Is Egypt’s health system beyond recovery?

Friday 03/07/2015
Patient’s relative on the floor inside a Cairo hospital room.

Cairo - When his father fell tragically ill, Mo­hamed Salah rushed him to the nearest state-run hospital in Cairo, hoping that doctors would do something to treat the sexagenar­ian.

At the hospital, the 30-year-old waiter was in for a shocking experi­ence. There was no empty bed for his father, the hospital was over­crowded and “full of dirt”, and there were no doctors to talk to.

“I just couldn’t believe that a place that is supposed to be offering medical treatment to human beings would be that unbearably unclean,” Salah said.

“Apart from the dirt that filled the whole place, there were no doctors around, no medication, no equip­ment or the minimum of what it takes for the treatment of any health hazard whatsoever.”

Egypt’s rickety and poor health system is once more in the head­lines, causing shock and disbelief across the country.

Hundreds of state-run hospitals are turning into no-go places for millions of patients as the facilities suffer from neglect, lack of equip­ment and scarcity of trained medi­cal workers.

Whether it is in Cairo or in other cities or provinces, state-owned-and-run hospitals are failing to pro­vide proper care to patients, a con­dition the country’s health workers blame on the lack of funding.

“Our country’s health sector is in bad need of a revolution and change,” said Alaa Ghanam, the head of Right to Medicine, a local non-governmental organisation. “This system must be restructured in a way that ushers in an independ­ent health council to run the hospi­tals according to the highest inter­national standards.”

Egypt’s health system made headlines after Prime Minister Ibra­him Mahlab said he was flabbergast­ed by conditions at the Heart Insti­tute, the largest cardiac hospital in Egypt, during a recent visit

Spending on Egyptian health is almost half of what other similar middle-income countries spend, according to the World Health Or­ganisation. Egypt allocated 1.7% of its gross domestic product, an es­timated $5.5 billion for the health sector in the 2014-15 budget. This amounted to 5.37% of overall gov­ernment spending.

The new Egyptian constitution, approved in 2014, stipulated rais­ing government spending on health to 3% of gross domestic product in the next budget. Many are sceptical about the government’s ability to do so while the country is struggling economically.

“I am sure that calls for raising the health budget will continue to be mere ink on paper for a long time,” Hossam Kamal, a member of the board of the non-governmental Medical Association, said. “The same old policies are being applied over and over again with no change, which at the end reflects negatively on poor Egyptians seeking medical treatment.”

Underprivileged Egyptians, like Salah’s father, who cannot afford to pay for medical care, have no choice but to take what’s available.

After trying another state-run hospital, the Hepatitis C patient was finally admitted. But first, he had to wait for hours in a long queue to be examined by the single avail­able doctor. The hospital room was equipped with dirty beds, had bro­ken windows, and there were no nurses or other doctors around to tend to patients.

“I had to give him the medicine myself,” Salah said. “When he want­ed to go to the toilet, I had to help him there. He was in bad need for professional care, but there was no one to give it.”

According to a recent study by the Egyptian Center for Economic and Social Rights, doctors make up 15% of Egypt’s health workforce, admin­istrative workers 70%, while nurses make up the remaining 15%.

Doctors and nurses are poorly paid, with their salaries account­ing for less than 20% of the health budget, the study added.

Cardiologist Dr Rashwan Shaaban pointed out that fresh graduate doctors receive 200 pounds ($26) a month in salary, whereas doctors like himself who have been in the job for 20 years, receive a monthly salary of less than 2,000 pounds ($263).

“This is why a doctor has to do more than one job and work at more than one hospital to be able to put food on the table for his family,” Shaaban said.

The country’s health system was targeted in a campaign filled with bitter sarcasm on the part of doc­tors who turned to social media to express their frustration with hospi­tal conditions. They created a Face­book page, posting shocking photos from inside hospitals, which they said was addressed to the prime minister “so he would not be sur­prised when he visits hospitals in the future”.

One photo shows a patient sleep­ing on a hospital bed while stray cats play freely in the room. Anoth­er photo illustrates a dirty operating room with cracked walls.

The poor conditions of state-run hospitals opened the door for the rise of a parallel private health sys­tem, which few Egyptians can af­ford. Private medical care was way beyond Salah’s means. He said his father was eventually referred to a state-run hospital where proper health services are offered but only for those who could pay.

When asked for an advance pay­ment of 5,000 pounds ($657) before his father received care, Salah, a fa­ther of two children, whose salary is 2,000 pounds ($263) a month, could not afford it.

His father was denied care he badly needed and died shortly after.

While this happened weeks ago, Salah continues to live with the bit­ter experience of poor medical care in his country. “I am sure if my fa­ther had been a moneyed business­man he would still be alive today,” he said.