COVID-19 vaccines could go to children first to protect the elderly



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Julian Savulescu, University of Oxford and Margie Danchin, Murdoch Children’s Research Institute

Several COVID-19 vaccines are in late-stage clinical trials. So discussion is turning to who should receive these vaccines first, should they be approved for use. Today, we discuss two options. One is to prioritise the elderly. This article looks at the benefits of vaccinating children first.


The World Health Organisation is discussing how best to allocate and prioritise COVID-19 vaccines when they arrive.

It is focusing on the immediate crisis. To reduce deaths quickly when there are extremely limited vaccine doses available, vaccinating older, more vulnerable people is expected to be the best option, even if the vaccine is relatively poor at protecting them. That is because the elderly are so much more likely to die from the disease.

But as we produce more vaccines, the goal will be returning to normality where we can freely mix without increased risk. If vaccines are not very effective in older adults, we will need many more people to be vaccinated, including children. One possible strategy is to prioritise children.

Why children first?

The risks and benefits of particular COVID-19 vaccination strategies depend on information we don’t yet have. For example, we don’t yet know whether vaccines work or are safe for specific population groups, such as the young or the old.

But it is worth thinking about the ethics of different strategies in advance. In a pandemic, time can save lives.

A COVID-19 vaccine may be less effective in the elderly because their immune systems decline naturally with age, making them perhaps less able to trigger an efficient, protective immune response after vaccination.

We see this with the flu vaccine, which only reduces influenza-like illnesses by around one-third in the over-65s and deaths by around half.




Read more:
Why are older people more at risk of coronavirus?


If there are similar results for a COVID-19 vaccine, to return to normality, we may need to also prevent community transmission through vaccinating young people, who generally mount a stronger immune response. This would in turn protect older, more vulnerable people because the virus would be less likely to reach them.

Yes, this is controversial. Children cannot autonomously consent to being vaccinated. Adults, who make these decisions on their behalf, are also likely to benefit from a reduced risk of contracting the virus within their own household, making the decision a possible conflict of interest.

When would this be OK?

We do sometimes make altruistic decisions on behalf of children. Children can be life-saving bone marrow donors for siblings, for example, despite the risks.

We can also apply the idea that we can restrict liberty where there is a risk of harm to others. For instance, if a child is infected with COVID-19, they need to be isolated and quarantined just like adults.

However, vaccination differs from both examples in one key respect. With vaccination, there is unlikely to be a single identified person the child will help, or whom they are uniquely placed to help. Instead, the potential benefits are collective, to the wider public.

If a child lived with a sibling who had an underlying condition that makes them particularly vulnerable to COVID-19, or lived with their grandparents, vaccination might be an easier choice.

Child sitting on grandfather's lap reading together
If a child lived with grandparents, vaccination might be an easier choice.
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Three factors could help us decide

When weighing up whether children should be vaccinated ahead of adults, we can ask:

1. How severe is the threat to public health?

So far, more than a million people have died from COVID-19. There’s also the risk of overwhelming health systems and the additional collateral damage in terms of economic, social, educational and risk of excess non-COVID-19 deaths as a result (for example through suicide, or delayed access to health care). COVID-19 affects everyone in society, including children.

2. Are there alternatives?

If vaccination works well enough in vulnerable people, or there are other strategies to achieve the same effect, such as general adult vaccination, we should use those instead.

3. Is the response proportional to the threat?

As we vaccinate the vulnerable, and the general adult population, even if it is not fully effective, we will reduce the severity of the crisis. We should assess at that stage whether the remaining problem warrants vaccinating children.

Assuming we meet these conditions, we argue prioritising childrens’ vaccination, on a voluntary basis at least, is the right strategy.

How about mandatory vaccinations?

Mandatory vaccination can be justified if voluntary strategies do not achieve herd immunity, or do not achieve it fast enough to protect the vulnerable.

To gauge whether mandatory vaccination is worth it, we might also need to consider how lethal and infectious a virus is.

For instance, smallpox had a death rate of up to 30% (although contagion requires fairly prolonged contact). It was eradicated by 1979 through vaccination, which was mandatory in many countries. With COVID-19, 0.1-0.35% of infections are fatal.

By definition, mandatory vaccination involves some form of coercion. This can include withholding financial benefits or access to early childhood education (No Jab, No Pay or No Jab, No Play in Australia); preventing children from entering school (USA, with specific rules varying by state) to fines (Italy). France even has legal provision for imprisonment for parents who refuse certain vaccines.

Mandatory vaccination (of some kind) could be justified in groups who are at increased personal risk from COVID-19 — such as health-care workers, the elderly, men, or people with other health conditions — if incentives such as increased freedoms, or even payment are not sufficient. For these groups, the vaccine is win-win: it both protects others and the person vaccinated.

And mandatory vaccinations for children?

The situation is more tricky with children. Unless they have underlying health conditions or have a rare but serious inflammatory condition after infection, children are less likely to have severe COVID-19 or die from it.

So the risk of the vaccine itself (as yet unknown) weighs more heavily.

On the other hand, children benefit from grandparent relationships, and other freedoms afforded by a pandemic-free society.




Read more:
Children may need to be vaccinated against COVID-19 too. Here’s what we need to consider


Mandatory vaccination might be justified in children if the following criteria are met:

  • the vaccine is proven to be very safe for children (including in the long term, as yet unknown), and safer than the effects of the disease

  • children are significant spreaders of infection (which does not appear to be the case for COVID-19, at least for pre-teens)

  • there are other non-COVID benefits to children, such as return to normal social and educational life (school), and access to normal health-care services which they otherwise could not have

  • measures are reasonable and proportionate, for instance, by limiting child care benefits (rather, for instance, than sending parents to prison).

We are certainly not close to meeting these criteria for mandatory vaccination of children against COVID-19 yet, especially as we don’t know how effective and safe candidate vaccines are in different populations.




Read more:
5 ways our immune responses to COVID vaccines are unique


The Conversation


Julian Savulescu, Visiting Professor in Biomedical Ethics, Murdoch Children’s Research Institute; Distinguished Visiting Professor in Law, University of Melbourne; Uehiro Chair in Practical Ethics, University of Oxford and Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why we should prioritise older people when we get a COVID vaccine


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Kylie Quinn, RMIT University

Several COVID-19 vaccines are in late-stage clinical trials. So discussion is turning to who should receive these vaccines first, should they be approved for use. Today, we discuss two options. One is to prioritise children. This article looks at the benefits of vaccinating older people first.


While we wait for further results from phase 3 trials, it’s clear that supply of any potential COVID vaccine would initially be limited.

Local authorities will need to prioritise distribution to specific groups, at least at first. So how might they make these decisions?

The general consensus is people with very high risk of exposure to COVID, such as workers in front line health-care and quarantine facilities, should be first.

Less clear is the question of who should be next. This group could include people with work, demographic or health characteristics that put them at high risk of either exposure or serious disease.

Following a National Cabinet meeting on Friday, the federal government indicated the elderly and vulnerable would be a priority group.

Here’s why prioritising older people to receive the earliest COVID vaccines is a good idea.

First, a bit of background

Vaccines work in several different ways, providing benefits to the individual and the community.

An obvious individual benefit is that vaccines can prevent infection in the person who is vaccinated. But vaccines can also reduce the amount of virus a person makes if they do end up becoming infected. This can reduce severe disease and reduce their likelihood of transmitting the virus to others.

All this leads to benefits for the community. If vaccine uptake is high enough and transmission is reduced, our collective (or herd) immunity can be used like a fire break. It blocks pathways of virus transmission and protects vulnerable people from infection, even when those people are not vaccinated.

Here’s what happens when you don’t vaccinate compared to when you do, if we were to have a vaccine that was 66% effective. The figures who turn red catch COVID-19.
Author provided

Severe disease due to COVID is a critical health issue, with the potential to put significant stress on health-care systems and resources. But if vaccine supply is limited, do we:

  • directly reduce severe disease by giving the vaccine to those most at risk, such as older people

  • indirectly reduce severe disease by vaccinating the people most likely to get sick and transmit the virus, such as certain groups of younger people

  • use a mix of both strategies?

The question is, how can a limited supply of vaccine have the most impact?




Read more:
90% efficacy for Pfizer’s COVID-19 mRNA vaccine is striking. But we need to wait for the full data


Vaccines and the elderly

As we get older, our immune cells can become more difficult to activate, in response to the natural ageing process or other factors like chronic inflammation. As a result, vaccines often don’t protect older people as well as younger people.

Importantly, a phase 1 study with a BioNTech/Pfizer COVID vaccine candidate showed the size of the immune response was lower in older people, which may suggest reduced protection.

Because of this, the public might think prioritising vaccines for older people is a bad idea. Why give a vaccine to people who it won’t work as well in? But we should explore older people as a priority group for several reasons.

First, older people are bearing the brunt of severe disease from COVID. In Australia, nearly half of severe cases requiring intensive care, and more than 90% of deaths, have been people over 65.

Second, a potential vaccine may not protect as well in older people, but it should protect to a degree. As an example, the flu vaccine provides 60-70% protection in the general community, dropping to 30-40% protection in people over 65 — but even at that rate it’s still protecting a substantial number of older people.

Third, where a potential vaccine doesn’t prevent infection, it could still reduce severe disease. For example, in one study, the flu vaccine reduced the rate of severe disease in vaccinated people by 23% regardless of age group.

A modest improvement in cases or severe disease in older people could have a big impact on the overall burden of disease and death.

In particular, aged-care facilities should be considered a top priority. This environment is high risk, combining people at very high risk of severe disease and high-density accommodation. Vaccinating aged-care staff could prevent the virus getting in and vaccinating residents could minimise the consequences if it did.




Read more:
5 ways our immune responses to COVID vaccines are unique


Finally, some vaccines may work well in older people. For example, the Shingrix vaccine stunned the research community in 2015 by demonstrating over 90% protection against shingles in older people — a vast improvement on the previous Zostavax vaccine which provided only 50% protection.

While initial supply will be limited, we may end up with access to multiple COVID vaccines, which could allow us to prioritise potent vaccines for older people.

Big decisions take a village

In any scenario, tackling complex questions around vaccine distribution will require specialist knowledge from across many disciplines.

We need to understand how the virus spreads in a given population, how the vaccine works in different groups within that population, who might be hesitant about the vaccine, how we can deliver the vaccine to a wide variety of people and many other factors.

An elderly woman wearing a mask looks out the window.
Older people are more likely to become severely unwell if they contract coronavirus.
Shutterstock

Importantly, we’re still learning about this virus. It behaves differently in different communities, due to different environments, demographics, biology and behaviours. Strategies may differ in different regions and must adapt with our evolving understanding of the virus. There won’t be a “one size fits all” approach.

It’s also vital to keep in mind that a vaccine won’t be a silver bullet. Vaccines are not 100% protective and will take time to roll out. Public health measures such as rigorous testing, hand-washing, mask-wearing and a level of social distancing will remain important for some time.

There will be challenging and contentious decisions for initial access to COVID vaccines, but ultimately vaccine supply will become less restricted. It’s important to remember we all collectively benefit by shepherding certain groups to the front of the vaccine queue.




Read more:
Creating a COVID-19 vaccine is only the first step. It’ll take years to manufacture and distribute


The Conversation


Kylie Quinn, Vice-Chancellor’s Research Fellow, School of Health and Biomedical Sciences, RMIT University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

For older people and those with chronic health conditions, staying active at home is extra important – here’s how



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Rachel Climie, Baker Heart and Diabetes Institute and Erin Howden, Baker Heart and Diabetes Institute

Fitbit recently released data showing a global decrease in physical activity levels among users of its activity trackers compared to the same time last year.

As we navigate the coronavirus pandemic, this is not altogether surprising. We’re getting less of the “incidental exercise” we normally get from going about our day-to-day activities, and many of our routine exercise options have been curtailed.

While we don’t know for sure how long our lifestyles will be affected in this way, we do know periods of reduced physical activity can affect our health.

Older people and those with chronic conditions are particularly at risk.




Read more:
How to stay fit and active at home during the coronavirus self-isolation


Cardiorespiratory fitness

To understand why the consequences of inactivity could be worse for some people, it’s first important to understand the concept of cardiorespiratory fitness.

Cardiorespiratory fitness provides an indication of our overall health. It tells us how effectively different systems in our body are working together, for example how the lungs and heart transport oxygen to the muscles during activity.

The amount of physical activity we do influences our cardiorespiratory fitness, along with our age. Cardiorespiratory fitness generally peaks in our 20s and then steadily declines as we get older. If we’re inactive, our cardiorespiratory fitness will decline more quickly.

As we get older, our cardiorespiratory fitness declines.
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One study looked at five young healthy men who were confined to bed rest for three weeks. On average, their cardiorespiratory fitness decreased 27% over this relatively short period.

These same men were tested 30 years later. Notably, three decades of normal ageing had less effect on cardiorespiratory fitness (11% reduction) than three weeks of bed rest.

This study demonstrates even relatively short periods of inactivity can rapidly age the cardiorespiratory system.




Read more:
5 ways nutrition could help your immune system fight off the coronavirus


But the news isn’t all bad. Resuming physical activity after periods of inactivity can restore cardiorespiratory fitness, while being physically active can slow the decline in cardiorespiratory fitness associated with normal ageing.

Staying active at home

Generally, we know older adults and people with chronic health conditions (such as heart disease or type 2 diabetes) have lower cardiorespiratory fitness compared to younger active adults.

This can heighten the risk of health issues like another heart disease event or stroke, and admission to hospital.

While many older people and those with chronic health conditions have been encouraged to stay home during the COVID-19 pandemic, it’s still possible for this group to remain physically active. Here are some tips:

  1. set a regular time to exercise each day, such as when you wake up or before having lunch, so it becomes routine

  2. aim to accumulate 30 minutes of exercise on most if not all days. This doesn’t have to all be done at once but could be spread across the day (for example, in three ten-minute sessions)

  3. use your phone to track your activity. See how many steps you do in a “typical” day during social distancing, then try to increase that number by 100 steps per day. You should aim for at least 5,000 steps a day

  4. take any opportunity to get in some activity throughout the day. Take the stairs if you can, or walk around the house while talking on the phone

  5. try to minimise prolonged periods of sedentary time by getting up and moving at least every 30 minutes, for example during the TV ad breaks

  6. incorporate additional activity into your day through housework and gardening.




Read more:
Why are older people more at risk of coronavirus?


A sample home exercise program

First, put on appropriate footwear (runners) to minimise any potential knee, ankle or foot injuries. Also ensure you have a water bottle close by to stay hydrated.

It may be useful to have a chair or bench nearby in case you run into any balance issues during the exercises.

  • Start with five minutes of gentle warm up such as a leisurely walk around the back garden or walking up and down the hallway or stairs

  • then pick up the pace a little for another ten minutes of cardio – such as brisk walking, or skipping or marching on the spot if space is limited. You should work at an intensity that makes you huff and puff, but at which you could still hold a short conversation with someone next to you


The Conversation, CC BY-ND
  • next, complete a circuit program. This means doing one set of six to eight exercises (such as squats, push ups, step ups, bicep curls or calf raises) and then repeating the circuit three times

    • these exercises can be done mainly using your own body weight, or for some exercises you can use dumbbells or substitutes such as bottles of water or cans of soup
    • start with as many repetitions as you can manage and work up to 10-15 repetitions of each exercise
    • perform each exercise at a controlled tempo (for example, take two seconds to squat down and two seconds to stand up again)
  • finish with five minutes of gentle cool down similar to your warm up.




Read more:
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If you have diabetes, check your blood sugar levels before, during and after you exercise, and avoid injecting insulin into exercising limbs.

If you have a heart condition, it’s important to warm up and cool down properly and take adequate rests (about 45 seconds) after you complete the total repetitions for each exercise.

For people with cancer, consider your current health status before you start exercising, as cancers and associated treatments may affect your ability to perform some activities.The Conversation

Rachel Climie, Exercise Physiologist and Research Fellow, Baker Heart and Diabetes Institute and Erin Howden, Group Leader, Baker Heart and Diabetes Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why are older people more at risk of coronavirus?



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Hassan Vally, La Trobe University

As we learn more about COVID-19, it’s increasingly clear that your risk of severe illness and death increases with age.

Children under nine years of age seem to be largely unaffected, either with no or mild symptoms. None have died as a result of the infection.

People over the age of 80 years and those with chronic diseases are the most vulnerable. For those over 80, approximately 15% of those infected will die.



The death rate starts to increase for those over 50 years of age. Those under 50 years who are infected have a death rate of 0.2-0.4%, while for those 50-59 years it’s 1.3%.

For those 60-69 years it’s 3.6%, for 70 to 79 year olds it’s 8.0% and for those over 80 years of age it is 14.8%.

A similar picture is emerging when looking at the increased risk of severe illness and death of those with underlying conditions.



The death rate for those with no underlying chronic conditions is approximately 1%.

For those with cardiovascular (heart) disease the death rate is 10.5%, for diabetes it’s 7.3%. Chronic respiratory disease (such as asthma and chronic obstructive pulmonary disease) has a 6.3% death rate, for hypertension (high blood presure) it’s 6.0% and cancer is 5.6%.

Why are older people at greater risk?

The likelihood of having chronic conditions increases markedly as you age. Four in five Australians aged 65 years and over have at least one chronic condition.

But the presence of chronic conditions only partially explains the high death rate in older people.

As we age, our immune system weakens. This makes us more vulnerable to infections of all types. And any sort of challenge to the body can do more damage.

When the immune system gears up in older people, there is also a higher likelihood of a phenomenon called a cytokine storm. This is where the immune system overreacts and produces too many of the chemicals to fight an infection.

So you get a severe inflammatory reaction which has the potential to cause significant damage in the body, including organ failure.




Read more:
How does coronavirus kill?


What about specific chronic diseases?

The biggest risk factor for dying of coronavirus is cardiovascular (heart) disease, with a death rate of 10.5%. But we don’t yet know why.

This doesn’t mean that infection necessarily causes a heart attack, just that people with underlying heart problems are more likely to become seriously ill and die from complications of coronavirus.

The increased risk of severe disease for those with diabetes, such as actor Tom Hanks, may be easier to understand. Diabetes depresses immune function and makes it harder to fight off viral infections.

Elevated glucose (blood sugar) levels in people with diabetes may also provide a more ideal environment for viruses to thrive.

The increased risk of severe disease from COVID-19 in people with chronic respiratory illness such as asthma and lung disease (known as chronic obstructive pulmonary disease, or COPD) is perhaps the clearest, especially if your illness is not well controlled.

Respiratory conditions – such as uncontrolled asthma, which causes causes inflammation of the airways – are likely to be exacerbated by infection with COVID-19, which also targets the airways.

How can you reduce your risk?

If you fall into a vulnerable group, or have close contact with someone who does, be vigilant with hygiene. The government reccomends:

  • sanitising your hands wherever possible, including entering and leaving buildings

  • using “tap and pay” to make purchases rather than handling money

  • travelling at quiet times and trying to avoid crowds

  • asking public transport workers and taxi drivers to open vehicle windows where possible

  • regularly cleaning and disinfecting surfaces that are touched a lot.

You may even want to limit your public transport use and non-essential travel to reduce your chance of coming into contact with the virus.




Read more:
To limit coronavirus risks on public transport, here’s what we can learn from efforts overseas


It’s also reasonable to ask family or friends not to visit you when they’re ill.

Even if you’re young and healthy and not feeling particularly at risk of coronavirus, remember you play an important role in stopping the spread of the virus to those more vulnerable.

What can governments do?

Some government are implementing additional measures to reduce the risk of older people becoming infected.

In the United Kingdom, the government has indicated that in the coming weeks people aged over 70 could be asked to self-isolate, or reduce their social contact, for up to four months.

The UK government has also asked that no one visits aged care facilities unnecessarily, and that people visiting elderly relatives for essential reasons keep their distance.

Some countries are asking families to restrict visits to aged care facilities.
Shutterstock

In the United States, president Donald Trump has urged older Americans to stay home for the next 15 days.

In Australia, the government has recommended limiting visits to residential care facilities and is likely to announce new measures tomorrow.

For now, asking older people in the community to take precautionary measures appears to be sensible advice, rather than imposing rules around self-isolation which come with logistical and social consequences.The Conversation

Hassan Vally, Associate Professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Blast Kills 21 outside Church in Alexandria, Egypt


Bomb explodes as Christians leave New Year’s Eve Mass.

LOS ANGELES, January 3 (CDN) — At least 21 people were killed and scores were wounded on Saturday (Jan. 1) when a bomb outside a church in Alexandria, Egypt exploded as congregants were leaving a New Year’s Eve Mass celebration.

The explosion ripped through the crowd shortly after midnight, killing instantly most of those who died, and leaving the entrance-way to the Church of the Two Saints, a Coptic Orthodox congregation, covered with blood and severed body parts.

The blast overturned at least one car, set several others on fire and shattered windows throughout the block on which the church is located.

Egyptian authorities reportedly said 20 of the victims have been identified. At least 90 other people were injured in the blast, 10 seriously. Among the injured were eight Muslims. Many of the injured received treatment at St. Mark’s Hospital.

Burial services for some of the victims started Sunday (Jan. 2) in Alexandria, located in northern Egypt on the Mediterranean Sea.

Witnesses reportedly said a driver parked a car at the entrance of the church and then ran away seconds before it exploded. Government officials have claimed they found remnants of the bomb, filled with nails and other make-shift shrapnel, at the site; they suspect an unidentified suicide bomber, rather than a car bombing.

No one has claimed responsibility for the bombing, but the attack comes two months after an Islamic group known as the Islamic State of Iraq (ISI) issued a threat stating that, “All Christian centers, organizations and institutions, leaders and followers are legitimate targets for the muhajedeen [Muslim fighters] wherever they can reach them.”

Claiming they would open “rivers of blood” upon Christians, the group specifically threatened Egyptian Christians based an unsubstantiated rumor that two Coptic women, both wives of Orthodox clergy, were being held against their will after converting to Islam. The statement came after ISI claimed responsibility for an attack on a Baghdad church during mass in which 58 people were killed.

The Egyptian government continues to suspect foreign elements mounted the Alexandria attack, but an unconfirmed report by The Associated Press, citing anonymous government sources, said an Egyptian Islamic group is being investigated.

Bishop Mouneer Anis, head of the Episcopal Diocese of Egypt, said in a written statement that he thinks the attack was linked to the Iraqi threats. He added that his church has taken greater security measures at its downtown Cairo location.

“We pray with all the people of Egypt, Christians and Muslims, [that they] would unite against this new wave of religious fanaticism and terrorism,” he said.

For weeks before the ISI issued its threat, Alexandria was the site of massive protests against the Orthodox Church and its spiritual leader, Pope Shenouda III. Immediately after Friday prayers, Muslims would stream out into the streets surrounding mosques, chant slogans against the church and demand the “return” of the two women. Before that, as early as June, clerics from at least one central Alexandria mosque could be heard broadcasting anti-Christian vitriol from minaret loudspeakers during prayers, instructing Muslims to separate themselves entirely from their Christian countrymen.

The Alexandria bombing comes almost a year after a shooting in Nag Hammadi, Egypt left six Christians and one Muslim security guard dead. In the Jan. 6, 2010 attack, a group of men drove by St. John’s Church, 455 kilometers (282 miles) south of Cairo, and sprayed with gunfire a crowd leaving a Coptic Christmas Eve service.

Three men were eventually charged with the shootings, but the case has yet to be resolved.

Egypt wasn’t the only place in the Middle East plagued with anti-Christian violence over the holiday season.

The day before bombers struck the Alexandria church, an elderly Christian couple in Baghdad was killed when terrorists placed a bomb outside of their home, rang the doorbell and walked away, according to media and human rights reports. The bombing happened at the same time other Christian-owned homes and neighborhoods throughout Baghdad were being attacked.

Estimates of the number of people wounded in the attacks in Iraq range from nine to more than 13.

Report from Compass Direct News

Recent Incidents of Persecution


Punjab, India, December 1 (CDN) — Hindu extremists on Nov. 14 beat a Christian in Moti Nagar, Ludhiana, threatening to harm him and his family if they attended Sunday worship. A source told Compass that a Hindu identified only as Munna had argued with a Christian identified only as Bindeshwar, insulting him for being a Christian, and beat him on Nov. 7. Munna then returned with a mob of about 50 Hindu extremists on Nov. 14. Armed with clubs and swords, they dragged Bindeshwar out of his house and severely beat him, claiming that Christians had offered money to Munna to convert. Local Christian leaders reported the matter to the police at Focal Point police station. Officers arrested three Hindu extremists, but under pressure from local Bharatiya Janata Party leaders released them without registering a First Information Report. Police brokered an agreement between the parties on Nov. 18 and vowed they would not allow further attacks on Christians.

Tripura – Hindu extremists attacked a prayer conference on Nov. 6 in Burburi, threatening Christians if they opened their mouths. A local evangelist known only as Hmunsiamliana told Compass that area Christian leaders organized a prayer conference on Nov. 5-7, but extremists ordered the participants not to open their mouth or make any sound. Christian leaders reported the threat to police, and the participants proceeded to pray aloud. On the nights of Nov. 6 and 7, a huge mob of Hindu extremists pelted the Christians with stones, but the participants continued praying. The meeting ended on the evening of Nov. 7 under police protection.

Chhattisgarh – Hindu extremists from the Vishwa Hindu Parishad (VHP or World Hindu Council) disrupted a Christian youth gathering in Raipur on Nov. 6 and accused organizers of forcible conversion. The Evangelical Fellowship of India reported that Vision India had organized the Central India Youth Festival with about 900 in attendance when the extremists stormed in at about 4:30 p.m. and began questioning leaders. The Christian and VHP leaders then held a meeting in the presence of police, with the Christian leaders explaining that it was a normal youth meeting with no forceful conversion taking place. Nevertheless, officers and VHP leaders proceeded to observe the gathering and proceedings, and the Christians were made to submit a list of participants. In this tense atmosphere, the meeting concluded at 10 p.m. under heavy police protection.

Madhya Pradesh – On Oct. 31 in Neemuch, Hindu extremists from the Bajrang Dal barged into a worship meeting shouting Hindu slogans and accused those present of forceful conversion. The Evangelical Fellowship of India (EFI) reported that about 40 extremists rushed into the church building at about 10 a.m. shouting “Jai Shri Ram [Hail Lord Ram].” The Rev. K. Abraham, who was leading the service, pleaded with them to come back later, but the invaders remained and continued shouting. After the service ended, the extremists rushed Abraham and accused the church of paying money to people to convert, as published in newspaper Pupils Samachar. The Christians said the newspaper published the false news because Abraham, principal of United Alpha English School, refused to advertise in it, according to EFI. The extremists grabbed a woman in the congregation who had a bindi (dot) on her forehead, claimed that she had been lured to Christianity and asked her why she was attending the service, according to EFI. “Where were you people when I was demon-possessed?” the woman replied, according to EFI. “You didn’t come to help me, but when I came to the church in God’s presence, these people prayed for me and helped me to get deliverance.”

Karnataka – Police on Oct. 29 detained Christians after Hindu extremists registered a false complaint of forced conversion in Kalammnagar village, Uttara Kannada. The Global Council of Indian Christians (GCIC) reported that at around 8:15 p.m. police accompanied extremists belonging to the Bajrang Dal, who along with members of the media stormed the Blessing Youth Mission Church during a worship service for senior citizens. They dragged out Ayesha Nareth, Hanumanta Unikal,Viru Basha Doddamani, Narayana Unikkal and Pastor Subash Deshrath Nalude, forced them into a police jeep and took them to the Yellapur police station. After interrogation for nearly six hours, the Christians were released without being charged.

Orissa – Hindu extremists refused to allow the burial of a 3-year-old Dalit Christian who died in Jinduguda, Malkangiri. The All India Christian Council (AICC) reported that the daughter of unidentified Christian tribal people fell ill and was taken to a nearby health center on Oct. 27. The doctor advised the parents to take the child to a nearby hospital, and the girl developed complications and died there. When the parents brought the body of the girl back to their village, according to AICC, Hindus refused to allow them to bury her with a Christian ritual. There are only 15 Christian families in the predominantly Hindu village. With the intervention of local Christian leaders, police allowed the burial of the body in a Christian cemetery.

Karnataka – On Oct. 6 in Beridigere, Davanagere, a Christian family that converted from Hinduism was assaulted because of their faith in Christ. The Global Council of Indian Christians (GCIC) reported that the attack appeared to have been orchestrated to appear as if the family provoked it. An elderly woman, Gauri Bai, went to the house of the Christian family and picked a quarrel with them. Bai started shouting and screaming for help, and suddenly about 20 Hindu extremists stormed in and began beating the Christians. They dragged Ramesh Naik out to the street, tied him to a pole, beat him and poured liquor into his mouth and onto his body. His sister, Laititha Naik, managed to escape and called her mother. Later that day, at about 8:30 p.m., the extremists pelted their house with stones, and then about 70 people broke in and began striking them with sickles, stones and clubs. Two brothers, Ramesh Naik and Santhosh Naik, managed to escape with their mother in the darkness, but the Hindu extremists took hold of their sister Lalitha and younger brother Suresh and beat them; they began bleeding and lost consciousness. The attackers continued to vandalize the house, damaging the roof and three doors with large boulders. The unconscious victims received treatment for head injuries and numerous cuts at a government hospital. Police from the Haluvagalu police station arrested 15 persons in connection with the assault.

Report from Compass Direct News

Pakistani Muslims Beat Elderly Christian Couple Unconscious


80-year-old’s bones broken after he refused prostitute that four men offered.

SARGODHA, Pakistan, October 21 (CDN) — An 80-year-old Christian in southern Punjab Province said Muslims beat him and his 75-year-old wife, breaking his arms and legs and her skull, because he refused a prostitute they had offered him.

From his hospital bed in Vehari, Emmanuel Masih told Compass by telephone that two powerful Muslim land owners in the area, brothers Muhammad Malik Jutt and Muhammad Khaliq Jutt, accompanied by two other unidentified men, brought a prostitute to his house on Oct. 8. Targeting him as a Christian on the premise that he would not have the social status to fight back legally, the men ordered him to have sex with the woman at his residence in village 489-EB, he said.

“I turned down the order of the Muslim land owners, which provoked the ire of those four Muslim men,” Masih said in a frail voice. District Headquarters Hospital (DHQ) Vehari officials confirmed that he suffered broken hip, arm and leg bones in the subsequent attack.

His wife, Inayatan Bibi, said she was cleaning the courtyard of her home when she heard the four furious men brutally striking Masih in her house.

“I tried to intervene to stop them and pleaded for mercy, and they also thrashed me with clubs and small pieces of iron rods,” she said by telephone.

The couple was initially rushed to Tehsil Headquarters Hospital Burewala in critical condition, but doctors there turned them away at the behest of the Jutt brothers, according to the couple’s attorney, Rani Berkat. Burewala hospital officials confirmed the denial of medical care.

Taken to the hospital in Vehari, Inayatan Bibi was treated for a fractured skull. The beatings had left both her and her husband unconscious.

Berkat said the Muslim assailants initially intimidated Fateh Shah police into refraining from filing charges against them. After intervention by Berkat and Albert Patras, director of human rights group Social Environment Protection, police reluctantly registered a case against the Jutt brothers and two unidentified accomplices for attempted murder and “assisting to devise a crime.” The First Information Report (FIR) number is 281/10.

Station House Officer Mirza Muhammad Jamil of the Fateh Shah police station declined to speak with Compass about the case. Berkat said Jamil told her that the suspects would be apprehended and that justice would be served.

Berkat added, however, that police appeared to be taking little action on the case, and that therefore she had filed an application in the Vehari District and Sessions Court for a judge to direct Fateh Shah police to add charges of ransacking to the FIR.

Doctors at DHQ Vehari said the couple’s lives were no longer in danger, but that they would be kept under observation.

Report from Compass Direct News

‘Blasphemy Laws’ Used to Jail Elderly Christian in Pakistan


‘Blasphemy Laws’ Used to Jail Elderly Christian in Pakistan

Muslim vying for same piece of land as Christian accuses him of speaking ill of Muhammad.

FAISALABAD, Pakistan, June 29 (CDN) — A Muslim vying with a Christian for a parcel of land here has accused the elderly man of “blaspheming” Islam’s prophet Muhammad, which is punishable by death or life imprisonment, according to the Christian Lawyers’ Foundation (CLF).

Jhumray police on June 19 arrested Rehmat Masih of village No. 165/RB Jandawali in Faisalabad district under Section 295-C of Pakistan’s controversial “blasphemy laws,” and he was sent to Faisalabad District Jail on judicial remand by Magistrate Muhammad Sajawal.

Section 295-C states that “whoever by words, either spoken or written, or by visible representation, or by imputation, innuendo, or insinuation, directly or indirectly, defiles the sacred name of the Holy Prophet Muhammad (PBUH) shall be punishable with death, or imprisonment for life, and shall be liable to fine.”

Christian sources said Masih, who suffers from arthritis, is 85 years old, though the First Information Report against him lists his age as 73.

The CLF’s Rai Navid Zafar Bhatti told Compass that hard-line Muslim Muhammad Sajjid Hameed filed the charges after learning that he would not be able to secure the Punjab Province land.

“He used the weapon of last resort, the controversial Blasphemy Laws’ Section 295-C, which preponderantly unbalances the scales of justice,” Bhatti said.

CLF President Khalid Gill said local Christian residents led by Masih had applied to the Punjab government to secure it for construction of a Christian residential area, and Hameed also had applied for the same parcel for commercial projects.

Hameed has testified in court that Masih made derogatory remarks about Muhammad, the prophet of Islam, and Khadija, the first wife of the founder of the religion, Bhatti said.

Gill said Masih has testified that he said nothing “humiliating” about Muhammad or Khadija.

“I am not a blasphemer, nor I can think of such a sinister thing, which is against the teachings of Christ,” Masih testified, according to Gill.

A CLF fact-finding team found that in April the frail Masih had argued with Hameed and several other Muslim hardliners – Shahbaz Khalid, Afzaal Bashir, Muhammad Aamer, Akber Ali and Asghar Ali – about the Virgin Mary, said Gill.

“At that time the elderly Masih, who at present is languishing in Faisalabad District Jail and facing discriminatory behavior and apathy of Muslim inmates and jail wardens, did not know that this altercation with Muslim men would lead to imprisonment for him,” Gill said.

Three of Hameed’s friends who backed him during the argument, 25-year-old Aamer, 45-year-old Akber Ali and 40-year-old Asghar Ali, have testified in support of Hameed’s accusation, according to Bhatti.

The CLF fact-finding team, led by Babu William Rose, a local Faisalabad Christian representative, found that Masih was also accused because he was a politically active member of the Pakistan Muslim League-Quaid-e-Azam party (PML-Q), while Hameed supports the PML-Nawaz Sharif (PML-N).

Representatives of the National Commission for Justice and Peace also asserted that Masih’s political views played a role in Hameed having him jailed under Pakistan’s blasphemy statues, saying that Hameed was using the power of the PML-N, which rules Punjab province, to implicate Masih in the case.

Gill and Azher Kaleem of the CLF sternly condemned the incarceration of Masih and said that the blasphemy laws must be repealed at once as they are widely used to take vengeance in personal or land disputes.

Section 295-A of the blasphemy laws prohibits injuring or defiling places of worship and “acts intended to outrage religious feelings of any class of citizens.” Section 295-B makes willful desecration of the Quran or a use of its extract in a derogatory manner punishable with life imprisonment.

Masih is the father of seven adult daughters and four grown sons.

Report from Compass Direct News

Egyptian Couple Shot by Muslim Extremists Undaunted in Ministry


Left for dead, Christians offer to drop charges if allowed to construct church building.

CAIRO, Egypt, June 9 (CDN) — Rasha Samir was sure her husband, Ephraim Shehata, was dead.

He was covered with blood, had two bullets inside him and was lying facedown in the dust of a dirt road. Samir was lying on top of him doing her best to shelter him from the onslaught of approaching gunmen.

With arms outstretched, the men surrounded Samir and Shehata and pumped off round after round at the couple. Seconds before, Samir could hear her husband mumbling Bible verses. But one bullet had pierced his neck, and now he wasn’t moving. In a blind terror, Samir tried desperately to stop her panicked breathing and convincingly lie still, hoping the gunmen would go away.

Finally, the gunfire stopped and one of the men spoke. “Let’s go. They’re dead.”

 

‘Break the Hearts’

On the afternoon of Feb. 27, lay pastor Shehata and his wife Samir were ambushed on a desolate street by a group of Islamic gunmen outside the village of Teleda in Upper Egypt.

The attack was meant to “break the hearts of the Christians” in the area, Samir said.

The attackers shot Shehata twice, once in the stomach through the back, and once in the neck. They shot Samir in the arm. Both survived the attack, but Shehata is still in the midst of a difficult recovery. The shooters have since been arrested and are in jail awaiting trial. A trial cannot begin until Shehata has recovered enough to attend court proceedings.

Despite this trauma, being left with debilitating injuries, more than 85,000 Egyptian pounds (US$14,855) in medical bills and possible long-term unemployment, Shehata is willing to drop all criminal charges against his attackers – and avoid what could be a very embarrassing trial for the nation – if the government will stop blocking Shehata from constructing a church building.

Before Shehata was shot, one of the attackers pushed him off his motorcycle and told him he was going to teach him a lesson about “running around” or being an active Christian.

Because of his ministry, the 34-year-old Shehata, a Coptic Orthodox Christian, was arguably the most visible Christian in his community. When he wasn’t working as a lab technician or attending legal classes at a local college, he was going door-to-door among Christians to encourage them in any way he could. He also ran a community center and medical clinic out of a converted two-bedroom apartment. His main goal, he said, was to “help Christians be strong in their faith.”

The center, open now for five years, provided much-needed basic medical services for surrounding residents for free, irrespective of their religion. The center also provided sewing training and a worksite for Christian women so they could gain extra income. Before the center was open in its present location, he ran similar services out of a relative’s apartment.

“We teach them something that can help them with the future, and when they get married they can have some way to work and it will help them get money for their families,” Shehata said.

Additionally, the center was used to teach hygiene and sanitation basics to area residents, a vital service to a community that uses well water that is often polluted or full of diseases. Along with these services, Shehata and his wife ran several development projects, repairing the roofs of shelters for poor people, installing plumbing, toilets and electrical systems. The center also distributed free food to the elderly and the infirm.

The center has been run by donations and nominal fees used to pay the rent for the apartment. Shehata has continued to run the programs as aggressively as he can, but he said that even before the shooting that the center was barely scraping by.

“We have no money to build or improve anything,” he said. “We have a safe, but no money to put in it.”

 

Tense Atmosphere

In the weeks before the shooting, Teleda and the surrounding villages were gripped with fear.

Christians in the community had been receiving death threats by phone after a Muslim man died during an attack on a Christian couple. On Feb. 2, a group of men in nearby Samalout tried to abduct a Coptic woman from a three-wheeled motorcycle her husband was driving. The husband, Zarif Elia, punched one of the attackers in the nose. The Muslim, Basem Abul-Eid, dropped dead on the spot.

Elia was arrested and charged with murder. An autopsy later revealed that the man died of a heart attack, but local Muslims were incensed.

Already in the spotlight for his ministry activities, Shehata heightened his profile when he warned government officials that Christians were going to be attacked, as they had been in Farshout and Nag Hammadi the previous month. He also gave an interview to a human rights activist that was posted on numerous Coptic websites. Because of this, government troops were deployed to the town, and extremists were unable to take revenge on local Christians – but only after almost the
entire Christian community was placed under house arrest.

“They chose me,” Shehata said, “Because they thought I was the one serving everybody, and I was the one who wrote the government telling them that Muslims were going to set fire to the Christian houses because of the death.”

Because of his busy schedule, Shehata and Samir, 27, were only able to spend Fridays and part of every Saturday together in a village in Samalut, where Shehata lives. Every Saturday after seeing Samir, Shehata would drive her back through Teleda to the village where she lives, close to her family. Samalut is a town approximately 105 kilometers (65 miles) south of Cairo.

On the afternoon of Feb. 27, Shehata and his wife were on a motorcycle on a desolate stretch of hard-packed dirt road. Other than a few scattered farming structures, there was nothing near the road but the Nile River on one side, and open fields dotted with palm trees on the other.

Shehata approached a torn-up section of the road and slowed down. A man walked up to the vehicle carrying a big wooden stick and forced him to stop. Shehata asked the man what was wrong, but he only pushed Shehata off the motorcycle and told him, “I’m going to stop you from running around,” Samir recounted.

Shehata asked the man to let Samir go. “Whatever you are going to do, do it to me,” he told the man.

The man didn’t listen and began hitting Shehata on the leg with the stick. As Shehata stumbled, Samir screamed for the man to leave them alone. The man lifted the stick again, clubbed Shehata once more on the leg and knocked him to the ground. As Shehata struggled to get up, the man took out a pistol, leveled it at Shehata’s back and squeezed the trigger.

Samir started praying and screaming Jesus’ name. The man turned toward her, raised the pistol once more, squeezed off another round, and shot Samir in the arm. Samir looked around and saw a few men running toward her, but her heart sank when she realized they had come not to help them but to join the assault.

Samir jumped on top of Shehata, rolled on to her back and started begging her attackers for their lives, but the men, now four in all, kept firing. Bullets were flying everywhere.

“I was scared. I thought I was going to die and that the angels were going to come and get our spirits,” Samir said. “I started praying, ‘Please God, forgive me, I’m a sinner and I am going to die.’”

Samir decided to play dead. She leaned back toward her husband, closed her eyes, went limp and tried to stop breathing. She said she felt that Shehata was dying underneath her.

“I could hear him saying some of the Scriptures, the one about the righteous thief [saying] ‘Remember me when you enter Paradise,’” she said. “Then a bullet went through his neck, and he stopped saying anything.”

Samir has no way of knowing how much time passed, but eventually the firing stopped. After she heard one of the shooters say, “Let’s go, they’re dead,” moments later she opened her eyes and the men were gone. When she lifted her head, she heard her husband moan.

 

Unlikely Survival

When Shehata arrived at the hospital, his doctors didn’t think he would survive. He had lost a tremendous amount of blood, a bullet had split his kidney in two, and the other bullet was lodged in his neck, leaving him partially paralyzed.

His heartbeat was so faint it couldn’t be detected. He was also riddled with a seemingly limitless supply of bullet fragments throughout his body.

Samir, though seriously injured, had fared much better than Shehata. The bullet went into her arm but otherwise left her uninjured. When she was shot, Samir was wearing a maternity coat. She wasn’t pregnant, but the couple had bought the coat in hopes she soon would be. Samir said she thinks the gunman who shot her thought he had hit her body, instead of just her arm.

The church leadership in Samalut was quickly informed about the shooting and summoned the best doctors they could, who quickly traveled to help Shehata and Samir. By chance, the hospital had a large supply of blood matching Shehata’s blood type because of an elective surgical procedure that was cancelled. The bullets were removed, and his kidney was repaired. The doctors however, were forced to leave many of the bullet fragments in Shehata’s body.

As difficult as it was to piece Shehata’s broken body back together, it paled in comparison with the recovery he had to suffer through. He endured multiple surgeries and was near death several times during his 70 days of hospitalization.

Early on, Shehata was struck with a massive infection. Also, because part of his internal tissue was cut off from its blood supply, it literally started to rot inside him. He began to swell and was in agony.

“I was screaming, and they brought the doctors,” Shehata said. The doctors decided to operate immediately.

When a surgeon removed one of the clamps holding Shehata’s abdomen together, the intense pressure popped off most of the other clamps. Surgeons removed some stomach tissue, part of his colon and more than a liter of infectious liquid.

Shehata could not eat normally and lost 35 kilograms (approximately 77 lbs.). He also couldn’t evacuate his bowels for at least 11 days, his wife said.

Despite the doctors’ best efforts, infections continued to rage through Shehata’s body, accompanied by alarming spikes in body temperature.

Eventually, doctors sent him to a hospital in Cairo, where he spent a week under treatment. A doctor there prescribed a different regimen of antibiotics that successfully fought the infection and returned Shehata’s body temperature to normal.

Shehata is recovering at home now, but he still has a host of medical problems. He has to take a massive amount of painkillers and is essentially bedridden. He cannot walk without assistance, is unable to move the fingers on his left hand and cannot eat solid food. In approximately two months he will undergo yet another surgery that, if all goes well, will allow him to use the bathroom normally.

“Even now I can’t walk properly, and I can’t lift my leg more than 10 or 20 centimeters. I need someone to help me just to pull up my underwear,” Shehata said. “I can move my arm, but I can’t move my fingers.”

Samir does not complain about her condition or that of Shehata. Instead, she sees the fact that she and her husband are even alive as a testament to God’s faithfulness. She said she thinks God allowed them to be struck with the bullets that injured them but pushed away the bullets that would have killed them.

“There were lots of bullets being shot, but they didn’t hit us, only three or four,” she said. “Where are the others?”

Even in the brutal process of recovery, Samir found cause for thanks. In the beginning, Shehata couldn’t move his left arm, but now he can. “Thank God and thank Jesus, it was His blessing to us,” Samir said. “We were kind of dead, now we are alive."

Still, Samir admits that sometimes her faith waivers. She is facing the possibility that Shehata might not work for some time, if ever. The couple owes the 85,000 Egyptian pounds (US$14,855) in medical bills, and continuing their ministry at the center and in the surrounding villages will be difficult at best.

“I am scared now, more so than during the shooting,” she said. “Ephraim said do not be afraid, it is supposed to make us stronger.”

So Samir prays for strength for her husband to heal and for patience. In the meantime, she said she looks forward to the day when the struggles from the shooting are over and she can look back and see how God used it to shape them.

“There is a great work the Lord is doing in our lives, we may not know what the reason is now, but maybe some day we will,” Samir said.

 

Government Opposition

For the past 10 years, Shehata has tried to erect a church building, or at a minimum a house, that he could use as a dedicated community center. But local Muslims and Egypt’s State Security Investigations (SSI) agency have blocked him every step of the way. He had, until the shooting happened, all but given up on constructing the church building.

On numerous occasions, Shehata has been stopped from holding group prayer meetings after people complained to the SSI. In one incident, a man paid by a land owner to watch a piece of property near the community center complained to the SSI that Shehata was holding prayer meetings at the facility. The SSI made Shehata sign papers stating he wouldn’t hold prayer meetings at the center.

At one time, Shehata had hoped to build a house to use as a community center on property that had been given to him for that purpose. Residents spread a rumor that he was actually erecting a church building, and police massed at the property to prevent him from doing any construction.

There is no church in the town where Shehata lives or in the surrounding villages. Shehata admits he would like to put up a church building on the donated property but says it is impossible, so he doesn’t even try.

In Egypt constructing or even repairing a church building can only be done after a complex government approval process. In effect, it makes it impossible to build a place for Christian worship. By comparison, the construction of mosques is encouraged through a system of subsidies.

“It is not allowed to build a church in Egypt,” Shehata said. “We can’t build a house. We can’t build a community center. And we can’t build a church.”

Because of this, Shehata and his wife organize transportation from surrounding villages to St. Mark’s Cathedral in Samalut for Friday services and sacraments. Because of the lack of transportation options, the congregants are forced to ride in a dozen open-top cattle cars.

“We take them not in proper cars or micro-buses, but trucks – the same trucks we use to move animals,” he said.

The trip is dangerous. A year ago a man fell out of one of the trucks onto the road and died. Shehata said bluntly that Christians are dying in Egypt because the government won’t allow them to construct church buildings.

“I feel upset about the man who died on the way going to church,” he said.

 

Church-for-Charges Swap

The shooters who attacked Shehata and Samir are in jail awaiting trial. The couple has identified each of the men, but even if they hadn’t, finding them for arrest was not a difficult task. The village the attackers came from erupted in celebration when they heard the pastor and his wife were dead.

Shehata now sees the shooting as a horrible incident that can be turned to the good of the believers he serves. He said he finds it particularly frustrating that numerous mosques have sprouted up in his community and surrounding areas during the 10 years he has been prevented from putting up a church building, or even a house. There are two mosques alone on the street of the man who died while being trucked to church services, he said.

Shehata has decided to forgo justice in pursuit of an opportunity to finally construct a church building. He has approached the SSI through church leaders, saying that if he is allowed to construct a church building, then he will take no part in the criminal prosecution of the shooters.

“I have told the security forces through the priests that I will drop the case if they can let us build the church on the piece of land,” he said.

The proposal isn’t without possibilities. His trial has the potential of being internationally embarrassing. It raises questions about fairness in Egyptian society during an upcoming presidential election that will be watched by the world.

Regardless of what happens, Shehata said all he wants is peace and for the rights of Christians to be respected. He said that in Egypt, Christians have less value than the “birds of the air” mentioned in the Bible. According to Luke 12:6, five sparrows sold for two pennies in ancient times.

“We are not to be killed like birds, slaughtered,” he said. “We are human.”

Report from Compass Direct News