Hospital emergency departments are under intense pressure. What to know before you go


David Caldicott, Australian National UniversityEmergency departments around Australia have experienced COVID in a variety of ways.

From the first quarter of 2020, most if not all have worked hard to plan for an influx of very unwell, highly infectious patients. In the less fortunate of jurisdictions, those apprehensions are being realised — though thankfully not yet to the magnitude seen in some overseas cities.

Hospital emergency departments (EDs) are under intense pressure and there have been calls for the public to carefully weigh up need before presenting there. Don’t come if you don’t need to, they’ve been told. But equally, don’t wait if you need treatment, especially for COVID.

Less staff, more pressure

For all hospitals, COVID planning has involved creating streams of patient flow, to ensure those infected can be treated in addition to and at the same time as those who are not — while preventing the former infecting the latter. This is labour-intensive work, often duplicating patient pathways but without a doubling of staff.

In fact, staff numbers in many EDs are down in Australia, for a variety of reasons. Many smaller rural departments rely on fly-in-fly-out locums, now locked out by lockdowns. At times, doctors and nurses have been furloughed because they have been infected at work or elsewhere, or because they have been close contacts.

Understaffed EDs push on, with the greater burden being carried by fewer health workers, resulting in their subsequent burnout. To that, add the task of working in full personal protective equipment, often for many hours at a time. It is physically demanding, uncomfortable, unpleasant work, in an environment in which both high levels of vigilance to keep staff safe and cognitive skills to manage often complex and rapidly deteriorating patients are required.




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Not just COVID patients

Much of the focus in the media on health care in a time of pandemic has understandably been on COVID hospitalisations and subsequent intensive care unit admissions. Less has been said about the impact of COVID on the treatment of other illnesses or injuries.

We are very fortunate in Australia there is still more of “the other” in our EDs than there is COVID. That might change in the run up to Christmas.

The ED is most obviously a place of treatment for acute injuries and illnesses. In addition to that, we treat people with chronic illnesses. The ED can act as a safety net for those who have no one else to turn to and reassure many without affliction. For patients in each of these categories, the experience of ED has changed significantly.

There are great concerns many of those who need immediate medical care are deferring seeking it. They may fear catching COVID or being a burden on a strained system. Many in the latter category are elderly patients and those with probably the most reasonable indications for using our services.




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Here’s what happens when you’re hospitalised with COVID


First off, it’s your emergency

So how should we, as a resource-constrained civil society, in the middle of a pandemic, use our EDs?

The first and overriding principle is that any medical emergency is YOUR emergency. If you think you are experiencing a medical emergency — one you cannot see yourself addressing with the resources available to you, at the time you are experiencing it — you should come to ED. It doesn’t matter if it seems trivial to others, it’s your emergency. And we are your emergency department.

If you don’t feel too unwell, and are uncertain where you should go for medical care, there are alternatives to the ED where excellent medical advice and treatment can be found.

Telehealth has been a godsend to both patients and our GP colleagues. There are now also numerous health lines to call. Pharmacists can provide excellent information about medication, as well as now providing COVID vaccinations.

The ED is not the best place to go to have a COVID test. If you are otherwise well, there are many testing locations where you will wait a far shorter time for a test and the results.

Similarly, many concerns about the very rare side effects of COVID vaccination can be addressed with a telehealth consultation and a blood test if required.




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Extra precautions, longer waits

If you do come to the ED, try and be patient. There are extra measures in place to keep you safe.

You’ll need to wear a mask and check in with a QR code, use hand sanitiser and physically distance. There are increasingly strict rules about the numbers of visitors.

If that’s a problem, you’re probably going to be asked to leave. It’s nothing personal — we have a duty of responsibility to all our patients.

You might wait longer than expected despite the efforts of medical staff to see everyone as quickly as possible.




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EDs treat all comers

Finally, if you’re worried about the consequences of catching COVID, get vaccinated. We treat all comers, with a variety of beliefs about their medical care — all as long as they agree to abide by the rules of “The House”: to be respectful and abide by hospital procedures.

But vaccination will reduce your chance of needing ED attention as a consequence of COVID — and protect you from catching it if you come to ED for another reason.

Working in the ED at the moment isn’t much fun for anyone. We’re all really tired and, for many, that’s even before the ED where we work has become COVID-dominant. We’re looking forward to moving out of this phase of the pandemic, safely. Then we can get back to treating the mishaps of more normal human lifestyles, led to the fullest.




Read more:
How well do COVID vaccines work in the real world?


The Conversation


David Caldicott, Senior lecturer, Australian National University

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

Syria: Intense Fighting Throughout the Country


Family of 17-Year-Old Somali Girl Abuses Her for Leaving Islam


Young Christian beaten, shackled to tree.

NAIROBI, Kenya, June 15 (CDN) — The Muslim parents of a 17-year-old Somali girl who converted to Christianity severely beat her for leaving Islam and have regularly shackled her to a tree at their home for more than a month, Christian sources said.

Nurta Mohamed Farah of Bardher, Gedo Region in southern Somalia, has been confined to her home since May 10, when her family found out that she had embraced Christianity, said a Christian leader who visited the area.

“When the woman’s family found out that she converted to Christianity, she was beaten badly but insisted on her new-found religion,” said the source on condition of anonymity.

Her parents also took her to a doctor who prescribed medication for a “mental illness,” he said. Alarmed by her determination to keep her faith, her father, Hassan Kafi Ilmi, and mother, Hawo Godane Haf, decided she had gone crazy and forced her to take the prescribed medication, but it had no effect in swaying her from her faith, the source said.

Traditionally, he added, many Somalis believe the Quran cures the sick, especially the mentally ill, so the Islamic scripture is continually recited to her twice a week.

“The girl is very sick and undergoing intense suffering,” he said.

Her suffering began after she declined her family’s offer of forgiveness in exchange for renouncing Christianity, the source said. The confinement began after the medication and punishments failed.

The tiny, shaken Christian community in Gedo Region reports that the girl is shackled to a tree by day and is put in a small, dark room at night, he said.

“There is little the community can do about her condition, which is very bad, but I have advised our community leader to keep monitoring her condition but not to meddle for their own safety,” the source told Compass. “We need prayers and human advocacy for such inhuman acts, and for freedom of religion for the Somali people.”

Somalia’s Transitional Federal Government generally did not enforce protection of religious freedom found in the Transitional Federal Charter, according to the U.S. Department of State’s 2009 International Religious Freedom Report.

“Non-Muslims who practiced their religion openly faced occasional societal harassment,” the report stated. “Conversion from Islam to another religion was considered socially unacceptable. Those suspected of conversion faced harassment or even death from members of their community.”

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

Two Iranian Christian Women Acquitted of all Charges


Young converts previously held in prison for Christian activities have fled country.

ISTANBUL, May 27 (CDN) — Nearly five months after releasing them from prison, an Iranian court has acquitted two women of all charges related to being Christians and engaging in Christian activities.

Iranians Maryam Rostampour and Marzieh Amirizadeh Esmaeilabad were arrested on March 5, 2009 and detained on charges of “acting against state security,” “taking part in illegal gatherings” and “apostasy” (leaving Islam) under Iran’s Revolutionary Court system.

After nearly eight months, on Nov. 18, 2009 authorities released them conditionally.

Although the court hearing their case originally set April 13 as their trial date, Compass was unable to confirm on what date the two women were acquitted, nor the conditions of their acquittal.

Senior Iranian judges and officials repeatedly intimidated the two women and pressured them to recant their faith, according to a press statement by Elam Ministries last week.

“They were warned that any future Christian activity in Iran will be seriously dealt with,” according to the statement.

Elam Ministries said the two women had fled Iran on Saturday (May 22) to an undisclosed location and were recovering.

Another Iranian convert who was forced to flee his country under similar circumstances years ago told Compass that he believed the intense lobbying efforts to release and acquit the women brought the government to an unspoken “standoff” with Christian rights groups outside the country.

“I think the court just made a political decision, ‘We will let you go, but we will not allow you to stay in the country,’” said the Iranian Christian, who requested anonymity. “That’s a pretty old-fashioned procedure they have – ‘We will let you go if you leave the country. You can have your faith, but not here.’”

In general, when Iranian authorities arrest Christians, they release them on bail within a few weeks and keep their case files open, thus applying soft pressure while allowing them to continue living in Iran. In cases where the government wants to remove Christians from the country because of their Christian activities, authorities have handed the Christians their passports and documents and told them to leave.

Iran’s government views all Christian activities as foreign intervention and thus a threat to national security. The two women’s families had hired a private lawyer.

Since their release, the young converts to Christianity had been waiting for a trial date and decision from an Iranian court to decide their fate as Christians living their faith. During this time, sources said that authorities watched them closely and that the two women were under “pressure” and received threatening phone calls.

“The government would not want them to stay in the country as heroes,” said the Iranian Christian. “It would be better for the government if they left Iran and didn’t become a positive example for the rest of the Christian community in Iran. Otherwise they would create a precedent of [Christians] who have not denied their faith, who have been acquitted and still live as Christians inside the country.”

The two women thanked Christians who have been praying for them, according to Elam.

“We hope to eventually share some of what the Lord allowed us to go through to highlight the need and the opportunity for the church in Iran, but right now we will take time to pray and seek the Lord for His will,” said Rostampour, according to Elam’s press statement.

Iran’s Constitution gives Christians “protected” religious minority status, but in practice they face substantial societal discrimination, according to the U.S. Department of State’s International Religious Freedom Report 2009.

An article mandating death for apostates in accordance with sharia (Islamic law) reportedly has been stricken from a draft penal code, but experts on Iran say The Council of Guardians and Iran’s Supreme Leader still have the final say on who receives capital punishment for leaving Islam.

Report from Compass Direct News

Egyptian Convert from Islam Devastated by ‘Delay Tactic’


Court suspends Mohammed Hegazy’s lawsuit pending outcome of separate case.

CAIRO, Egypt, May 17 (CDN) — An Egyptian convert to Christianity said he is devastated by a recent court decision to suspend a lawsuit he filed to change the religion on his identification card from Muslim to Christian.

The First District of the Court of the State Council on April 27 suspended Mohammed Ahmed Hegazy’s case until the Constitutional Court rules on a challenge to Article 47, a section of the civil code that in theory allows Egyptians to change the religion listed on their ID card.

Hegazy, 27, said the suspension endangers his children’s welfare and will force them to lead a double life indefinitely – at home they will be taught to live in accordance with the Bible, and outside it they will be taught to live according to the Quran.

If they ultimately decide to follow Jesus, Hegazy said, his children will be declared “apostates” and be persecuted the rest of their lives for “leaving Islam.” Hegazy, who has suffered severely after Egypt’s religious authorities declared him an apostate, including being imprisoned by State Security Investigations (SSI) several times, said he filed the case so his children would avoid the same fate.

“I didn’t want them to have to go through the same harassment and persecution that I went through,” he said. “My daughter won’t be able to go to school without constantly fearing for her safety. She might even be killed simply because she is my daughter.”

Hegazy is arguably the most well-known Muslim convert to Christianity in Egypt. He rose to national prominence in August 2007 when he became the first Muslim convert in Egypt to sue for the right to change the religious status on his identification card to “Christian.”

Hegazy said he became a Christian in 1998 after seeking God during a period of intense study of religion. In his final assessment, he said, he found that Islam was void of the love and forgiveness found in Christianity.

Not long after his conversion, Hegazy said, he was arrested by SSI agents who tortured him for three days. In 2001, the SSI arrested Hegazy for writing a book of poems critical of the agency, which has been accused of abusive practices to preserve the regime. In 2002, the SSI arrested Hegazy and held him for more than two months in a prison he compared to a “concentration camp.”

In addition to the government response to his conversion, Hegazy said his mother and father have attacked him repeatedly for becoming a Christian.

“In the culture in Egypt, for a person to change his religion, it’s a big deal because it’s a question of honor and tradition,” Hegazy said. “My dad and my mom took it in a really bad way and would beat me.”

Hegazy married another convert from Islam, Katarina, in 2005. Katarina also wants her ID changed but fears government reaction; there are numerous reports circulating among Egyptian Christians about female converts being arrested and tortured by the SSI or simply disappearing in Egypt’s prison system under Egypt’s Emergency Law. Renewed last week for another two years, the law grants the government broad powers of arbitrary incarceration that human rights groups have roundly criticized.

Delay Tactic

When Hegazy filed his suit in 2007, he and his wife were expecting their first child. Overnight, Egyptian media propelled him into the national limelight. And the persecution got much worse.

Two religious scholars from Al-Azhar University, one of the leading voices of Islamic thought in the Middle East, publicly declared it was legal to kill Muslims that convert to Christianity. In one incident, extremists surrounded a home where Hegazy had once lived and stayed there for several days. In another incident, a group of men ransacked and set fire to Hegazy’s apartment while he was away.

Throughout his legal proceedings, several of Hegazy’s attorney’s have dropped out of the case after receiving death threats, being sued or being arrested. On Jan. 28, 2009, a court ruled that Muslims were forbidden to convert to another religion and ordered Hegazy to pay the costs of hearing his case. He appealed.

Hegazy lives in hiding. Unable to work, the former journalist is supported by friends and other Christians. Last month’s ruling will likely delay a decision in Hegazy’s case for several years and keep him and his family in limbo.

“The court is using this decision as a way of delaying having to make an ultimate decision,” Hegazy said.

The couple’s first child, Mariam, is now 2 years old, and their second child, Yousef, is 3 months old. Because Hegazy and his wife are unable to change their ID to reflect their true faith, the government lists both of their children as Muslims. If they choose to become Christians, they will be considered apostates who, in accordance with longstanding interpretation of the guiding scriptures of Islam, must be killed by faithful Muslims.

“It makes me feel like religion in Egypt isn’t something you can choose by your own free will; it’s something that you are forced to be, and nobody has a choice to choose what their religion is,” Hegazy said. “It bothers me a lot because my kids know they are being brought up as Christians in their home and their parents are Christians, but they can’t practice their religion outside the house.”

Inconsistent Rules

Every Egyptian citizen age 16 or older must carry a state-issued ID card that is required for opening a bank account, enrolling children in school and for starting a business, among other activities. Religious identity also determines to which civil or family court one is subject.

Of primary importance to Hegazy is that the religion indicated on the ID card determines what religious education classes a child is required to take in school.

There is a stark contrast in Egypt between the treatment of Christians who want to change the religious affiliation on their ID card to Islam and Muslims who want to change their affiliation to Christianity. Generally speaking, because Muslims consider the preaching of Muhammad to be the last of three revelations from God to man, in practice “freedom of religion” in Egypt means only the freedom to convert to Islam.

Article 47 of Egypt’s constitution guarantees freedom of religion, but the constitution also states that Islam is the official religion of Egypt. Article 2 of the constitution states that Islamic law, or sharia, is “the principle source of legislation” in Egypt.

The difference between the treatment of converts to Christianity and converts to Islam is illustrated in the case of Samy Aziz Fahmy. The week before the court postponed Hegazy’s case, Fahmy, a Coptic Christian from Saayda village, changed his legal status to Islam. He received his ID card reflecting his new religion on the same day he applied for it – on the day he turned 18, the legal age for conversion.

“I think it’s very weird and not fair that when Christians want to convert to Islam there’s no problem, their papers go through and there’s no discrimination against them,” Hegazy said. “But when Muslims want to convert to Christianity, all of the sudden it’s a big deal.”

Hegazy is not alone in his legal battles. After he filed his case, other Muslim converts sought court action to change their IDs. Like Hegazy, most are in hiding of some sort. Hegazy’s lead attorney, Ashraf Edward, said he is working on several ID cases. He estimates there are more than 4 million converts to Christianity who want to change the religion listed on their ID, though the basis for that figure is unclear.

“There are a lot of people who want to change their ID, but they’re afraid of turning it into a court case because they don’t want to be persecuted,” Edward said.

International Condemnation

Human rights groups and government agencies around the world have condemned Egypt for its record on religious freedom. In a report issued earlier this month, the United States Commission on International Religious Freedom outlined Egypt’s problems with identification cards and the treatment of converts from Islam, taking note of Hegazy’s case.

“The Egyptian government generally does not recognize conversions of Muslims to other religions,” the report states. “Egyptian courts also have refused to allow Muslims who convert to Christianity to change their identity cards to reflect their conversions. In the first such case, brought by Muhammad Hegazy, a lower court ruled in January 2008 that Muslims are forbidden from converting away from Islam based on principles of Islamic law. The court also stated that such conversion would constitute a disparagement of the official state religion and an enticement for other Muslims to convert. Hegazy, who has been subjected to death threats and is currently in hiding, has appealed the ruling.”

The report cited numerous other problem areas in regard to freedom of worship in Egypt, and the country remained on USCIRF’s Watch List for 2010. Egypt has been on the list since 2002. Among the changes USCIRF said are necessary in Egypt is how religion is reported on Egypt’s national ID card.

The commission said Egypt must “ensure that every Egyptian is protected against discrimination in social, labor, and other rights by modifying the national identity card, either to omit mention of religious affiliation or make optional any mention of religious affiliation.”

Report from Compass Direct News 

Pakistani Muslims Accused of Rape Allegedly Attack Sisters


Fearing conviction, five suspects said to beat 15- and 21-year-old into dropping charges.

LAHORE, Pakistan, March 18 (CDN) — Five Muslims allegedly ransacked the house of an impoverished Christian in this capital city of Punjab Province last month and angrily beat his daughters in an effort to get the family to withdraw rape charges.

Muhammad Sajjid wielding a pistol, Muhammad Sharif brandishing a dagger and Muhammad Wajjad and two unidentified accomplices carrying bamboo clubs arrived at the Lahore home of Piyara Masih the afternoon of Feb. 26, Christian leaders said. The Muslims allegedly ransacked the house and began thrashing his two daughters, a 15-year-old and her 21-year-old sister, Muniran Bibi, according to attorney Azra Shujaat, head of Global Evangelical Ministries, and Khalid Gill, president of the Christian Liberation Front (CLF).

Muniran said Sharif stabbed her four times with the dagger.

“They ripped apart my clothes, as well as my sister’s,” she said. “In the meantime, Muhammad Sajjid kept firing into the air to terrorize us.”  

The family accuses the men of raping her then-13-year-old sister in 2008. Their frail father said that the gang leader, Sajjid, commanded his accomplices to abduct both Muniran and her sister in the most recent attack, without success. A neighbor who requested anonymity said that a large number of people gathered in front of the house upon hearing the cries of the Christian family, causing the five Muslims to flee.

The alleged attacks on the family were predicated in part on the assumption that, as Christians, they will get little help from a justice system biased against non-Muslims and easily swayed by threats, bribes or other means of persuasion from Muslims, Christian leaders said. When the family approached Nishtar Colony police for help, officers refused to register a case.

Attorney Shujaat said that in refusing to file assault charges, police bowed to the power of wealthy area Muslims. Shujaat, who is providing pro-bono counsel for the family, said he registered a First Information Report (FIR) at the Lahore High Court, accusing the men of ransacking the house and illegal weapons. Only after the high court order for police to file an FIR and strenuous efforts by him, Christian politicians and clergymen did the Nishtar Colony police register one against the Muslim gang.

Police did not register the FIR until March 2, he said, on orders of Additional Sessions Judge Justice Mahr Muhammad Yousaf.

The Christian family said they were still receiving death threats.

Gill, who besides being president of CLF is head of the All Pakistan Minorities Alliance, said the alleged rape took place on Easter Sunday, April 8, 2007, when Sajjid, Sharif, Wajjad and an unknown accomplice attacked the family.

“The chastity of [name withheld], who was 13 years old then and youngest among her sisters, was ruined by all four Muslim gang members, and later they abducted her and kept her at an undisclosed locality,” Gill said.

Police later recovered her, and a medical examination proved that she had been repeatedly sexually abused, Gill added.

Shujaat said the four men were being prosecuted for rape and abduction of the girl in District and Sessions Court. Sources told Compass that the alleged rapists were granted bail and secured liberty soon after their apprehension.

Shujaat said evidence at their trial showed they were responsible for the rape, and that a conviction was imminent.

Ferhan Mazher, head of Christian rights group Rays of Development Organization, said the only way for the “perverse Muslim criminals” to do away with the court’s judgment was to convince the Christian family, through threats and violence, to drop the charges.

“Therefore the Muslim men invaded the house of the Christian family to exert intense pressure on them to quash the case,” Mazher said.

Report from Compass Direct News 

Muslim Mob in Pakistan Wounds Christian Family


Assailants threaten to charge mentally ill son with ‘blasphemy’ if victims pursue justice.

ISLAMABAD, Pakistan, January 4 (CDN) — Infuriated by an alleged anti-Islamic comment by a mentally ill man, more than a dozen Muslims attacked his Christian family here last week, beating his 20-year-old sister unconscious and breaking her leg.

The woman’s father, Aleem Mansoor, said his daughter Elishba Aleem went unconscious after being struck in the head with an iron rod in the Dec. 28 attack. Mansoor said a Muslim known as Mogal beat him and his daughter with the rod on the street in front of their apartment home after falsely accusing his 32-year old son, who suffers from schizophrenia, of blasphemy.

“Elishba shouted, ‘Father look! He is going to hit you,’ and she came somewhat in front and the rod hit her head,” Mansoor told Compass. “She touched her head, and her hand was covered with blood.”

After she fell unconscious, the assailants began striking her on her legs and back, Mansoor said.

“As soon as the mob realized that Elishba was totally unconscious, they shouted that the girl was dead and fled from the scene,” he said.

Elishba Aleem had rushed down from the family’s third-floor apartment in Iqbal Town, Islamabad and was attacked when she pleaded for the mob to stop beating her father, who received five stitches for a hand wound. With iron rods and cricket bats, the mob also injured Mansoor’s wife Aqsa and his sister-in-law Aileen George. Another of Mansoor’s sons, 24-year-old Shazir Aleem, saw the assault from the apartment and also was beaten when he hurried down.

“When Shazir’s wife Sanna saw that her husband was being beaten, she rushed down with [infant daughter] Hanna in her arms and pleaded with them, ‘Why are you beating my husband?’” Mansoor said. “Someone in the mob snatched Hanna from Sanna and threw her on the ground, and then those beasts began beating Sanna as well.”

The baby girl escaped serious injury.

Initially the assailants had attacked Mansoor as he tried to leave home with his son Shumail Aleem, whom he intended to take to police to clear up accusations by shopkeeper Muhammad Naveed that he had spoken ill of Islam.

As Mansoor reached his car, however, about a dozen men with cricket bats and metal rods got out of a parked Suzuki van and surrounded them, he said, and within 10 minutes more than 100 angry Muslims had joined Naveed, his other brothers and his father, Mogal.

“Naveed shouted, ‘Why are you people looking at these choohras [derogatory term for Christians]? Catch them and kill them,’” Mansoor said. “My wife Aqsa and sister-in-law Aileen George threw their doppatas [Indian head coverings] at Naveed’s and others’ feet to humbly request that they not attack us, but they refused to listen. They began beating all of us with rods and cricket bats.”

Area Muslims resent that the family has a car and is well-off, Mansoor said.

“They say Christians should be suppressed and kept under a tight control,” he said. “They think Christians should salute them when they pass by them.”

His son Shumail has been under medical treatment for schizophrenia for more than five years, he said, and because of his condition he does not work.

“As long as Shumail takes medicine, there is no one nicer than him on the earth, but if he is not taking the medicine then he is the worst creature,” Mansoor said.

Mansoor’s daughter, a first-year college student, received treatment at the Pakistan Institute of Medical Sciences (PIMS) and eventually regained consciousness, though she remains in intense pain. Mansoor said members of the Muslim mob ensured that she did not receive a medical-legal certificate documenting her condition. 

When Mansoor told Naveed and others that he would take them to court over the attack, his Muslim adversaries said he would fail because they had paid PIMS officials 50,000 rupees (US$600) to withhold the medical report on his daughter’s injuries. He said they also told him that they had paid off officers at the Shehzad Town Police Station to pressure the family to drop the case with an out-of-court settlement.

“The assistant sub-inspector, Ghulam Gilani, of Shehzad Town Police Station, called my wife and told her that if the family pursued the case of assault on us, then we would be implicated in the blasphemy case, which would have serious consequences for us,” Mansoor said.

Gilani and hospital officials were not immediately available for comment.

‘Blasphemy’ Accusation

The comment said to have triggered the violence was uttered at a nearby general store, where Shumail Aleem had gone to buy cigarettes at about 8:30 p.m. on Dec. 28.

Dec. 28 was Islam’s 10th of Muharram, or Yom-e-Ashura, when Shiite Muslims mourn the death of Hussein ibn Ali, grandson of the Islamic Prophet Muhammad. Pakistan’s population is made up primarily of Sunni Muslims, who also honor the day on the claim that Moses fasted on that day to express gratitude to God for freeing the Israelites from Egypt.

At the store an elderly Christian man known as Baba Sadiq asked Shumail Aleem why movie channels were not being shown on the store’s cable-fed TV.

“Shumail told him, ‘Are Muslims out of their minds? Why would they show movie channels on Ashura?’” Mansoor said.

The comment apparently supported Naveed’s decision to refrain from showing films on the Muslim holy day, but the shopkeeper began beating Shumail Aleem, demanding to know why he had profaned Hussein’s name, Mansoor said.

Two weeks prior, Mansoor said, Naveed and his brothers had beaten a Christian boy so severely that when he bled a piece of flesh issued from his nostrils.

“Shumail had seen this all, and had protested with Naveed over this, and when he came home he was very upset over the beating and repeatedly asked his mother to go and ask Naveed about it,” Mansoor said. “We think that Naveed bore a grudge because of Shumail’s inquiry and protest about that beating of a Christian.”

Mansoor said that after Naveed severely beat him, Shumail Aleem returned when the rest of the family was not at home, as several had taken Mansoor’s 3-month-old granddaughter Hanna to the doctor. When they returned at 9:45 p.m., Mansoor said, he found several things in the house “thrown around or broken.”

A neighbor told them that police and about two dozen men had come searching for Shumail Aleem – who had hid in an upper storeroom – because Naveed had accused him of blasphemy. 

“We went to Naveed, who was at his shop, and inquired what had happened,” Mansoor said. “He told us that Shumail had tried to steal several things from the store and also damaged several things, and worst of all that he profaned Imam Hussein. My wife told Naveed that he knew that Shumail was mentally ill so he should have waited for us, and that we would have paid the damage, but that there was no need to go to the police.”

Naveed told them that whether their son was mentally ill did not matter, that he had filed a police report – which later proved to be untrue – and that they would search relentlessly for Shumail Aleem, Mansoor said.

The mob stopped pursuing members of Mansoor’s family only after the intervention of Pakistan People’s Party politician Malik Amir, he said, but neither police nor the hospital has cooperated with him in legal matters. An influential Muslim in the area, Raja Aftaab, is also urging the family to settle out of court, he added.

“My stance is that the entire mob that attacked us should come to our house and apologize in front of all the neighbors, and then I will start negotiations with them,” he said.

Report from Compass Direct News 

Iran Releases Two Christian Women from Evin Prison


No bail required; charges of ‘proselytizing’ and ‘apostasy’ remain.

ISTANBUL, November 18 (CDN) — Two Christian Iranian women, Maryam Rostampour, 27, and Marzieh Amirizadeh Esmaeilabad, 30, were released from prison this afternoon with no bail amid an international campaign calling for their freedom since their arrest on March 5.

The two women, whose health deteriorated while in detention at the notorious Evin prison in Tehran, are at their homes recovering from their nine-month ordeal, an Iranian source told Compass. They still could face charges of proselytizing and “apostasy,” or leaving Islam.

The women were released at 3:30 p.m.

“Words are not enough to express our gratitude to the Lord and to His people who have prayed and worked for our release,” the two women said in a statement from United Kingdom-based Elam Ministries.

The women’s lawyer had been working to secure their release, and although they were expected to be released yesterday, he was not able to do so because of the high bail the court was demanding. The Compass source said that it was too soon to determine how the lawyer was able to secure their release without bail today, a rarity for Christians released from prison in Iran.

The source credited their release to international lobbying and pressure on the Iranian government.

“It was from the international pressure, and also the government couldn’t handle it anymore,” said the source. “Already their detention was illegal. At the same time, the government wasn’t ready to prosecute them for apostasy. They already have many headaches. They cannot handle everything.”

The source said he suspected the two women will be very closely watched and would not have full freedom of movement, limiting their contact with others.

“It is too soon to give all the details,” he said. “It is not just about them. When people get out of jail we need time to get information … it is very difficult.”

Rostampour and Esmaeilabad were arrested in March and detained on charges of “acting against state security,” “taking part in illegal gatherings” and apostasy under Iran’s Revolutionary Court system.

On Aug. 9 the women appeared before a judge who pressured them to recant their faith and return to Islam or spend more time in prison. The two women refused. Last month, on Oct. 7, they were acquitted of the charge of “anti-state activities,” and their case was transferred to the General Court.

The charges of proselytizing and apostasy remain against them but are not handled by the Revolutionary Court. While proselytizing and apostasy are not crimes specified in the current Penal Code, judges are required to use their knowledge of Islamic law in cases where no codified law exists.

With a draft penal code that may include an article mandating death for apostates in accordance to sharia (Islamic law) still under parliamentary review, experts on Iran fear things may get worse for the country’s converts from Islam.

Elam reported that the women were “doing as well as could be expected, and are rejoicing in the Lord’s faithfulness to them.” The women reportedly lost a lot of weight during their imprisonment. Esmaeilabad suffered from back pain, an infected tooth and intense headaches, and Rostampour got severe food poisoning last month.

Elam requested continued prayers as the women may still be called to court hearings. The Iranian source said that all Christians released from prison in the last year have pending court cases against them, but almost none of them have been given court dates.

“Maryam and Marzieh have greatly inspired us all,” Director of Elam Ministries Sam Yeghnazar said today in a press statement. “Their love for the Lord Jesus and their faithfulness to God has been an amazing testimony.”

A member of Open Doors, one of many ministries that mobilized prayer support for the two women internationally, expressed gratitude for the two women’s release but cautioned that continued prayers were necessary until they were completely out of danger.

“Open Doors is so thankful for the release of these two women, and we praise God that they are safely home now,” said an Open Doors field worker who requested anonymity. “But we continue to pray for them, for physical and mental health. Open Doors also thanks the worldwide Christian family for their prayers for them, but we urge our brothers and sisters to not stop praying. They still have a path to go.”

Compass has also learned that on Oct. 13 the leader of a large network of churches in the northern city of Rasht was arrested and is still in prison. Pastor Yousef Nadarkhani has had contact with his family and has been pressured to recant his faith and return to Islam, according to an Iranian Christian who requested anonymity. Nadarkhani is married and has two children under the age of 10.

Another source confirmed that while six of the 24 Christians who were arrested in a police raid on July 31 in the area of Fashan north of Tehran have been released, one identified as Shaheen remains in prison unable to pay bail for his release.

Report from Compass Direct News