by Faten Sobhi

You can read this newsletter online here – http://lesglorieuses.fr/healthcare-discrimination

When Rabab Adel was diagnosed with hepatitis C, her husband left. He abandoned Adel, a 49-year-old teacher from Egypt’s Fayoum province, along with their two children, claiming he needed to protect himself. He also stopped supporting his family financially.

“If he was so afraid of infection, why didn’t he take the children to protect them too?” Adel says.

When the Egyptian government launched its 100 Million Healthy Lives initiative to combat hepatitis C, Adel was able to get free treatment for her condition and made a full recovery. By then, her husband had already married another woman and cut off all ties.

It’s an all-too familiar story around the world: a woman becomes seriously ill, and her male partner walks out. A 2009 study of brain tumour patients in the US found that male partners were six times more likely to leave a relationship after a diagnosis. In 2015, researchers found an elevated risk of divorce among couples following a serious physical illness only when the unwell person was a woman.

In Egypt, the problem is particularly acute, healthcare professionals say, and the cost of treatment is frequently a factor.

“Husbands often abandon their wives when the cost of medical treatment is high.” says Ziad Waleed, a specialist in women’s sexual and reproductive health who volunteers with several women’s organisations. “They think that spending on
women’s treatment is a luxury only affordable to those who are well-off.”

In other cases, families stay together but refuse access to treatment because they don’t want to spend money on female family members.

Heba Rashed, the founder of the Cairo-based Mersal Foundation, a healthcare NGO, describes  healthcare
discrimination in Egypt as “one of the worst forms of violence against women.”

It is not just men who discriminate against female family members. “I’ll never forget a mother who insisted on treating her son first, even though her daughter’s condition was more urgent,” Rashed says. “She justified it saying that her daughter will eventually stay home and serve her, versus her son who will raise his own family and support her financially.”

An analysis of data from the International Agency for Research on Cancer found that
four boys were diagnosed with cancer worldwide for every three girls, despite sex differences not being significant for childhood cancers. Researchers believe this is because, worldwide, families were more likely to seek treatment for sons than they were for daughters.

Doaa Mahmoud, a nurse at a health unit in Matrouh Governorate sees the consequences of healthcare discrimination for women every day.  “Their prescriptions are often torn up and their husbands decide that they’ll give them whatever is already available at home,” she says.

Mahmoud notes that men and boys in the region often get the best food, like meat, while girls are more likely to go without. This can mean that women’s haemoglobin levels are often too low when they get pregnant, leading to haemorrhage, miscarriages, and postpartum bleeding.

According to World Bank data, limited access to nutritious food led to a 28% anaemia rate in 2019, negatively affecting both mothers and babies. Anaemic mothers are much more likely to give birth to underweight babies, which can increase the likelihood of wasting or stunting and can have a lifelong impact on a child’s physical development.

To counter this, the Egyptian government’s Ministry of Social Solidarity launched “First 1,000 Days” a programme that offers services to pregnant women and children up to the age of two.

“The project provides newly married women with medicine and vitamins to cover the period from pregnancy through the first two years of breastfeeding,” Mahmoud says, but notes that newlyweds can be pressured into getting
pregnant too quickly, preventing the healthcare centre from preparing them appropriately for pregnancy.

While free treatment helps women and girls receive some of the care they need, it nonetheless means there is essentially a two-tier healthcare system in the country, often divided on gender lines.

“Boys receive full care, support, and medications, while girls are left to rely on the free services at healthcare units,” Mahmoud says.

Some families block women and girls from receiving care even when
it costs them nothing. The Mersal Foundation also tries to combat healthcare discrimination by seeking out women who are denied treatment by their families and offering them free healthcare services.

“Sometimes we succeed but at other times we fail when the family refuses to deliver the free service to their daughters,” Rashed says.

Hoda El-Saadi, head of the National Council for Women in the Upper Egyptian governorate of Qena says deprivation is a major factor in health discrimination in the region.

“The healthcare disparity between males and females within families is linked to the conservatism and poverty in the south,” she says.

Member of Parliament Maha Abdel Nasser says the root of the problem is that there is no social stigma associated with husbands abandoning their wives when they fall ill, and no laws to protect them.

“We can empower women economically in several ways, but the law does not protect women,” she says. “Nothing will really change unless we raise awareness about this issue.”

This article was
produced in collaboration with Egab.

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