Medical brain drain endangers Egypt’s health care

The deficit ratio in health-care personnel in government hospitals in remote areas in Egypt is about 50% and 34% in hospitals in major cities. In nursing, the deficit stands at 55%.
Saturday 17/08/2019
Doctors take blood samples at the Sheikh Zayed Al Nahyan Hospital in Cairo. (AFP)
A sector at risk. Doctors take blood samples at the Sheikh Zayed Al Nahyan Hospital in Cairo. (AFP)

CAIRO - With the increasing exodus of Egyptian doctors and medical professionals, many large hospitals and smaller health-care facilities in Egypt face mounting challenges and the country’s health sector is at risk of failing.

Statistics from the Egyptian parliament’s Health Committee indicate the deficit in health-care personnel in some government hospitals in remote areas in Egypt is about 50% and 34% in hospitals in major cities. In nursing, the deficit stands at 55%.

This deficit finds a logical explanation in deteriorating working conditions of doctors in most official health facilities, in the collapse of wages, increasing rate of assaults on medical personnel in hospitals, lack of suitable environment for the completion of postgraduate studies, increasing demand for doctors in private hospitals and the draw of job opportunities for medical personnel abroad.

To address the flight of medical doctors, the Egyptian government came up with several recommendations, including increasing the number of students admitted to medical schools and expanding plans for new public and private medical schools.

The goal is to inject large numbers of doctors into government hospitals to deal with the crisis through temporary action until long-term solutions are found. However, experts said they fear the move could lead to producing poorly qualified doctors.

The government’s move caused a stir among Egyptian doctors, led by the Egyptian Medical Syndicate (EMS), which pointed that there is no way to add large numbers of doctors before students complete the necessarily long process of medical school and training.

EMS Under-Secretary Mona Mina said: “The government’s recommendations constitute a sabotage of the medical profession. The real problem is the unfavourable work environment of doctors, compounded by administrative arbitrariness… and very low wages of approximately $150 a month.”

Mina claimed the Egyptian Ministry of Health does not care about providing appropriate working and living environments for doctors in remote areas, which explains why doctors increasingly shun working in those areas. There are also difficulties experienced by resident doctors and the almost daily harassment experienced by female doctors and nurses.

Some observers said part of the doctors’ crisis has to do with government policies related to curbing expenditures on public services while allowing the private sector to take over some activities in the education and health sectors.

Experts said increasing the number of medical schools would not be productive or efficient without an increase in the number of university hospitals because the country could end up with unqualified doctors. Instead of solving the issue of a lack of doctors, the government could end up compounding it with new problems.

Dr Mahmoud Hamed, who opted to work in Saudi Arabia last year, said it is not only the opportunity to work abroad that pushes doctors in public hospitals to resign. Private hospitals in Egypt are enticing young doctors to leave their jobs in government hospitals.

Hamed said: “Government hospitals suffer from an acute shortage of qualified personnel in certain specialties currently in high demand, such as brain surgery, neurological and cardiovascular surgery or psychological and neurological disorders.”

He said “80% of public hospitals” cannot provide open heart, kidney or liver surgeries.

There is an alarming increase in acts of violence against doctors in public hospitals in Egypt. Doctors have become targets of anger and frustration experienced by patients’ families to the point that, in 2015, EMS suggested a bill for the House of Representatives concerning medical liability and hospital protection but the measure has not yet been considered by legislators.

Medical errors leading to death are considered criminal offences, subject to up to 5 years in prison. EMS is lobbying to have cases of medical malpractice transferred to the civil damages compensation system.

EMS said only cases of proven gross negligence should be referred to criminal courts, while cases of post treatment complications should not be penalised at all. The syndicate wants to double the maximum prison sentence to 10 years for those convicted of assault against doctors and hospital staff.

The Egyptian health sector may face further challenges unless the government acts within its moral and social responsibilities to protect the health of the citizens and provide appropriate working conditions for doctors. The brain drain in the health sector is putting the health of millions of Egyptians at risk.