EgyptFeatures/Interviews

Amid security problems and desperation, Egypt’s hospitals struggle

A man walks into a hospital, asking to be admitted as a patient into the neurology department. The receptionist apologizes and politely informs the man that this particular hospital does not have a neurology department. The man responds by pulling out a gun, aiming it at the receptionist, and repeating his request.

“He simply refused to believe that we did not have a neurology department he kept screaming ‘what kind of hospital is this,’ calling us con artists, and making threats,” recalls Dr. Mohamed Mostafa Abdel Ghaffar, general manager of Ahmed Maher Teaching Hospital in downtown Cairo’s Sayeda Zeinab neighborhood, where the scene unfolded a few weeks ago. “What do you do in that kind of situation?”

This is a question that Ghaffar and countless other hospital employees in Egypt now commonly find themselves facing. The most significant consequence of the revolution remains the ongoing absence of an effective police force and, consequently, the escalating state of lawlessness. Few people have felt the effect of this critical situation as strongly as doctors and hospital workers, who now find themselves caught between their sworn duties as medical practitioners, and the dangers of dealing with a desperate and at times delusional ­population. In its visits to seven hospitals in the greater Cairo area, Al-Masry Al-Youm was subjected to a seemingly endless list of similar complaints and alarming anecdotes.

“People have come out of the revolution with the belief that there is no limit to the amount of rights that they can demand any request, any desire or whim has now become a basic human right,” says Ghaffar. “You add that to widespread anti-authority sentiments and a state of lawlessness, and it’s not at all surprising that the result will be absolute chaos.”

According to Ghaffar, this chaos is on daily display at the Ahmed Maher Teaching Hospital. “With an increase in patients, you get an increase in visitors,” says Ghaffar, explaining that in these large, high-strung, and mostly armed crowds, “fights break out regularly now over the simplest things, and they can get very violent very quickly.”

Consequently, it’s become routine, he explains, for hospital workers to brace themselves for a physical altercation of some kind upon hearing angered cries of "what do you mean there’s no room in the hospital?" or "what do you mean you can’t perform my surgery right now?"

Worse yet, Ghaffar points out, is the violence that comes spilling in from the streets, and the Ahmed Maher Teaching Hospital suffers from its central downtown location, with one building separating it from the Cairo Security Directorate which makes the hospital’s lack of police protection surprising. “Sometimes it feels as if we’re in a war zone,” he says of both the influx of patients and the intensity of their wounds.

Doctors at the Coptic Hospital on Ramses Street have had to deal with similar situations, particularly following the violence that broke out between Coptic protesters and the armed forces outside the state television building, Maspero, on 9 October. “People were throwing burning tires and Molotov cocktails through our windows,” explains Dr. Mohib Ibrahim Fanous, the hospital’s general manager. “We couldn’t rely on the police they were more scared than the hospital staff. Most of them ran away.”

“For our protection, we rely on our staff, the community which we’ve been serving for 86 years, and God,” Fanous claims. “We try to absorb people’s anger, but sometimes it’s too overwhelming. And sometimes people don’t want their anger absorbed; sometimes they want to express it.”

“Now, everyone is armed,” Ghaffar confirms. “People come to the hospital seeking treatment, but they’re still carrying guns and knives. Others come to the hospital seeking revenge, because they know their enemies will be there, visiting their latest casualty.”

Often the hospital will admit a victim of a family feud or gang warfare, only to have its premises turned into a battleground, a converging point for the two opposing parties and the next round of their fight.

When these fights break out, it’s up to the hospital staff to control them to the best of their abilities. “Police involvement in these situations is strictly limited to paperwork,” Ghaffar sighs. “They will wait till the fight fizzles out or until everybody’s dead and then they’ll come in to survey the damage, write up a report, and resume their posts.”

The hospital’s vulnerability extends beyond its lack of proper police protection ongoing extensive renovations have left most of the ground floor exposed and the low perimeter walls are riddled with gaping holes. The building itself has numerous entry points, none of which seem to be guarded.

“Our security relies solely on the how well our doctors can take a punch to the face, or a knife-assisted threat or insult,” Ghaffar smiles bitterly. “The official way we’re dealing with this is by telling ourselves that all our patients are mentally ill and we just have to do our best to help them, regardless of their irrational behavior.”

For Dr. Moenes Abulatta, medical director of Al-Salam International Hospital, the answer is simple: Take matters into your own hands.

“We have our own form of security,” he says, smiling. “Let’s just leave it at that.”

Al-Salam hospital has had its fair share of issues, most of them stemming from a surge in patients, which the staff has been struggling to deal with.

“I won’t lie and tell you that we haven’t been having problems,” says Abulatta. “But we don’t rely on others to take care of them for us. We’ve taken the appropriate measures.”

While Abulatta won’t elaborate on these “appropriate measures” some clues can be found in the hospital’s security adviser, Anjan Kumar Gurung, a stern-faced, no-nonsense wall of a man whose stance on Al-Salam’s security policy is: "We’re not allowed to carry firearms unfortunately.” Whether or not this official policy is upheld is another matter.

Along with a panel of surveillance screens continuously studied by a team of security officers directly outside his office, Gurung’s demeanor is a clear indicator that Al-Salam hospital is not taking any chances. Neither is Abulatta, who seems to believe that the worst may very well be yet to come.

“People are scared and there are a lot of questions hanging over everything,” he explains. “But I will say this this state of lawlessness is being very carefully controlled. It’s like those responsible don’t want us to feel safe, but they’re not willing to burn the country to the ground to make their point at least, not yet.”

In Abulatta’s opinion, the lawlessness limbo is a sign that the current situation is as heavily controlled as, he believes, the calls broadcast on television during the height of the revolution, in which supposed citizens claimed that their “houses were being burned to the ground, and their daughters raped on the street.”

Among those panic-stricken calls were reports of continuous, brutal raids against the Children’s Cancer Hospital in Old Cairo, targeted by thugs and looters for its expensive equipment and cache of prescription drugs. It comes as a relief, then, that one of the most heart-wrenching episodes of the 28 January the “Day of Anger” turns out to be, in the words of a hospital official, “completely false.”

“There were no thefts or break-ins, no casualties,” says Ahmed Abdel Moneim, director of public relations at the Children’s Cancer Hospital. “There were several attempts, certainly, but they were all successfully warded off by neighborhood residents, our own staff and security, as well as parents of the hospital’s patients, and members of the armed forces.”

“Generally, I don’t think people would attack a place like this,” says Abdel Moneim. “The attempts all happened during the first wave of chaos, when people lost their minds. Now, things are calmer, and I personally don’t think we have to worry about being targeted.”

Nonetheless, Abdel Moneim points out that the hospital board has devised a “series of emergency plans” should his faith in the population’s integrity prove to be misplaced. In addition, he claims the hospital is “continuously guarded” by members of the armed forces, although none were spotted during Al-Masry Al-Youm’s visit. These measures have cemented a sense of comfort in Abdel Moneim that doctors in other hospitals can only dream of, at least for now.

“People need to calm down,” Fanous suggests, expressing his belief that the current situation will only improve once “people stop panicking and get back to work.”

Others are not as optimistic.

“It’s unlikely that the situation will improve soon,” says Ghaffar. “Especially as the discourse held by those in power is still ‘how do we put the people down’ or ‘how do we shut them up’ as opposed to ‘how do we give them what they want'”

“You need to realize the majority of the Egyptian population consists of people who can’t explain why they’re poor, and who can’t understand why they’re sick. Unfortunately, most people don’t know what they want, and even if they did, they wouldn’t know who to ask for it.”

“The real danger lies in the fact that, now, Egyptians have developed this love for rebelling violently against any type of authority, regardless of a legitimate cause,” he sighs. “It’s the new national epidemic.”

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