A view on the challenges in Egypt’s public healthcare amid political turmoil

While working for a special issue on stone disease with Prof. Ahmed Shokeir, renowned urologist from Mansoura Urology & Nephrology Center in Egypt and editor-in-chief of the Arab Journal of Urology, I had the opportunity to ask him some pertinent questions regarding the recent political events in Egypt. Prof. Shokeir described its impact on medical services and the way healthcare professionals responded to challenges.

Below are selected excerpts from the interview:

Q: Prof. Shokeir how would you describe the main outcome of the Egyptian revolution?Shokeir: For the first time in many decades we can call ourselves free people. Although we still have a long road filled with hardships ahead of us, we finally stand on solid ground, feeling proud and the honour, for the first time, in many decades.

Q: In the light of recent changes, what were the main problems in the patient-doctor relationships in Egypt beforehand?Shokeir: Long had Egyptians suffered from oppression. It was not an uncommon practice at that time to imprison people, repress free will and falsify elections. In the midst of all that corruption, both doctors and patients lost the excitement or interest in politics, as well as any hope for change. The fraudulent abuse of the people’s votes occurred in a stereotypical way which made everyone despair of any renewal. Patients experienced humiliation and brought to submission, which made them fear to ask help from the doctor.Doctors, on the other hand, are not without flaws themselves. Some were disrespectful of the patients’ wishes and did not appreciate the patients’ rights to all relevant information about their treatment plans, or the need to obtain their consent before starting any treatment.

Q: What has changed in the patient – doctor relationship?Shokeir: Such an historic event had an impact on all classes, including the educated and the illiterate, doctors and patients. Despite the positive changes there were also some behavioural changes, and unfortunately they were not always of the decent kind. The respect towards doctor is no longer there, and many moral courtesies were abandoned along the way, such as appreciation and esteem for others. Patients could no longer differentiate between personal rights and the violation of the rights of others. Moreover, some patients lost respect for medical professionals and became rude, more violent and less courteous. That naturally led to conflicts among patients, doctors and all those working in the medical sector.

Q: Was there an impact on the relationships among doctors as well?Shokeir: Junior doctors have lost that professional ‘barrier’ or respect formerly given to their seniors, who have more veteran experience. These young doctors no longer hold in high esteem professional expertise or seniority. Fortunately, that is not the case with all doctors since there are still many who have moral values and civil manners.

Q: Surely, all these professional relationship problems must have been also reflected in the supporting staff level?Shokeir: Medical personnel, including nurses and staff employees started asking for more, increasing their demands for salaries and lesser work hours. They rebelled against the hospital management. It seems that now they demand for more rights and privileges, while neglecting the consequent responsibilities.

Q: There seems to be an upheaval particularly in the professional interactions on all levels in medicine. Can you give us your personal outlook for the future?Shokeir: This will take Egyptians some time (perhaps more than it should) to learn that practising the rights of freedom does not mean losing respect and honour for others. Egyptians need to learn again the value of honour and respect, devotion and dedication, philanthropy and love for their country. It is only after reviving such values will there be hope for our people to excel and gain our rightful place in the Middle East and the rest of the world.