Abu Zabal is not a name featured on the tourist map, nor indeed one that slips easily from the lips of government officials or company directors.

Situated well off the main highway, on the edge of the desert, 60km north of Cairo, Abu Zabal is the location of a leprosarium. There, in an area made almost picturesque with flower beds and fruit trees, government doctors and
voluntary aid workers with the charity Caritas look after several hundred men, women and children affected by a disease thought to have had its first incidence in 2nd century Egypt.

Leprosy - a disease associated with poor hygiene and diet - may not be widely acknowledged but its existence is a stark reminder of the social problems facing the country as it enters a new millennium.

Multidrug therapy of the kind administered at Abu Zabal has reduced the prevalance of the disease. According to the World Health Organisation, the prevalence of cases in Egypt last year was 0.5 per 10,000, well below the WHO's target level of less than one case per 10,000 globally by the year 2000. According to local NGOs the 3,263 cases in Egypt registered with WHO last year compared with 30,000 cases 20 years ago.

Nevertheless, cases of the disease continue to be reported in under-developed rural villages. Moreover, many of those living in Abu Zabal are there because they remain ostracised by the wider community, regardless of whether they have been cured or not.

The government has pledged to alleviate the kind of poverty that makes havens such as Abu Zabal necessary. Its flagship programme, the Social Fund for Development, has acquired semi-permament status since being launched in
1991. The SFD now draws from the proceeds of privatisation as well as from external donors. Phase two of the programme which began in October 1997 and runs to December 2001, has a budget of $775m.

The SFD's main objective is to cushion the social consequences of economic reform and structural adjustment. Working with NGOs and community groups, its employment and retraining programmes cover public sector workers displaced by privatisation. The SFD's responsibilities include improving social services and developing labour-intensive work projects in low-income areas.

The SFD prides itself in being a semi-autonomous agency, operating with fewer bureaucratic restraints than other government departments. However, some NGOs complain that administrative and legal restrictions limit them from building an effective advocacy on behalf of the poor.

A report last year, prepared by two leading Egyptian academics for the Ford Foundation, found that despite the government's commitment to free healthcare and free education, at least one quarter of Egypt's population was poor by any standards and another quarter lived on the margins of poverty.

The report noted that 54 per cent of births in Egypt are unattended by a physician or a midwife, with the figure rising to 67 per cent in rural areas. Meanwhile, the high rate rates of drop outs (51 per cent) of pupils in basic education is attributed both to "their own poverty as well as the poor educational services they receive". The study also found that the
illiteracy rate was highest among women, at 76 per cent in rural areas, and 45 per cent in urban areas.

Hania Sholkamy, an anthropologist working for the Population Council, believes the most disturbing aspect of being poor in Egypt is not just a low standard of living but the lack of channels through which to demand better services. "The poor cannot dent a system that is being more and more geared to serve the super-rich," says Ms Sholkamy.

One of the most startling symbols of social inequality is the estimated 1m squatters that have been forced - through lack of affordable housing - to turn the burial grounds of the rich into their living quarters.

Tourists are unlikely to notice the inhabitants of the City of the Dead as they are whisked by bus or car from hotel to Citadel in the heart of Cairo's medieval Islamic quarter. But to anyone who cares to listen, those who have built precarious dwellings next to the mausoleums provide a telling tale of the limited capacity of government institutions to reach the poor at local level.

Long-term residents who have no cars are unimpressed by a new paved road, claiming that it simply serves to connect Cairo's ring roads and help those with the money to escape from the city. There is greater access to electricity and running water than there once was, but the complaint focuses on poor health and educational services, and the new housing that is constantly advertised on TV but rarely materialises in an affordable way.

The living conditions of many of the squatters would undoubtedly be far worse were it not for the charity extended by local mosques and the informal self-support mechanisms developed in the area. Meanwhile, the fact that an area of Cairo known as Imbaba appears today to receive greatest help, say local NGOs, reflects not so much the government's social conscience as its obsession with security.

For it was the poverty and alienation of Imbaba that fuelled the Islamic militancy in the early 1990s, turning the area virtually into a state within a state. The government's initial response was to lay siege to the area, purging the neighbourhood of suspected militants with massive security clampdown.

It subsequently moved to alleviate the social hardship in the area, diverting funds into local schools, hospitals, and housing, and improved infrastructure.

Local inhabitants still remember the brutality with which the government dealt with the "uprising" and a sense of fear rather than gratitude pervades the area.

Social disgruntlement among some families would be even greater were it not for the employment projects organised by NGOs.

An example is the community action programme funded by several western governments and a Swiss-based Catholic charity, and managed by the Ibn Khaldun Centre for Development Studies.

The organisation makes available low interest loans for the setting up of small businesses by residents of Imbaba, including former prisoners. It also provides a literacy programme - "empowerment classes" - to young Egyptian women who have traditionally had less access to education than men.

In the least developed areas of Imbaba, as in other areas of Egypt, some families scrape a living from the garbage, feeding their animals and sometimes themselves on discarded food waste. Loaves of bread are carried on donkey led carts. Children, poorly dressed and unwashed, inhabit the streets rather than the schoolroom.

These images, like those of the disfigured men and women that shuffle between the mud brick huts and landscape gardens of Abu Zabal, are persistent reminders of social disparity and displacement.


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