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In Egypt, even an autopsy is political

CAIRO, Egypt — Egyptian forensic officials in Cairo say they are struggling with the overwhelming number of bodies that continue to arrive at their facilities bearing marks of torture and abuse in police custody, even when the streets are calm from political unrest.

Senior pathologists with the government-affiliated Forensic Medical Authority (FMA) — speaking to GlobalPost on the condition of anonymity — say Cairo’s main forensic facility has dealt with more than 1,000 cases of suspected abuse of police force each year since the uprising at the beginning of 2011.

But poorly-trained, ill-funded and under the supervision of Egypt’s justice ministry, forensic staff are under pressure to either hide or downplay such cases, both doctors and political activists say. Forensic officials report coming under indirect pressure to follow direct orders and nothing more, while staff members who do not comply can face salary deductions or relocation to facilities far from Cairo.

Despite the popular uprising that swept Egypt’s hated police forces from the streets two years ago, police brutality remains a key feature of the Egyptian state. Now, autopsies on both deceased political activists and ordinary Egyptians who may have been tortured — where government-linked doctors are suspected of issuing falsified reports — have become the latest battleground for activist goals of justice and state accountability.

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“We are used to complicity between the police and the forensic authorities,” said Aida Seif El Dawla, head of the El Nadeem Center for Rehabilitation of Victims of Violence in Cairo.

“Of course, autopsies can never be 100 percent conclusive in difficult cases,” she said. “But if there is a slither of doubt that this person could have died of torture, it must be mentioned.”

President Mohamed Morsi, himself a political prisoner under former President Hosni Mubarak, cannot afford to be seen as presiding over a security apparatus that acts with the same routine brutality that was witnessed under his dictatorial predecessor.

Under Mubarak, autopsies of activists and others suspected of having died in police custody commonly attributed deaths to immediate physical triggers, such as a drop in blood pressure. This type of hedging exonerated the security services of responsibility by failing to record any accompanying injuries. 

Today, forensic workers in Cairo say they are witnessing the same injuries and cover-up techniques. 

The most common injuries they see in cases of suspected police abuse are blunt trauma to the head and feet, electric shocks and welts that are believed to have come from beatings with cables and belts. Suspension and sexual assault are also described as frequent.

In one of the most high-profile cases of police abuse since the revolution, friends and activists circulated on social media photographs of the bruised body of their opposition activist colleague, Mohamed Al Guindy, in February.

An initial forensic report suggested he had been hit by a speeding van in downtown Cairo, after disappearing from the vicinity of a protest. But his injuries bore the hallmarks of police abuse, and security sources later told Reuters that Guindy had been “interrogated” for three days and nights before he died. 

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A revised medical report released in March, after significant press coverage, concluded that he had been “beaten violently,” but did not identify of the perpetrators.

In another murky case, journalist Al Husseini Abu Deif was shot and killed in December while reporting on clashes between supporters and opponents of Morsi and the Muslim Brotherhood group from which the president hails.

The preliminary medical report was heavily delayed, and failed to include details on the ammunition that was used. This month, a new report concluded that Abu-Deif had been shot with an expanding bullet, ammunition that is routinely handed out to law enforcement officials.

“Our results are independent,” the forensic authority’s acting head, Dr. Magda Al Karadawy, said in defense of the organization’s independence. “No one can interfere with what we do. Where there are delays, these come from the side of the prosecution.”

Indeed, rights groups have criticized the Morsi-appointed prosecutor-general of presiding over the prosecution’s new role in aiding police impunity.

“If they [the forensic doctors] want to examine anything further, [doctors] have to request approval from the prosecution, which it often denies,” said Dr. Mostafa Hussein, a psychiatrist who trained with the FMA. 

In addition to the apparent political pressure, delays and inaccuracies also cloud the process.

Egypt’s overall expenditure on healthcare, estimated at $4.5 billion in the fiscal year 2012-13, accounts for just five perfect of the state budget. Only a paltry amount of this filters through to the forensic authority, and staff complain that they often have to pay for their own gloves, tools, and even drugs.

Inside Zeinhom, a morgue adjoined to the forensic authority’s Cairo headquarters that handled most of the cases coming from the city’s political protests, the implications are clear: dirty floors remain flecked with blood, and equipment can be decades old.

When political violence results in an influx of corpses, staff says they are left with no choice but to leave them out in the open until space is found in refrigerators. Bodies can be left for days without proper preservation.

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In cases of alleged police abuse, documentation tends to be rudimentary in detail, subject to significant delays, and in some cases, includes fabrications, according to FMA staff. Doctors can take between two and six months to issue medical reports.

But human rights organizations say these delays minimize the chances of achieving justice for those who have faced abuse.

The United Nations Committee Against Torture says prompt physical examinations are vital if successful prosecutions are to be achieved, otherwise physical traces of torture disappear.

“It’s a question of transitional justice,” said Prof. Khaled Fahmy, a historian of forensic science at the American University in Cairo. “There are so many families who have yet to receive an answer as to how their children died in police custody, and forensic medicine lies at the very core of this.”

For Fahmy, the crisis runs deeper than a budgetary or staffing shortage. The problem is one of systemic failure in medical institutions stunted by decades of authoritarian rule.

“Physicians are neutral to most cases,” adds Dr. Hussein, “But not those involving the state.”

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