Syrian physician refugees have come under severe criticism by their Libyan colleagues who are skeptical about the Syrians’ qualifications and recruitment processes; no committee has been formed to evaluate the Syrians’ competencies. Most of the Syrian physicians, fleeing the raging war in their country, have either signed employment contracts with Tobruk Medical Centre (TMC) – the largest hospital in Tobruk – which is not affiliated with the Ministry of Health (MoH), or work with private clinics.

Syrian physician refugees have come under severe criticism by their Libyan colleagues who are skeptical about the Syrians’ qualifications and recruitment processes; no committee has been formed to evaluate the Syrians’ competencies. Most of the Syrian physicians, fleeing the raging war in their country, have either signed employment contracts with Tobruk Medical Centre (TMC) – the largest hospital in Tobruk – which is not affiliated with the Ministry of Health (MoH), or work with private clinics.

 “They do not adhere to standard prescriptions since they do not determine the age, sex and weight of the patient, and their prescriptions lack the date, signature and official stamp of the prescribing doctor, not to mention writing their prescriptions in Arabic often using pencils, which violates pharmaceutical and medical practice,” said Dr. Hussain Rwe’e, a well-known member of the Pharmacists Syndicate in Tobruk and an official at the MoH’s pharmacies.

“Some Syrian physicians do not define their prescribed medication and their prescriptions lack important details. For instance, a doctor should not just write ‘antipyretic’ but should mention the medicine’s name and do so in English using generic rather than trade names,” said pharmacist Khalifa Ghrebil. “Further, the patient’s sex and age are considerably important.”

“Any notes made during diagnosis should be mentioned to which most of them do not adhere. For example, I often receive prescriptions of banned medicines that must be dispensed only after initial treatment such as Tramadol-Obreval-Valium,” he added.

“In the current circumstances of Syria, it is easy to forge certificates, especially since many departments in Tobruk have signed contracts with some of these physicians depending on trust without verification of submitted documents and certificates,” said Rwe’e

Rwe’e believes that recruiting those physicians is a grave mistake since they entered the country as refugees without any official work visas by which their country’s embassy could be held responsible for any violations they commit. He stresses that some of them had served at private and governmental clinics for a long period of time before they finally signed employment contracts in the last three months.  He claims their salaries are double to what Libyan physicians earn, regardless of their competence and experience.

Inappropriate to generalize

Urologist Ihab Joumaa Shaeri however refuses to generalize since he believes that some Syrian physicians are competent enough to address the Libyan shortage in some medical specialties while others are a burden because they have committed serious mistakes. “I have encountered one of them who was unable to speak English, but he was highly efficient and well experienced,” he said.

Shaeri does not object to hiring Syrian physicians in principle nor does he consider the language issue an obstacle, but he agrees on the need to regulate the process of employment and contraction.

High salaries

Dr. Munir Yunis Bakkar, an intern at the TMC General Surgery Ward accuses the Syrian physicians working with him at TMC of being incompetent and “inhumane” when it comes to bedside manners. He also objects to their high salaries, reportedly amounting to US$5,000 a month while the Head of the TMC Surgery Ward, who has experience of over 22 years, is paid only 1,700 Libyan dinars(US $1,333). “My salary, which I have not received for four months, is negligible compared to Syrians’,” he said.

Surprisingly enough, says Bakkar, “The medical departments hire physicians who have entered the country without passports through Musaid Port and sometimes through the desert without being brought before competent committees.”

Significant qualifications

TMC Director Dr. Saied Hammad advocates TMC employment of Syrian physicians, saying the 30 Syrian physicians have great and distinguished qualifications and some of them have been promoted to Ward Heads where Libyan expertise in Tobruk or even the eastern region is not available.

“We employ them according to the TMC regulations and laws and specialized committees evaluate and classify them in accordance with competence, expertise and specialization. Most of them are members of the Syria-based Arab Fellowship of Physicians while others have been selected by competent committees in Jordan,” he added.

“We have not paid the salaries of any Syrian physician yet and they have only received little advance payments since we are still in the process of formulating their contracts. Therefore, we have allowed them to work in private clinics outside the TMC official work hours,” Hammad explained.

Based on qualifications

Regarding the complaints of the high salaries paid, Hammad said, “This is normal since salaries are determined according to competence and some Syrian physicians deserve high pay. Some of them even receive salaries higher than mine, although I am the TMC Director. These are special contracts that are subject to regulations and laws different from the local and governmental contracts.”

Hammad expressed bewilderment of the complaint of the Syrian physicians’ poor English language proficiency saying, “When we contracted Ukrainian and Korean physicians, some complained that they did not speak Arabic and when we contracted the Syrians they said they did not speak English. I do not think that lack of English proficiency is an obstacle to contracting these doctors and basically no law bans this.”

About the circulated medical errors of the Syrian physicians, Hammad said, “Skeptics should read the assessment prepared on the TMC performance for the first quarter of this year. I personally have not received any formal complaints.”

Raising wage ceiling

Dr. Miftah Arhuma, Head of Tobruk Health Services Office – an MoH centre – denied contracting any Syrian physician since, he claimed, they did  not  meet the required qualifications, pointing to the different approach of Syrian school that teaches medicine in Arabic which causes some problems regarding the different medical terms and names of medicines.

He stresses that his office has not received any formal complaint, saying, “Medical examination and diagnosis do not result in grave mistakes and fortunately no surgeries have been performed.”