Doctors' strike in Egypt wins promise to double health spending

Doctors on strike demanding a raise in their salaries, better working conditions, and improved services at the country's hospitals. The Arabic reads 'Doctors deserve the high salaries category.'

CAIRO // The government promise to nearly double healthcare spending in hospitals across the country has set Egypt on a course to rebuilding its crumbling public healthcare system, supporters of a doctors' strike said yesterday in claiming victory.

But the strike's resolution could also strain the government budget and encourage a growing wave of destabilising labour disputes across the country, critics warned.

Organisers decided to suspend the strike at least until Sunday after meeting with Essam Sharaf, the prime minister, and other officials, said Mohammed Hassan Khelil, the co-ordinator of the Committee to Defend the People's Right to Health, that played a leading role in the strike.

"The ministry of finance has told us that the percentage spent on health has been increased and nearly doubled. It's less than we asked for but it's an important step forward," said Dr Khelil, who attended the meeting.

He said that the government officials also promised to improve the transparency of the budget and study the doctors' other demands.

Suspending all care except emergency services at public hospitals on Monday, the striking doctors also demanded better equipment for patients, higher salaries, better security at hospitals, and the resignation of the minister of health.

"I think we are in the era of a real democracy, for the first time the civil society has a say in the government health budget," said Mr Khelil.

The total budget for public health care and university hospitals as a proportion of government spending will rise to well above 7 per cent from 4.6 per cent today, Dr Khelil said.

The Egyptian government, which uses a different definition of total spending and sees the new proportion spent on health care between 11 and 12 per cent, starts its new financial year on July 1 and was scheduled to approve a final budget late yesterday.

The doctors had demanded an increase to 15 per cent of spending - using Dr Khelil's definition of spending - to conform to international standards set down in the UN Millennium Development Goals.

At Mounira Hospital, a large public facility near downtown Cairo with several hundred doctors, a handful of striking doctors interviewed on Monday said they had finally lost patience with a public health system that provides them with inadequate supplies and medicines for patients and offers them basic salaries of less than 400 Egyptian pounds (Dh247) a month.

Mohammed el Benhawi, a radiologist, estimated that between 70 and 80 per cent of patients are asked to fund the cost of medicines and some basic supplies such as bandages because the hospital cannot provide them.

At the same time, he said, he is forced to supplement his job with work in a private practice and takes home just 1,000 pounds a month, even with 80-hour work weeks.

Egypt maintains a multi-tiered healthcare system in which those with means can pay a premium for good-quality care in private hospitals and clinics.

Everyone else is left to the mercy of a nationwide healthcare scheme that purports to offer a basic level of care but frequently fails to meet the government's own standards.

"It's like a stage play: I'm playing doctor, and the patient is acting as patient, and the medicine is acting as a medicine" because it is frequently expired or ineffective, said Mohammed Hassouna, a resident in the general surgery department.

"The image here is not all black, but we need to realise there is a real problem in the health sector."

An impromptu tour of the hospital's emergency rooms and outpatient clinic revealed a number of deficiencies even to the untrained eye.

Beds in exam rooms had no sheets or plastic covering, rocked back and forth on rusted frames and were riddled with holes in the upholstery.

Sinks had precious little soap for doctors to wash their hands and no paper towels. Medical instruments were properly sterilised and there were plenty of clean disposable syringes, doctors said, but they complained about a shortage of latex gloves.

The hospital's intensive care unit was better equipped and has modern facilities, doctors said, but even much of that had come from private donations.

The hospital's director was unavailable for comment.

The doctors said they had been inspired by the January 25 uprising against former president Hosni Mubarak, Dr Hassouna said. "The revolution gives us hope, even if we can't know that we'll be successful," he said.

Doctors are hardly the only labour group drawing inspiration from the revolution. Police, postal workers, factory labourers and dozens of other groups have alternatively walked off the job in the last three months, seeking higher wages and better working conditions.

The country's military leaders have warned that such disturbances are taking a significant toll on the economy in the form of lost production and reduced foreign investment.

The doctors should have taken more time to negotiate before taking the step of striking, said Hamdy Said, the head of the Doctor's Syndicate, which voted, against his wishes, to strike.

"The financial situation in Egypt is bad, we are reaching a crisis, everybody should slow down their claims," he said.

"I think the government will be in a very tight situation, they will have to give a little bit to everybody rather than meet all the demands of just one group."