligible for ART received it in 2010.

Other Resources: Read this blog entry about being diagnosed with herpes in Egypt. Here's a link to a study on gonorrhea in Egypt. Here's a link and another link to studies on chlamydia for Egyptian women.

What to Get & Where to Get It

Testing Facilities

• National Blood Service: This is the government-run blood testing service. Address: 51 Wezaret El Zeraa St. Agouza, Giza, Inside National Organization For Drug & Control Research, Toll Free Call: 0800-1110111, Phone Number: 19447, 02-37620202, 02-37613117
• Check city pages for local recommendations, like the Cairo page.

Support

• UNICEF Egypt

Medications & Vaccines

What to Get & Where to Get It

Warning: "Due to rampant poverty, Egyptian pharmacies are sometimes flooded with generic drugs of questionable quality. Some of these drugs don’t work, others are extremely powerful and a very small percentage have proven fatal. As a rule, never take anything that does not come in a clearly marked package, and always take care to follow dosage instructions to the letter (even generic packaging usually has English instructions alongside the Arabic). If you’re unsure that you’ve been given an effective (or safe) generic medicine, ask an Egyptian friend or co-worker (or a fellow expat) for her opinion."

In Egypt, yeast infection medication is under the names Diflucan, Flucoral, Fungican, Triconal.

There are currently no PrEP programs in Egypt.

Menstruation

Laws & Social Stigmas

In Egypt, women typically use pads and know very little about tampons. There is a myth than tampons take your virginity or that they're extremely uncomfortable. Other women think they can't urinate if they wear tampons. Read more in this article.

What to Get & Where to Get It

In Egypt, pads are easy to find. But tampons are not commonly used by Egyptian women. If you do want tampons, you may be able to find them at Metro Markets (see this link for locations), where they come in packs of 12 (regular absorbency) with cardboard applicators. There's a chance that they'll also be at certain pharmacies or Carrefour (since it is an international chain). You can also purchase menstrual products online and pay in Egyptian Pounds (EGP) -- check out this link for an example.

For a personal story, here's a blog entry about an American woman buying tampons in Cairo.

Costs

Tampons should be around 45 Egyptian Pounds.

Gynecological Exams

What to Get & Where to Get It

Here's a list of the main hospitals in Egypt:

• Gohar Hospital & Women’s Health Clinic: 25 Abd El Aziz Saoud St. 
Manial Roda, Cairo, 11451, Egypt
• Cairo Medical Centre: Tel: + 20 2 450 9800, Address: 4 Abou Obaida, Al Bakry, Roxy, Helioplis
• City Medical Clinic: Tel: +20 238 571 591, Address: Hadaeq Al Ahram, 427N, Entrance 4 (Mena)
• Cleopatra Hospital: Tel: + 20 2 414 3931, Address: 39 Cleopatra Street, Salah El Din Square, Helioplis
• As-Salam International Hospital: Tel: + 20 2 303 0501, Address: Cornich El Nile, Maadi
• Hawwa International/Egyptian British Hospital: Tel: +20 2 760 9258, Address: 25 Mohammed el Gaimini Street
• Integrated Clinic: Tel: + 20 2 653 5553, Address: 59 Abdelmonem Road, El Mohandeseen

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Egypt, abortion is only permitted to save the life of a woman. Misoprostol (the abortion pill) sales have been restricted. All other reasons, including to preserve physical health, to preserve mental health, rape or incest, fetal impairment, social/economic reasons or available upon request, are not permitted. These laws are found in the Egyptian Penal Code of 1937 (sections 260-64). Furthermore, anyone who induces an abortion, including the pregnant woman, may face imprisonment for up to three years. Medical professionals, such as physicians, pharmacists, surgeons or midwives, may be subject to imprisonment of 3-15 years and/or hard labor if they induce any abortions. However, the government cannot convict someone merely for having the intent to commit the act.

There is also strong religious disapproval of abortions. In January 2004, the foremost mosque in Egypt issued a fatwa against abortions.

However, women continue to seek abortions in Egypt. As reported by CairoScene: "Women in Egypt have always managed, one way or another, to find some method of terminating their unwanted pregnancies, because although most doctors refuse to perform the procedure on legal or religious grounds, there has always been an underground web of physicians who perform them and the women who have had them done, and the web is laden with whispers from both ends." According to one study, one third of Cairo women (married and unmarried) had tried to terminate a pregnancy. Another study found that 41% of women in one rural Upper Egypt area had at least one abortion and 25% had more than one. One of the most common methods is ordering Misotac, the abortion pill from abroad.

To read the personal stories of abortions performed in Egypt, click here, here and here. Also, here is an article about women who cannot access abortion services so either turn to self-induced abortion or abandoning their newborn babies.

Warning: Some underground abortion doctors in Egypt expect sexual favors performed by their patients. Read this article for personal stories.

What to Get & Where to Get It

• Egyptian Family Planning Association (EFPA): This has been recommended by Women on Waves. Address: 24 A Anwar El - Mufty St, Apt.12 & 13 ( Behind Tiba Mall ) Nasr City , Cairo , 24 A Anwar El - Mufty St, Tel: +2000 20 2 402 7852 , 00 20 2 4028458, Fax: +2000 20 2 4031240

Costs

In 2004, a professional and safe medical abortion in a clinic cost around $460. Cheaper abortions in less sanitary and advanced facilities could be found for $150 in 2004.

List of Additional Resources

• General number for the police, Cairo: 122
• Number for the tourist police hotline, Cairo: 126
• The Association for the Development and Enhancement of Women: Founded in 1987 to empower Egyptian women. Has micro-loan programs, free legal assistance, literacy programs, etc. Also manages Beit Hawa (see below).
• Beit Hawa (the House of Eve): an autonomous women's shelter. Here's an article on them. Managed by The Association for the Development and Enhancement of Women - contact the association for info.
• The Egyptian Center for Women's Rights: "Committed to improving the political and legal status of women since 1996." Has successfully lobbied for legislative changes, fights street harassment, helps women obtain ID cards and register to vote. Address: Engineers Towers, 2nd Tower, 20th Floor, flat No. 3, Maadi, Cairo Egypt. Tel : +202 527-1397, +202 528-2176, Fax : +202 528-2175.
• Nazra: Focuses on feminism and gender awareness, especially among youth
• Women and Memory Forum: Works to combat negative representations of Arab women. Conducts research, advocacy, etc. Has a Gender Education Workshop.
• Karama: NGO created in Cairo that collaborates with activists throughout Middle East and North Africa. "Karama held its first national workshop in Cairo in 2005. It brought together 35 Egyptian NGOs to discuss the problem of violence against women in Egypt, what Egyptian civil society has been doing to address it until now, and how the new Karama approach might amplify these efforts. Since that first meeting, Karama’s focus on women’s dignity, on the society-wide impact of violence against women, and on grassroots-led collaborative efforts to end violence has continued to resonate. The majority of groups that participated in the national workshop have stayed on to become the core of Karama’s network in Egypt, and to build a social movement for a life free of violence against women."
• Bosla Egypt: Provides services for victims of human trafficking, survivors of sexual and gender-based violence, women, refugees and asylum seekers. Email: contact@bosla-egypt.info