Hell-th

I used to cover the long-running campaign by Ministry of Health doctors for better conditions and wages, and it was one of my favourite beats. The activist doctors (members of the Doctors Without Rights group) were tireless and inspiring and their struggle brought together all the recurring themes of Mubarak’s Egypt: state security investigations officers lurking in Syndicate corridors, an intransigent ministry, and a sclerotic syndicate run for over a decade by a double-dealing National Democratic Party corpse of a septuagenarian having an uncomfortable affair with the syndicate board of Muslim Brotherhood members who, when they were not being arrested by the regime were very happy not to rock its boat.

The syndicate head has changed (and been replaced by someone equally antique and corpse like; it seems to be some kind of rule) and now the MB find themselves running the country. But other than that everything’s the same.

Last month I went to a small press conference doctors organised at the doctors’ syndicate where mostly leftist political activists came to express solidarity with the doctors’ strike (which today entered its 41st day).

The syndicate board had clearly not been informed in advance that the press conference would be happening, and at one point the door burst open western saloon style and secretary general Abdel-Fatah Rizq strode in, hands on hips, suit jacket off a la Obama. You could almost hear his spurs chinking as, like meat in a mincing machine, he forced out pleasantries through a taut slash of a smile. The whole episode lasted less than a minute, and after he had pissed on his lamppost Rizk returned to his office.

Before the revolution doctors were fighting the government and their own syndicate. Now they have to fight the government, their own syndicate and occasionally patients themselves.

On Saturday I accompanied my friend Ghazala, who is making a video about the doctors’ strike, to Boulaq al-Dakrour General Hospital. The hospital is next to the district police station, burnt down during the revolution. The last time I had been to Boulaq was to watch a protest by Sunni Muslims demanding that Egypt’s Shia Muslims basically be hung drawn and quartered and then killed again. This area of Boulaq is a particularly grim concrete explosion of stacked bridges, fragrant rubbish and evil traffic, and the sagging hospital building watches over it all, sadly.

The hospital’s accident and emergency (A&E) department has been closed in protest since October 30, when a doctor informed relatives of a patient who needed an injection that said injection wasn’t available, and that complaints about this should be directed to the hospital manager. The relatives responded by beating him unconscious. One of his assailants turned out to be a police officer from the police station next door.

There was an eerie silence in the A&E and its dark rooms. Devoid of people, it looked even more neglected and tatty than it presumably usually does. Handwritten signs hung on broken doors and cockroaches crawled up stained walls. A friendly kitten rushed out to greet us but was ambushed by a panicked tailless adult cat who streaked out when we entered. The kitten froze in a comical gros dos.  We were shown a prehistoric X-Ray machine that doesn’t work. Luckily however there is another, modern, CAT scan machine that does work but there is rarely any film to print out results. So doctors have to come down to the machine to see patient scans or patients have to provide the film themselves.

Upstairs, patients and their relatives sat in sparse rooms, alternately dark or fluorescent lit. On the almost empty neonatal ward a tiny baby in an incubator lay all alone, his chest fluttering, his eyes seeking out something. The room next door was closed because of a fire. The damage has still not been repaired. Opposite this room was another miniscule baby on a ventilator having light therapy for jaundice, his eyes covered in a mask with jaunty sunglasses drawn on it. A doctor told us that the hospital only has one functioning ventilator, and that when it is occupied parents are forced to seek out ventilators at private hospitals, funds for which they cannot always raise.

Patients are allowed to have one family member with them outside of visiting hours, and this is mostly to assist them with the things that nurses are supposed to do. So you will see people pushing their relatives around on gurneys, taking them to the toilet, bathing them. This isn’t necessarily problematic in theory except that where a relative isn’t available it means relying solely on overstretched and under motivated nurses.

We asked the doctor who was guiding us around to let us talk to hospital cleaning staff, but he couldn’t find any. The doctor asked a woman sitting at a nurses’ station how much, approximately, a cleaner’s salary is – he had heard that they earn something bonkers like LE 2 a day. Of course not, the woman said. They earn something in the range of LE 200 to LE 300 per month. The doctor laughed. “That’s my basic salary,” he said.

**

There was chaos at the A&R entrance of the Qasr el-Aini Hospital when my colleague Adam and I arrived on Wednesday night.

A group of men were gathered around the door carrying planks of wood, steel pipes and other assorted makeshift weapons. They were anticipating an attack following an earlier fight sparked when visitors of the revolution’s wounded receiving treatment in Qasr el-Aini reportedly objected to paying the LE 5 entrance fee. The previous week there had been a similar confrontation resulting in a huge brawl.

(The ticket system is a way of raising revenue. Patients in Ministry of Health hospitals in any case frequently have to pay for services. Under Mubarak there was a move towards privatisation of the healthcare system and given the Brothers penchant for all things capitalist there is little reason to think that this will change.)

Hospital employees were intensely suspicious of us as journalists, saying that the media has misrepresented Qasr el-Aini hospital’s side of the story by presenting it as persecuting the revolution wounded when in fact, they said, the revolution wounded are given many concessions which they abuse by bringing visitors to the hospital until 2 in the morning and smoking drugs on wards. (It also didn’t help that Adam had elected to cover the hospital wearing shibshib and tracksuit bottoms, the uniform of thugs according to the hospital staff and he was accused of being One of Them.)

(At one point an elderly man with alarming dyed red hair pushing a buggy like he was driving a speeding tank appeared in the doorway and promptly drove the buggy into my leg. Manoeuvring round me he then pushed the buggy away from him in the direction of one of the admin employees and then turned around to leave while muttering about something. Inside the buggy a girl of around two with a puffy face and orange skin sucking on a bottle stared out oblivious to the fact that she had almost just been abandoned. I saw the man later on, still pushing the buggy aimlessly.)

The revolution wounded had a different version of events.

Sayyed is an animated, frail man who was injured in the pelvis on January 28 2011. He appeared tiny in his dreary room. A Qu’ran was propped up next to a certificate of thanks for his revolution efforts. Having learnt to walk on crutches he was sent back to a wheelchair a couple of months ago when, he says, an officer tortured him. He was interviewed by Al Jazeera and insisted that while hospital security and some of the nurses treat him and others badly the hospital admin manager who took us to interview him for example is, “7abeebo”. He said that foreign doctors materialised one day and recommended that he and others be flown abroad for treatment not available in Egypt, but that this hasn’t happened.

Downstairs we found another of the revolution wounded, Osama, in an electric wheelchair holding on for dear life as his friends attempted to repair one of the wheels. They ended up by removing it entirely and assured Osama that it wouldn’t fall over. He moved forward and it listed right dangerously. His friends propped it up they trundled off.

Qasr el-Aini is meant to be one of Egypt’s best Ministry of Health* hospitals. It is vast and in relatively good repair. But there is a sadness about the place typical of anything state-owned and for the poor.

* Moftases points out that it is actually a university teaching hospital. Still public sector, but there is a distinction in funding terms. Doctors Without Rights’ Mona Mina has argued however that while the people who work in university hospitals are paid out of a different budget (Education) the institution itself falls under the Ministry of Health and thus university hospitals should be included in the strike. They are currently excluded.

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2 Responses to Hell-th

  1. Anon says:

    Sarah…I’m the weird Canadian who follows you on twitter. I have just spent the afternoon with a Doctor who is working in a public clinic…hope you don’t mind but I am sharing this on Facebook. Too bad you are no longer on this beat; the sorry state of health care in Egypt is a disgrace! I know many people who went to Tahrir in 2011 just because of this!

  2. Basil Fawlty says:

    Caaah – your best piece ever. Your writing style has taken a weary-but-undeterred tone, which is pitch perfect for these post-revolutionary times. A book, please.

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