At just eight years old, Yemeni schoolboy Marwan Mohamed was one of the first patients at an Abu Dhabi hospital to undergo heart surgery via a tiny incision in his thigh.
The young boy was treated at the NMC Royal Hospital earlier this year after securing medical financial assistance from a UAE health programme.
He was not the typical heart patient seen by doctors, who would usually treat men over 50 with a history of poor lifestyle, smokers and the obese.
Marking World Heart Day, doctors revealed details of the unusual surgery to show heart problems can strike at any age.
In May, Marwan was taken to Sukatra Hospital in Yemen after his parents realised he was not growing like his friends and was persistently unwell.
A doctor heard abnormal sounds coming from the boy’s heart.
He was found to have severe narrowing of the pulmonary valve and a big defect between two chambers of his heart, caused by a congenital condition.
The young boy’s father, a fisherman, did not want to be named but because of the family’s poor financial situation, qualified for assistance from NMC Healthcare under a UAE government assisted health programme.
Marwan was flown in to Abu Dhabi in May 2021 and stayed in the country for around 40 days.
“A plan was developed to perform balloon dilation of his pulmonary valve and closure of the defect in his heart without open-heart surgery, but through cardiac catheterisation with a very small needle prick in his thigh,” said Dr Anas Abu-Hazeem, a consultant paediatric cardiologist at NMC Royal Hospital, Abu Dhabi.
“The child’s heart valve was expanded with a balloon catheter and the heart defect was closed using a 15mm device. Marwan was able to walk the same day.”
The procedure was the first of its kind to be performed at the hospital, and because of its success it has led to other similar operations.
Marwan is now back in Yemen with his family and friends.
Cardiovascular disease (CVD) remains the world’s number one killer, resulting in 18.6 million deaths a year.
It has many causes, mainly from smoking, diabetes, high blood pressure, obesity and even air pollution but occasionally genetic defects from birth.
Young nurse struck down
Another younger patient was paediatric nurse Leena Susan Santhosh, 39, who was preparing celebrations for her daughter’s second birthday when she suddenly felt ill in August.
Although she was a diabetic, Ms Santhosh had no previously diagnosed heart conditions.
As she was about to drop her daughter off at crèche before a hospital shift in Al Ain, she began to experience sudden, unusual chest pains.
“I experienced chest heaviness after walking just a short distance,” Ms Santhosh said.
“My duty started at 9am and my routine was to drop my daughter to the babysitter before I went to work.
“Initially, I ignored the pain assuming it was because of my poor fitness levels.”
The nurse went for a check-up, with blood tests and an electrocardiogram that came back with normal results.
This was a clear sign and symptom of angina. But what anguished me was her gender, age and her being a non-smoker
Dr Austin Mohan Komranchat,
a specialist cardiologist
By the end of the day, she was in a lot of pain and discomfort. After she failed to complete a routine treadmill test, doctors decided to run an angiography - the gold standard in detecting heart disease.
“Shockingly, the test confirmed multiple blocks in her heart’s major blood vessel,” said Dr Syed Tanveer - a consultant cardiologist at NMC Speciality Hospital, Al Ain.
“Her left anterior descending artery - the largest coronary artery supplying blood to two thirds of the heart, was also blocked.
“She was immediately taken up for the angioplasty and the three blocks were treated by placing two stents — mesh-like structures placed inside the blood vessel at the site of the heart blocks to provide for an easy blood flow.”
The procedure required an overnight stay, but on September 6, Ms Santhosh was allowed to go home to her daughter and was back at work in the paediatric ward just two weeks later.
“A typical symptom is similar to exercised induced pain that gets better when the patient is at rest,” said Dr Austin Mohan Komranchat, a specialist cardiologist.
“This was a clear sign and symptom of angina. But what anguished me was her gender, age and her being a non-smoker.
“It is a known fact that premenopausal females of her age have oestrogen protection and rarely become a coronary heart patient.
“My advice to young females would be simple — maintain a healthy lifestyle of balanced diet with regular exercise and take preventive annual health check-ups.”
Rapid response critical
Doctors have stressed the importance of calling for an ambulance to take patients with chest pain to hospital.
Dr Mahmoud Traina, an interventional cardiologist at Cleveland Clinic Abu Dhabi, reported a culture of friends or family members driving patients into hospitals themselves - sometimes with catastrophic consequences.
“People think they can just drive to a clinic themselves, but that clinic or small hospital may not have the right resources,” Dr Traina said.
“What typically happens is that clinic will then evaluate the patient and then call for an ambulance themselves and have the patient transferred to a specialist hospital like ours.
“This causes a delay in their care.
“There is a culture of not using ambulances but people do not fully understand the kind of service they can provide.
“They will first triage the patient and then transfer them to the appropriate place.”
Recent data from the hospital suggested just 15 per cent of severe heart attack cases arrived at Cleveland Clinic Abu Dhabi in an ambulance, with the vast majority arriving at the emergency department after being driven by a friend or family member.
There are three hospitals dedicated or cardiac care in Abu Dhabi, including Cleveland Clinic AD, which is also the main hub for emergency cardiac care.
Other specialist cardiac centres are at Sheikh Khalifa Medical City and Sheikh Shakhbout Medical City.
A major heart attack needs to be treated quickly and any minute of delay worsens patient outcome.
Door-to-balloon times are internationally recognised metrics that determine the time from hospital arrival to getting the patient opened up in a surgical procedure. Ideally, this should be under 90 minutes.
For every ten minute delay, there is an 8 per cent increase in mortality, Dr Traina said.
“We get pre-notified by the ambulance via a signal to our emergency room so the right team is notified before the patient arrives at the hospital,” he said.
Abu Dhabi doctors use a 3D printed model of a two-year-old's heart to treat him — in pictures
UAE currency: the story behind the money in your pockets
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Benefits of first-time home buyers' scheme
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Learn more about Qasr Al Hosn
In 2013, The National's History Project went beyond the walls to see what life was like living in Abu Dhabi's fabled fort:
Classification of skills
A worker is categorised as skilled by the MOHRE based on nine levels given in the International Standard Classification of Occupations (ISCO) issued by the International Labour Organisation.
A skilled worker would be someone at a professional level (levels 1 – 5) which includes managers, professionals, technicians and associate professionals, clerical support workers, and service and sales workers.
The worker must also have an attested educational certificate higher than secondary or an equivalent certification, and earn a monthly salary of at least Dh4,000.
'Manmarziyaan' (Colour Yellow Productions, Phantom Films)
Director: Anurag Kashyap
Cast: Abhishek Bachchan, Taapsee Pannu, Vicky Kaushal
Rating: 3.5/5
'The Last Days of Ptolemy Grey'
Rating: 3/5
Directors: Ramin Bahrani, Debbie Allen, Hanelle Culpepper, Guillermo Navarro
Writers: Walter Mosley
Stars: Samuel L Jackson, Dominique Fishback, Walton Goggins
Ten tax points to be aware of in 2026
1. Domestic VAT refund amendments: request your refund within five years
If a business does not apply for the refund on time, they lose their credit.
2. E-invoicing in the UAE
Businesses should continue preparing for the implementation of e-invoicing in the UAE, with 2026 a preparation and transition period ahead of phased mandatory adoption.
3. More tax audits
Tax authorities are increasingly using data already available across multiple filings to identify audit risks.
4. More beneficial VAT and excise tax penalty regime
Tax disputes are expected to become more frequent and more structured, with clearer administrative objection and appeal processes. The UAE has adopted a new penalty regime for VAT and excise disputes, which now mirrors the penalty regime for corporate tax.
5. Greater emphasis on statutory audit
There is a greater need for the accuracy of financial statements. The International Financial Reporting Standards standards need to be strictly adhered to and, as a result, the quality of the audits will need to increase.
6. Further transfer pricing enforcement
Transfer pricing enforcement, which refers to the practice of establishing prices for internal transactions between related entities, is expected to broaden in scope. The UAE will shortly open the possibility to negotiate advance pricing agreements, or essentially rulings for transfer pricing purposes.
7. Limited time periods for audits
Recent amendments also introduce a default five-year limitation period for tax audits and assessments, subject to specific statutory exceptions. While the standard audit and assessment period is five years, this may be extended to up to 15 years in cases involving fraud or tax evasion.
8. Pillar 2 implementation
Many multinational groups will begin to feel the practical effect of the Domestic Minimum Top-Up Tax (DMTT), the UAE's implementation of the OECD’s global minimum tax under Pillar 2. While the rules apply for financial years starting on or after January 1, 2025, it is 2026 that marks the transition to an operational phase.
9. Reduced compliance obligations for imported goods and services
Businesses that apply the reverse-charge mechanism for VAT purposes in the UAE may benefit from reduced compliance obligations.
10. Substance and CbC reporting focus
Tax authorities are expected to continue strengthening the enforcement of economic substance and Country-by-Country (CbC) reporting frameworks. In the UAE, these regimes are increasingly being used as risk-assessment tools, providing tax authorities with a comprehensive view of multinational groups’ global footprints and enabling them to assess whether profits are aligned with real economic activity.
Contributed by Thomas Vanhee and Hend Rashwan, Aurifer
Abaya trends
The utilitarian robe held dear by Arab women is undergoing a change that reveals it as an elegant and graceful garment available in a range of colours and fabrics, while retaining its traditional appeal.
The specs
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