• 350,000 Egyptians work in the furniture-making industry in Damietta, a town along the Mediterranean coast
• About 5,000 people per year are hospitalized with serious accidents involving industrial saws, overwhelming the healthcare system
• Workshop owners are usually uninsured, and workers often go without compensation or help with the medical bills
• Many of the injured are unable to find work, and if they succeed in applying for state disability benefits, the amount is about $20/month

“Even now, when I hear the sound of a saw I run down the street, choking and crying.”

Mohammad Al-Ulfi’s story is, sadly, not rare. He started working when he was 14 years old in Damietta, the furniture manufacturing capital of Egypt. In his early 20s, he lost a finger on his right hand while sawing wood. Doctors were able to stitch it back. 

But in 2010 he had a much more horrific experience. “I will never forget that day as long as I live.” As he watched, the industrial saw that he was working on chopped off three of his fingers on his left hand. “I loved that machine and I had been working on it for years.”

Speaking at the dinner table in his mother’s apartment, Al-Ulfi recounts the tale of his emergency treatment, which took 45 days. His employer didn’t have insurance, refused to compensate him for his injury, and only agreed to pay for part of his medical bills.

“I became unable to hold things with my hands. I had to quit and search for any odd jobs,” he said. After three years with almost no income, the government began sending him monthly disability payments of 440 Egyptian pounds ( approximately $22 as of this writing).

Al-Ulfi’s case may be 12 years old, but the loss of fingers is a daily occurrence in Damietta, the furniture-making capital of Egypt. Early last year, Hani Abdo Orabi, 38, lost four fingers to an industrial saw. “Three fingers were eaten by the machine, and one was saved, but it can’t move,” he said. Just like so many cases, it was not Orabi’s first injury. Five years earlier he had lost a finger on the same hand.

“I never thought about insurance, and my employer never thought about it either. And he never thought about compensating me after either accident,” said Orabi, who had been working in the same workshop since he was 8 years old. Now he can’t do any jobs that need manual labor.

Anyone who walks along Damietta’s streets will notice men with one or more fingers missing, and sometimes the entire hand. “We are known as the victims of the saw,” according to Orabi.

About 350,000 out of the 1.6 million people who live in Damietta work in the furniture industry, according to Salama Juhr, an official in the local Chamber of Commerce. The district has more than 13,000 factories and workshops producing furniture. Many of these workers career began while they were in school. Some finished their high school education and some didn’t.

In Damietta, it’s normal for someone to work as an engineer or teacher by day, and work in the furniture workshops by night. But this Damietta tradition, handed down for generations, has come at a high cost for this generation. Their grandparents used simple tools to carve and cut wood. But with the modernization of the industry, production has skyrocketed, but no safety procedures have been put in place. The results have been devastating for the craftsmen and workers.

Osama Masaad, 28, started working when he was 6 years old and he relays a heartbreakingly similar story. “I had been working non-stop for two days with no rest. The boss asked me to carve an intricate piece of wood, and I knew I was too tired to focus. But he insisted, and I agreed to do it. I lost two fingers to fatigue.”

Masaad was taken to Damietta Specialist Hospital. “It was 8pm. No one was there to care for me. No doctor, no nurse, no x-ray technician,” he says. Two fingers were amputated and he was in an out of the hospital for a year. “After that, I fell into a deep depression, and I haven’t been able to walk into a workshop since then,” he said. “I was angry with myself.”

As is typical in many of the cases documented by this reporter, the management of the workshop had not insured his staff. He didn’t offer compensation and refused to engage. Over the years, Masaad has tried to file for welfare income from the Ministry of Social Solidarity to no avail, but has been rejected every time. He depends on menial day work to make a living.

The furniture workers of Damietta are not only the victims of machines. The entire system is broken. It begins with workshop owners who don’t follow the insurance laws. But it goes all the way up to the Health Ministry, which has not built a hospital specialized for Damietta’s unique injuries, even though the city leads the country in limb injuries.

According to a study conducted by the two main hospitals in town, there are 5,000 limb injuries in Damietta every year. Between July 2021 and June 2022, this reporter was able to verify 583 cases. Most (552 cases) were treated in outpatient clinics, and 31 required major surgery. Many cases go unrecorded, because they are treated with First Aid, or in the reception area.

During the height of the COVID-19 pandemic shutdowns, cases fell, but the records still show an average of 25 injuries per day. Some of the injuries were major, and the others were recorded as moderate. All were caused by electric saws, according to Dr. Ahmed Tawousi, head of the Hand Surgery Unit at Damietta Hospital.

Another doctor said the numbers were even higher. “Before the pandemic, Damietta Specialist Hospital would register 40-50 cases and Al-Azhar Hospital would register 10-15 cases per day,” said Dr. Salah Abdul Ghani, a lecturer at the Medical College of Al-Azhar University.

Hani Muhammad Abdul Rahman, 50, says he’s sad because he lost all his fingers on his right hand. “My dream was to be a professional weightlifter, and that dream is long gone,” he said. He won the Damietta championships in 1992 and 1993, and competed at the national level.

“I started working when I was 15 years old, and I learned everything from my father,” said Abdul Rahman. He was 23 years old when the accident happened with the saw. But his case is fortunate, as the workshop owner was a relative, and had purchased an insurance to cover Abdul Rahman. Today he owns his own furniture store. “But my heart still hurts from leaving my sport,” he said.

The decision to restore or amputate fingers is a victim of “misdiagnoses,” according to Dr. Abdul Ghani, adding that “amputation should not be the first option, saving a life takes priority over saving a limb.”

Tawousi said that most experts in “Hand Surgery” who used to work in Damietta have left. “There are three of us still here, and sometimes the plastic surgeons who deal with burns help us,” he said.

In 2021, the Planning Ministry set aside an initial package of EGP 100 million ($3.2 million approximately), including EGP 5 million from the budget of Damietta University, to build a new hospital, according to the president of the university, Dr. Sayed Dadour. On Nov. 7 of that year, the university announced the selection of a contractor. In July 2022, the ministry announced that it had revised the package to EGP 200 million ($6.4 million). “The contractor has not begun work,” according to the Budget Manager of the university, Ehab Fouzi.

Before that, in 2017, parliamentarian Dia Uddin Daoud had requested that the government build a hospital specialized in surgery on limbs and rehabilitation in Damietta. The Egyptian parliament sent a recommendation to the Local Development Ministry to set aside land and inform the Health Ministry. But nothing came of that project either.

The ministry feels that the project should be part of Damietta University, according to Daoud. “This type of surgery needs specialists in microvascular surgery, orthopedics, and plastic surgery. These types of specialists are hard to come by in a small hospital. But it’s feasible in a university hospital,” he said.

Insurance has been another challenge. The Egyptian Parliament passed a law in 2019 covering workplace injuries, requiring all types of workers, including temporary and seasonal workers, to be insured. But the actual number of insured workers in all industries in Damietta is under 70,000 people, according to an official in the Insurance Inspections Department who preferred to remain anonymous.

Damietta has about 83,000 institutions listed with the National Authority for Social Insurance (NASI), and about 30% of those are furniture workshops, according to (NASI) inspector Tareq Ghobashi.

The minimum monthly installment for workers’ insurance contribution is EGP 420 ($21) from the employee, and EGP300 from the employer. Most employers and employees won’t pay because so many workshops have shut down due to poor economic conditions, and also because people aren’t aware of the importance of insurance, according to Ghobashi. “Most just want to get their pay at the end of the week,” he said.

“Most furniture makers are uninsured,” said Abdul Hakim Amer, 60, a former member of the labor union’s advisory board. “In my experience the only ones insured are relatives of the employer.”

The law does not allow workers to self-insure, even though construction workers are allowed to buy their own insurance. Amer said it would be a step forward if the law was amended to allow furniture workers the same rights as construction workers.

Another problem that employers face is trying to delete former workers from the insurance registry when they leave. “Work is unstable. Very rarely does a worker stay in one workshop for years. When they leave, the employer tries to cancel their insurance, but the insurance agency insists that another worker replace them,” instead of lowering the insurance bill, Amer said.

A study by Solutions Forum, a socio-economic research center at the American University of Cairo, found that the number of Egyptians participating in the official National Authority for Social Insurance regime had dropped from 52% in 1998 to 30% in 2018.

The study found that the system underinsures the beneficiaries, and the government has not been able to force people to buy in. The high cost and low payout makes it unsavory to most workers.

The Labor Relations Board in Damietta estimates that 100 workshops per year are charged with violations of workers’ rights. “We demand proof of insurance for workers, review the contracts, make sure workers get their annual leave, review payroll, inspect the registration of the workshop, and look for performance reviews from the employer,” said Asad Qishawi, head of the Labor Relations Board in Damietta.

“We find that most workshops don’t have any documents regarding workers’ rights. Workshops that have 10 or more workers don’t provide regular training as required by the law. Workshops that have 30 or more workers don’t have an emergency fund that goes to the workers in case the workshop is destroyed by fire, or shut down in a pandemic. So we issue citations,” Qishawi said.

When a worker is hurt, the accident is recorded, and both the Industrial Safety Agency and the Labor Relations Board try to reach a settlement between employee and employer, according to Qishawi. “It can be anywhere between EGP80,000 ($2500) to EGP200,000 ($6500 approximately),” he said. But if there is no agreement, the case is filed with the Labor Court, he said.

The Damietta Furniture Workers Union doesn’t have an exact number of workers who have lost fingers or hands, according to the union’s senior adviser, Mohammad Hattab. “The authorities are not making sure that the workshops are insuring the workers, so we will do this,” he said. 

Hattab admits that most workers in the industry have not bothered to join the union. “We have 10,000 members, even though there are 350,000 workers in this industry.”