A middle-aged man is lying shirtless on a hospital bed. Gray in the face, it looks like he is suffering from a heart condition or perhaps the last stages of a debilitating disease. Wires are attached to his chest and an oxygen mask covers his nose and mouth.

Since August 1, this image has been on every cigarette pack in Egypt, emblazoned with captions such as: “Attention: smoking damages health and causes death,” “The devastating effects of smoking affect smokers and non-smokers” and “Smoking causes heart and lung diseases.” The new labels are part of a government campaign to traumatize smokers into quitting.

The ‘sick’ man on the cigarette pack is perfectly healthy, however. Hamdy Balala, the man in the picture, works as a driver for a major advertising company and agreed to pose for the photo to make a bit of extra money.

Balala says he never imagined that his picture would lead to media attention and constant teasing in the street. Above all, he never thought that his picture would result in a lawyer suing Minister of Health Hatem El-Gabali, demanding his resignation for allegedly deceiving the public with a misleading picture.

In an attempt to discourage people from smoking, the Ministry of Health decided to put an picture on cigarette packs to show smokers how much smoking can damage their health. The image was supposed to be striking and intimidating enough to make smokers think twice before lighting up.

Lawyer Khaled Shaaban is taking on the Ministry of Health.

The production assistant at the company where Balala works learned about the project and suggested Balala audition for the part. Upon seeing the driver, who is in his 50s, the Ministry’s doctor chose him immediately, saying that Balala’s age made him look more believable, reflecting the theme that smoking for a long time leads to a painful end.

Balala agreed to have his photo taken for the campaign. However, he claims that the picture taken was a normal picture of him lying down on a hospital bed and that the machines attached to his body were added later.

Wesam Seif, 22, works with Balala at the agency. Upon the release of Balala’s picture on the cigarette packs, Seif and his friends started to tease Balala, making fun of him and the picture.

“We didn’t mean to insult him or anyone else, we were just having fun.” Seif says. “The situation was hilarious.”

Mohamed Allouba Lawyer Khaled Shaaban is taking on the Ministry of Health.

Balala, a heavy smoker, agreed to pose in photos that Seif later uploaded onto the popular social networking site Facebook for a group he named after Balala. There is a picture of Balala laughing while holding a cigarette pack with his picture on it. Another shows Balala smoking with Seif and both of them are raising their hands to make the peace sign.

The Facebook group started with a few members, just friends of the two men. A few days later, however, the group had more than 200 members, most of them smokers relieved to know that the dying man on their cigarettes is in fact still alive and smoking heavily.

Mohamed Osman, 20, one of the group’s members says, “the [Facebook] picture of Balala is funny [ it’s] as if it tells the smokers to go ahead and smoke.”

Shahd Farahat, 19, another member of the group, said “I joined the group because the picture of Balala makes me laugh. I believe that what they have done is a joke. It’s not serious.”

Some people, however, consider the Facebook pictures offensive, tarnishing “the respectable campaign that was supposed to help people quit smoking,” as Sherihan Mansour, a 23-year-old college student, believes.

“The Facebook group didn’t intend to offend the minister or the ministry’s campaign or to attract media attention at all. It was supposed to be a joke among a group of friends,” says Seif.

A journalist from local daily newspaper Al-Masry Al-Youm saw the group and published an article under the headline: “Hamdy Balala smokes and makes fun of the Ministry of Health’s campaign on Facebook.”

Seif claims that the journalist did not ask his permission to use his pictures in his article, adding that the journalist also “put words in my mouth and published them in the article without contacting me at all.”

The joke among friends got even more complicated when lawyer Khaled Shaaban filed a lawsuit against the Minister of Health, asking that Balala’s picture be removed from cigarette packs and demanding El-Gabali’s resignation.

“The false picture makes fun of the people,” Shaaban asserts. “It tells people that you are ignorant and you can’t read.”

Some considered the lawyer’s demand for the Minister’s resignation excessive, but Shaaban says, “the simplest thing we want to see in an authority figure is credibility. If he deceived the public then he will never be credible, and he will never gain the public’s trust in any of his actions.”

The lawyers insists that there was no need to use a model in the first place. He has visited the National Heart Institute in Cairo and interviewed 58 heart patients and says they all told him that they would be glad to be on the cigarette pack campaign or any other campaign that might help people quit smoking.

Shaaban believes that there are other, more effective tools to discourage people from smoking than staging a photo of a sick man. He says that he has spoken to the head of the railway administration, who told him that in 19 years, there have been no reported violations of the law against smoking on the Cairo Metro. Strictly enforcing the laws prohibiting smoking in public places and workplaces can work, he believes.

Responding to those who say his charges are frivolous and that he is just seeking media attention, Shaaban says, “If every person who sees something wrong and decides to take an effective action is labeled a publicity seeker then I really hope that the 80 million Egyptians will become publicity seekers.”

In an interview on the TV show Al-Hayat Al-Youm (Life Today), Shaaban claimed that he has gathered data from officials that prove that the smoking rate has not decreased after putting Balala’s picture on the cigarette packs. “This means that the money used on the campaign was wasted. The minister wasted [] the public’s money.”

Mohamed Mehrez, director of the Health Ministry’s Administration for Combating Smoking, says that it doesn’t matter whether the person in the photo was sick or healthy as long as the message gets across that smoking kills.

Mehrez notes that the ministry spends LE 3 billion per year on treating smoking-related illnesses. This is a large sum of money to be wasted, he says, and it negatively affects the developing national economy.

“We urgently need to fight smoking by all means; the concept itself is important, [not] the methods,” he says, adding that the Ministry of Health plans to conduct a study by the end of the year, which will survey 22,000 random people to determine smoking trends. A 2001 study surveyed 4,000 random people, finding that 39 percent of the people surveyed were heavy smokers. This is a high percentage, Mehrez says.

He declined to comment specifically on Shaaban’s lawsuit since the case is now being considered by the court.

Shaaban presented his case at Abdeen Court on September 10. “I demand the immediate removal of the sick man’s picture from all the cigarette packs. Campaigns should be trustworthy in order to be effective and this one is completely deceptive,” he told the judge.

The state lawyer, who spoke on the condition he not be named, did not comment on any of Shaaban’s accusations; He successfully requested postponing the trial to collect relevant documents.

After the hearing, the state lawyer told Egypt Today, “It’s not an issue whether the picture was of a sick, healthy or even a drawing of a man, as long as the message is delivered.” He also claimed that Shaaban doesn’t have the right or the power to demand the Minister of Health’s resignation.

“The minister doesn’t even know about this issue. We don’t inform him of such trivial matters,” the state lawyer said. He declined to give further comment before the case is resolved.

The court reconvenes on October 10 to consider Shaaban’s lawsuit

Balala, who says he has been subjected to daily verbal harassment from people in the streets who recognize him, appeared on TV show Al-Beit Beitak (The House is Yours) on August 17 to tell his side of the story.

Since that appearance, he has received numerous calls from journalists and TV shows wanting to interview him, but Balala now refuses to speak to the media. He feels that this incident has subjected him, as well as his family, to bad publicity, and he now wants to stay out of the media spotlight.

Seif says, “Balala used to be a funny, friendly guy. After this incident and the attacks he received, he has really became a sad, depressed person.”

Islam Ragab, 20, a student in the Faculty of Commerce at Cairo University has been smoking for more than five years. He says that Balala’s picture scared him “only about 30 percent, but I never stopped buying cigarettes.” He adds, “I hate to look at the cigarette pack now. At the beginning, I started to buy fewer Egyptian cigarettes, but now that the picture is on all packs, I just buy any cigarettes because I know they’re all the same.”

Ragab, however, supports the Health Ministry’s decision to run the campaign because he believes that smoking is an unhealthy, addictive habit and that action to stop its spread is crucial. However, he thinks that more effective images, like medical diagrams and information, could educate people rather than trying to scare them.

Ragab also has a young brother and he worries his brother will turn out to be a heavy smoker too. “I’ll do my best to prevent my brother from smoking. I’ll convince him to keep away from smoking by talking to him and convincing him logically.”

Sherifa Fouad, 45, a housewife with two children, has been smoking on and off for 20 years. “The picture on the cigarette packs gave me goosebumps. I pictured myself in the man’s position, lying on the intensive care bed, and my children are looking at me and crying.” Fouad says that the picture made her quit smoking for a week, but then she started up again, deciding to buy separate cigarettes instead of the whole pack to avoid looking at Balala’s picture. Fouad supports the position of the Minister because she thinks that smokers who purchase the pack won’t think of whether the sick man is real or not, the picture will just make them face the consequences of smoking.

Mayada Ibrahim, 47, a doctor and a mother of three sons, was thrilled at first to see the campaign. “I have lost hope in convincing my sons to quit smoking. The picture said what I stopped saying years ago.” Ibrahim, however, believes that the lawyer is right in saying that the false picture is deceitful. She says that once her sons learned the truth about Balala, they started mocking the campaign and smoking even more.

Mohamed Maged, 22, an athlete and bodybuilder, started smoking eight years ago at school. Peer pressure was the reason why he started, but he took the habit further and still smokes today, though he wants to quit. “I’m a personal trainer at a gym and I advise the people I train to quit smoking because it ruins their lungs and makes them age way beyond their real age. Yet, they don’t know that I can’t quit smoking myself.”

Maged says that the picture of Balala is not effective enough. “Since the campaign was planned by the Ministry of Health, they should have put more effort into scientifically proving to people that smoking is devastating.” He believes that a picture of two lungs, one healthy and the other diseased, would have been more effective and wouldn’t have created such a controversy.” et