Salaam Centre

Location: Cairo, Egypt
Director: Sister Maria
Founded: 1976

How it all started
There is an overwhelming level of poverty affecting the majority of the Egyptian population, which is often unknown, or overlooked.  In rural areas, when subsistence farming is no longer able to support either single families or village communities, people migrate to Cairo in search of work.  This has resulted in an over-population of the city – a situation that has intensified with the recent return of two million Egyptians from Iraq.  Housing conditions are poor and cramped and regular employment is in short supply. 

One particularly extreme case of poverty can be found in the Ezbet El Nakhl sub-district of Cairo, a rubbish dump that houses 15,000 people.  The people of this area, the Zabaleen (meaning ‘rubbish pickers’), live in small huts which are literally built from the rubbish that surrounds them.  Living in absolute poverty and squalor, the inhabitants earn their meagre living by sorting through the rubbish brought in for recycling from Greater Cairo.  They then sell on the plastic, tin and other recyclable commodities to local companies.  Food and other organic waste are used as feed for the pigs, that often share the same living quarters as the families themselves.

Conditions at Ezbet El Nakhl are so appalling that they are hard to imagine.  The area is affected by chronic overcrowding, pollution, high unemployment, illiteracy, high infant mortality and a lack of basic health, hygiene and welfare services.   Due to the dreadful living conditions, the Zabaleen people are at the highest possible risk of infection and epidemic. 

This is where the Salaam Centre for Medico-Social Services (SCMSS) works.  The Centre was begun, in 1976, by some Sisters of the Convent of St Mary’s Daughters, a convent of the Coptic Orthodox Church.  The Sisters lived in a small hut in the middle of the rubbish dump, visiting every family, sharing their experiences and building relationships with them.

Current activities
The Centre began by providing basic primary healthcare and emergency medical aid but, over the past three decades, it has expanded extensively.  Now its three main areas of activity are a hospital, a child healthcare programme, and a school for children with mental and / or physical disabilities, serving those who live in Ezbet El Nakhl and another seven surrounding sub-districts – a total of 1,000,000 people.

The Under Fives Healthcare Programme began in January 2001.  Children, particularly under the age of five, who live and work in the rubbish dump, are hugely susceptible to many diseases and conditions such as hepatitis, malnutrition, chronic chest complaints and serious eye infections, while skin disorders caused by the filth are also common.  The Centre aims to improve the health of these children, and to teach the families basic health care. 

One of the first children that the Centre saw was a four-year-old boy who was totally blind, malnourished, anaemic and who had parasites.  He spent most of his day sorting through the rubbish, looking for items to recycle.  When he came to the Centre, he was covered in cuts as he was not able to see what he was picking up or where he was walking.  Through the work of the Centre, he was treated in a holistic manner.  His parents were taught how to feed him nutritionally, he was given medicine for the parasites, and the Centre bought him an Arabic Braille Bible. This holistic care is provided to around 650 Zableen children.

Each child receives twice yearly examinations, and those with special needs are given the appropriate treatment, or referred to a nearby hospital.  The Centre has a fund to help pay for any emergency medical care that a child may need, if their families are unable to afford the costs.

Each child receives immunisation against the most prevalent diseases.

The Centre supplies vitamins for over 800 children, asking the parents to contribute about 10p per child, per month.  The local pharmacy and the Centre cover all other costs.

The Centre provides prenatal and postnatal care to mothers and their babies, and has seen a decrease in maternal and infant mortality and illness rates as a result.

Each child who attends the Centre has their own medical records, charting any problems and illnesses, and treatment they have received.  Whilst this is ordinary practice in Western culture, it is a fairly new concept in Egypt.

Through the programme, the Centre is able to identify those children who have physical or mental disabilities, who are then referred to the specialist school that the Centre runs.  Those children with physical disabilities are visited by the community physiotherapist, and provided with rehabilitation equipment.

The programme employs two doctors, six community health workers, a physiotherapist and two social workers.  The community health workers make home visits, giving health advice and challenging unhealthy cultural traditions related to family planning and female circumcision.

All of these services are provided at a reduced cost, or are free to those who cannot afford to pay anything.

This work is crucial in providing health care to these young children, where illness makes daily life even more of a harsh reality.