“Like you, I’m from New York,” he said in the handwritten letter, which was smuggled out of the maximum security Tora prison. “I am going on hunger strike knowing full well that I may not survive it,” he wrote.
The letter finished: “I am putting my life in your hands.”
The Working Group on Egypt, a bipartisan group of foreign affairs experts, raised Mr. Kassem’s case in a letter to Secretary of State Mike Pompeo in June, warning that he was a diabetic with a heart condition who was in imminent danger of death.
Mr. Pompeo responded that the well-being of detained American citizens was a “top priority” for him.
“I am deeply saddened to learn today the death of U.S. citizen Moustafa Kassem who’d been imprisoned in Egypt,” the State Department’s assistant secretary for Near Eastern affairs, David Schenker, said at a Monday news briefing. “His death in custody was needless, tragic and avoidable.”
The issue of medical negligence in Egyptian prisons came to the fore last June, when Mr. Morsi collapsed in a soundproof cage during a legal hearing and died. Mr. Morsi’s family, who had complained for years about inadequate medical treatment in prison, blamed Mr. el-Sisi for his death.
The death put pressure on the Egyptian authorities to improve conditions in prisons, and in November they led foreign reporters on a stage-managed tour of the Tora prison complex south of Cairo, where many political prisoners are held.
Prisoner advocacy groups say that in reality little has changed.
In August, Human Rights Watch said that Khaled Hassan, an Egyptian-American limousine driver imprisoned on terrorism charges, had tried to kill himself in his cell.
On Monday, the Egyptian National Action Group, an opposition group, said that over 300 detainees in the maximum security wing of Tora prison had been on hunger strike since Jan. 5, when a 47-year-old inmate died in detention because of inadequate medical care.