Egypt Unrest Casualties Mount; No Official Death Toll Yet

Feb. 4, 2011— -- Exhausted emergency room doctors working in two Egyptian hospitals estimate that at least 45 people have died from injuries suffered in the street battles by protesters demanding that President Hosni Mubarak step down, and in Cairo alone treated more than 900 people who were shot, stabbed or struck in the head by rocks.

The Egyptian government has yet to provide official casualty figures for the unrest, citing only eight dead and nearly 900 injured in violence that rocked Cairo Wednesday into Thursday, and an estimated 5,000 injured since the unrest began. The overall number of fatalities likely exceeds 45 because other hospitals could not be reached or did not offer figures. Navi Pillay, the top United Nations human rights official, estimated on Tuesday that, based upon unofficial reports, 300 people had died by that day.

Most of the wounded brought to Cairo University were treated for mild to moderate injuries and released. But on Thursday, 86 severely wounded patients remained at the hospital. The worst-injured suffered brain trauma from bullets, depression fractures from large stones and "massive lacerations of the liver" caused by knives and other sharp tools wielded in street attacks around Tahrir Square, said Dr. Alia Abdel Fattah, a critical care specialist overseeing emergency and intensive care units at the university's nine hospitals.

Fattah estimated that in two days, her staff saw 62 ruptured globes, which are tears in the surface of the eyeball, created during trauma.

Fattah said some of the most critically ill "died just on arrival, and some when we were doing resuscitation, because they arrived late." She counted 10 deaths at the hospitals in the first four days of protests, and another five to six deaths on Wednesday.

In Alexandria, a physician who asked not to be publicly identified, said that last Friday, he saw "masses of people coming into our ER" and estimated that "about 30 protesters" had died on arrival after being hit by "gunfire from live bullets to the chest, abdomen and head." He described "tens of patients" with bullet injuries to the chest, and others with bullets that had penetrated their brains and left them "deeply comatose." Like many doctors and surgeons, he described large numbers of people treated for "ruptured eye globes due to rubber bullets."

Despite the early chaos, he described relative calm in Alexandria on Wednesday, when his hospital had no trauma cases.

Reports from hospital-based physicians suggested that casualties and deaths far outpaced official figures provided by the Egyptian government. On Thursday, Egypt's health minister told state television there were five dead and more than 800 injured after overnight violence.

As emergency and critical care services were continuing apace, patients in many cities were facing significant obstacles to surgery, scheduled appointments, diagnostic tests and services such as kidney dialysis. Although major public hospitals were faring well, curfews impeded many health professionals' ability to get to other hospitals, clinics and medical offices, and their patients' abilities to see them. Public transportation was shut down and many gas stations were out of gas, further thwarting the mobility of patients and doctors. Several doctors conveyed their own and their patients' increasing wariness about encountering armed thugs in the sometimes lawless streets.