It is a movie scene Egyptians remember well. In the 1954 classic, ‘A Matter of Life and Death’, a warning is transmitted over the radio to save the life a patient’s life: “To Ahmed Ibrahim who lives in Deir Nahhas, do not take that medicine your daughter asked for, as it contains a deadly poison.”
It is a movie scene Egyptians remember well. In the 1954 classic, ‘A Matter of Life and Death’, a warning is transmitted over the radio to save the life a patient’s life: “To Ahmed Ibrahim who lives in Deir Nahhas, do not take that medicine your daughter asked for, as it contains a deadly poison.”
Sixty years later, many Egyptians feel that the entire health system is a deadly poison. A shortage of medical supplies combined with the disappearance of some medicines from pharmacies, after the government decided to float the Egyptian pound, as well as the rise of the US dollar’s exchange rate to unprecedented levels, have resulted in a health system in need of a recovery.
In the 2016-2017 general budget, the state allocated L.E. 48.9 billion (USD 2.7 billion) for the health sector (7% of public spending) compared to L.E. 45 billion *USD 2.5 billion) last year (8.9% of public spending). However, the recent government’s decision to float the Egyptian pound and the fall of the Egyptian pound’s value by about 50% will devalue the health budget by almost 50%.
Wake-up calls
Mona Mina, the Doctors Association’s Undersecretary, sounded the alarm, warning against the fall of medical supplies in hospitals by 50% and the instructions to use syringes for more than one patient to reduce consumption, which risks lives.
After doctors exposed how dangerous the situation was, the state moved quickly to face Dr. Mina. Dr. Khaled Mujahed, the spokesperson of the Ministry of Health, said the ministry would take the “necessary measures” against her.
Cairo University gave the association 48 hours to punish Dr. Mina. Media figures affiliated with the ruling regime including Mustafa Bakri, Ahmed Musa and Azmi Mujahed ferociously attacked Dr. Mina who is highly respected and revered by doctors and wide sectors of people.
The Doctors Association’s Council responded by issuing a statement on November 19 attesting to what Dr. Mina said on the Manshet Program, which is shown on the Asima TV Channel. The statement says that what Dr. Mina said on a TV program “was a long dialogue which discussed the health system’s problems, sounding the alarm that there are shortages of many medicines and medical supplies which aggravates the suffering of Egyptian patients. It called on officials to urgently take the measures needed to solve these problems.”
The users of social-networking sites launched campaigns demanding that the state provide the necessary medicines and medical supplies to save the patients’ lives after wide sectors of people realized the health sector’s dire situation.
Death centres
Based on official statistics, annually more than 20,000 people are released dead from medical facilities across Egypt. Many sources confirm that these statistics are not comprehensive and do not reflect the actual numbers of the health system’s victims since the Ministry of Health exclude those who die before or during their transport to hospitals or those released on the pretext that they need rest before undergoing surgeries after doctors confirm their deteriorated medical situation and imminent death or because families fear the complicated measures of taking corpses out of the hospitals’ freezers.
Accusations are leveled at medical negligence, incompetent doctors due to a poor education system especially the anesthesiologists. Other factors reveal the major failure of the health system which turns even doctors into victims.
One of those victims was Dalia Mehrez, a 28-year-old doctor who died “of a deadly infection during work in November 2015.” The story was published on the association’s website. There are no reliable statistics for the number of doctors whose lives are threatened as a result of the health system’s poor management or work risks. Egyptian doctors have been struggling for years to improve their wages and raise the infection allowance from L.E. 19 (USD 1) to L.E. 1000 (about USD 55).
The low wages of the doctors working in public and educational hospitals, which provide healthcare services to the majority of Egyptians, as well as the doctors’ feeling that they are treated unjustly, undermine their work quality. Doctors are also forced to deal with increasingly difficult working conditions.
For example, there are not enough beds for patients. In 2016, the Central Agency of Public Mobilization and Statistics revealed a sharp decline in the number of hospital beds despite the population growth. The total number of beds in 2003 was 145,703 with a population of 68,000,000 compared to 124,300 beds with a population of 90,000,000.
In light of the decreasing number of beds and the law ratio of doctors to population, the number of deaths due to a poorly functioning health system is on the rise, the same statistics show. In 2010, of the 2,152,799 patients who were admitted into hospitals, 22,148 died and in 2012, 2,037,039 were admitted and 26,300 died with an increase of 4,000 deaths.
Systemic problem
Dr. Amr Shora, member of the Doctors Association’s Board of Directors, ascribes the failure of the health system to “corruption and the distribution and priorities of the state spending on the health sector, poor distribution of medical workers and the absence of a control system.”
He says the association ensures doctors’ competence through the licenses it grants them and its disciplinary committee which holds wrongdoers accountable. The punishment scale starts from blaming, warning, fining, temporary withdrawal of licenses and eventually permanent withdrawal of licenses.
He adds: “In 2014, the association received 700 complaints which were investigated and 60 doctors were convicted. The other complaints were dropped as no mistakes were committed by doctors. Anesthesiologists are victims. They are the most accused of negligence due to their sensitive work. However, in most of the cases, the problems are caused by the medicines’ implications rather than the doctors’ mistakes,” says Shora.
Shora claims that the association, civil society organisations and some parties plan to improve the health system but they are ignored by the executive and legislative powers under a military dictatorship.
