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The information in the health record belongs by lawto the CCSS. Currently the EDUS process involvesdevelopers, database administrators (responsiblefor the “data centre”), support staff and healthpersonnel who have access to different groups ofdata, which are handled in line with confidentialityclauses. The policies or regulations that will constitutethe legal framework for the management andprotection of the health records are not yet defined.The existing regulatory framework dates from 1999and corresponds to physical files. While there is avery good law for data protection in Costa Rica, itsregulations and implementation remain weak.According to the stakeholders interviewed forthis report, in the CCSS there are multiple visions ofwhat should be done in terms of the developmentof information and communications technologies(ICTs), as well as computer systems, includingEDUS. A discussed and shared policy, updated inthe light of major issues such as the governance ofhealth technologies, citizen surveillance, open government,security and data privacy, and the use ofcloud technology, among many other urgent technologicalconsiderations, is not available.Discussions with stakeholders show that addressingcitizen surveillance has not been a priorityin the development of EDUS up until now. This iscompounded by the lack of understanding of thetopic and the risks entailed at the technical andpolitical levels. It is possible that the issue of surveillancemight not be a priority, because it is notvisible.One can tell that the development of EDUS iscaught between two forces: On the one hand thepolitical pressure and the mandates of the ConstitutionalCourt, the Legislative Assembly and theComptroller General’s Office in terms of the right tohealth; and on the other hand, the need for clearlydefined policies, the strengthening of knowledgeand skills, and citizen participation to address thesystem from perspectives that go beyond the technicalaspects of computing.Action stepsTo address the issue of citizen surveillance in CostaRica, the following steps are proposed:• Continue the discussion with academia, theCCSS, civil society and other stakeholders tostrengthen understanding of the topic of citizensurveillance in Costa Rica, specifically in thecase of EDUS.• Civil society should participate in forums wherethe issue is being addressed (CCSS, the legislature,the Medical Association and the BarAssociation, among others).• Raise awareness in community health committeesand associations on the subject of healthinformation systems.• Create opportunities for citizen participation inthe design, development and implementation ofEDUS so that it is not perceived as a technicalissue but as a matter dealing with the right toinformation.• Strengthen the training of staff in the judiciary,the CCSS and the legislature on issues such ascitizen surveillance, security and data privacy.• Strengthen the technical capacity of health staffon the development of public information systemsand the importance of managing privacyand data security, as well as the risk of citizensurveillance.EgyptEgypt’s internet surveillance: A case of increasing emergencyLeila Hassaninlhassanin@gmail.comIntroductionAfter the overthrow of Hosni Mubarak, Egypt’s presidentfor 30 years, on 11 February 2011, the countryhas been in political, social and economic turmoildue to an unstable transition that is still unfolding.Under Mubarak’s regime the information and communicationstechnology (ICT) sector had been aflagship for the Egyptian economy since the early2000s. To promote its growth and competitiveness,the sector has been modernised and liberalised tothe extent of becoming one of the most deregulatedand promising economic sectors in Egypt. 1The government’s plan was to make Egypt a regionaland global ICT outsourcing hub, on par withleading Asian countries. Egypt positioned itself asan international call centre and competed with Gulfcountries in its contribution to Arab content localisationand development. In addition, the countryhosts the SEA-ME-WE2, a central communicationnode linking the Middle East, Southeast Asia andEurope. The IT sector was a potential labour marketfor many income-seeking youth in Egypt who wereencouraged to acquire IT skills from networking andprogramming to hardware assembly and ICT customerservicing.In June 2013, 36 million Egyptians, or 43% ofthe population, were online – an increase of 4.79million from 2012. Mobile diffusion has literallygone through the roof, at 116%, i.e. 98.8 million in2013. 2 Egypt’s population was officially estimatedat 85 million in 2013. 3 This means that many adultEgyptians own more than one mobile phone. Smart-1 For a more detailed account on Egypt’s ICT infrastructure, seeHassanin, L. (2008). Egypt. In APC, Global Information SocietyWatch 2008: Access to infrastructure. www.giswatch.org/countryreport/2008/egypt2 Ahram Online. (2013, October 28). Egypt Internet users reach 36million in June 2013: MCIT. Ahram Online. english.ahram.org.eg/NewsContent/3/12/84996/Business/Economy/Egypt-Internetusers-reached--million-in-June--MCI.aspx3 World Population Review: worldpopulationreview.com/countries/egypt-populationphone diffusion, however, was estimated at only 5%in 2013, on the lower end in the region. 4With all this computer, mobile and internet diffusion,online spaces were also being used in waysthat the government did not like. Bloggers andpolitical activists began using mobile phones to organisestrikes and demonstrations. Social networksrallied youth to common political causes and blogswere used to vent discontent and alert the publicand international media to infringements – political,socioeconomic, gender-related or any other.The Egypt country report in GISWatch 2009: Accessto online information and knowledge givesexamples of online activism and the government’ssurveillance and control of bloggers and activists. 5The same tactics are still being employed, althoughsince February 2011 more repressive measures suchas widespread arrests and military trials of activistsand bloggers have been taking place.Internet surveillanceIn this report, internet surveillance is defined as“the monitoring of the online behavior, activities, orother changing information, usually of people, andoften in a surreptitious manner. It most refers to theobservation of individuals or groups by governmentalorganizations.” 6Surveillance includes scanning internet use,but is often conducted in a more intrusive mannerinvolving interception of electronically transmittedinformation online through special equipmentand software. Surveillance is done by direct humanobservation and automated means. Softwarecaptures internet traffic and analyses it. Remote accessto individual computers and mobile phones isalso widely used. Online open-source intelligence(OSINT), using information available through socialmedia, blogs, forums and so forth, is another importantmeans of information sourcing. In Egypt this isdone primarily by the government.4 Ipsos. (2013). Presentation at ArabNet, Beirut, Lebanon, 25 March.www.slideshare.net/IpsosMENA/ipsos-arab-net-presentationbeirut-20135 Hassanin, L. (2009). Egypt. In APC, Global Information SocietyWatch 2009: Access to online information and knowledge. www.giswatch.org/country-report/20/egypt6 IT Law Wiki: itlaw.wikia.com/wiki/Internet_surveillance120 / Global Information Society Watch egypt / 121