Monthly Archives: June 2016

Medical Care in Egypt

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Until now, most of my writing about Egypt has been effusive and adoring. No doubt, I love this country for so many reasons. But the longer I stay here, the more I start to see the tragic failures and inadequacies that are causing suffering for millions. It really hurts to have to share the ugly and heartbreaking side of Egypt, but it’s a reality that needs to be known.

My first experience with Egyptian medical care was during my first visit. My husband and I wanted to get standard STD tests to ensure that neither of us had any sexually communicable diseases that could be passed to one another. Apparently this is something that Egyptians don’t do much, because we had to explain numerous times what we wanted to the lab workers. Instead of testing us for things like chlamydia, gonorrhea and the like, we were given tests for Hep B, Hep C, and AIDS. They all came back with negative results, alhamdulillah.

But this is what exactly happened when we went for those tests. I was asked, by the phlebotomist who was at the same reception table she sits at to take payments and do other business dealing with customers, to expose my arm to her right there. I was not taken to a private room. She was not wearing protective gloves.

She drew my blood, but not into the same type of syringe I’m used to seeing. The syringe was the kind that draws the fluid into its own built-in chamber. The test tube that collected the sample was lying on the table separately. She drew my blood with that syringe, and then squirted it back into the test tube through the needle that was in my arm. Kind of like what you do when you are drawing up an insulin dose, and you are squirting some out to release the air, except she emptied the whole chamber of course. I could not determine if the needle attached to that contraption was a sterile, disposable one or not.

Next it was my husband’s turn. Same procedure, different equipment than the one used on me. That at least was reassuring. When she removed the needle from his arm, though, a drop of his blood spilled on her table. She (still not wearing gloves) got a piece of cotton and wiped it up, then threw the used cotton in the regular trash bin next to her desk.

This was shocking to me, but mild in comparison to what I will share in a moment.

Because of the notorious healthcare practices, besides what we experienced as I just described, my husband and I were intent to avoid any unnecessary procedures when we had to have a medical examination to get our health certificate to present for our legal marriage. We completely waived the recommended blood tests- which were actually the same ones we had done before anyway. They still insisted to get a blood sample to check the compatibility of our blood types, which only required a finger stick. Fortunately, they used disposable, sterile lancets to do that. However, when they got the sample from our fingers, they mixed the sample with a solution on test slides right in front of us, again using only tissue to wipe them once finished.

While we were waiting for them to get the sterile lancets to complete the tests (which I believe my husband had insisted on, otherwise we might not even have been given those), several people came in in and out of the tiny room where we were. One of them was carrying his own test tube blood samples in his hand, asking where to go to submit them for testing.

And that is where I will begin to describe what happens when someone actually admits into a general hospital here for serious care, whether it is a life-saving operation, communicable disease management, or any other number of emergent conditions. This is what has been happening to my father in law, while he is waiting for an operation to remove a cancerous tumor on his spine.

My father in law entered the hospital about a week ago paralyzed from the waist down. He is catheterized and wearing adult diapers. Even when he got the catheter before his admission, no nurses were willing to come to his house to insert it properly, and my own husband ended up being the one to do so. He had to obtain the catheter lead and disposal bag on his own, as well. There are no “home based medical care” services here that will routinely perform such procedures.

My father in law is in a large room shared with eight other beds besides his own. These are not medical beds, where you push buttons to raise up or lower yourself. They are not on wheels. They are iron flat beds that look pretty much like the kind you would see in an orphanage circa 1920.

His hospital room-mates are not all cancer patients, or awaiting operations. There is no organized unit based on symptoms or treatment needs. Everyone is thrown together with everyone else. One room-mate in particular is a young boy who is psychotic. He is yelling and crying constantly, and sits on his bed thrashing about.

Each patient has about 4-6 people visiting or attending to him at any given time, 24 hours a day. So the commotion, when that is multiplied by 9, is mind-boggling. There is no privacy between the beds, so whatever one patient is suffering is seen by all. So if someone is vomiting blood, all in the room witness it. If someone loses their bowels, everyone smells it.

As if that weren’t bad enough, the sanitation standards are completely unacceptable. That bloody vomit on the floor? It stays there for a while. No one cleans it up right away. If it is cleaned up, chances are it’s with a quick swipe of an already filthy mop that has been stored in a much filthier bathroom just across the hall.

Ironically, the cleaning staff seems to be doing most of the work around the hospital. When my father in law needed help with something and my husband asked the nurse to do it, he was told to ask the cleaning staff instead because that was not “part of her job”.

In fact, it seems like very little is “part of the job” of a nurse or doctor. When my father in law had some alarming symptoms that needed to be investigated, the nurses were told. When nothing happened, the nurse said “I told the doctor, I did my job”. When the doctor was asked why no one is treating him, the doctor said “I told the specialist doctor, I did my job”.

When my father in law’s urine bag or diaper needs to be changed, my husband or his brother does it. The nurses will not touch him. They excuse themselves by saying, “he’s a man, and I’m a woman”, even though there are plenty of religious concessions for this sort of thing when it comes to medical need.

The hospital does not provide blankets for the patients, or basic medical supplies. When blood samples are needed, my husband or his brother secure the test tubes themselves. The nurse will do the actual blood draw (actually I’m convinced that’s all the nurses will do), but after that my husband or his brother must take the samples themselves to the nearby lab, and also retrieve the results when they are ready.

In the case of an operation, the patient and his carers must be able to provide many of the items needed for the procedure, including dozens of bags of blood for transfusion. It doesn’t matter that getting bags of blood or plasma is illegal and difficult for a regular person to do. The patient also has to secure the surgery garments for the surgeon, as well as his own. If all of the necessary things are not obtained by the surgery date, it will be cancelled altogether- no matter how risky that may be to the patient’s health.

Thankfully, what I am describing is what is seen in the government-run hospitals that provide care for the mass population. There are better alternatives in private healthcare settings, but those are priced at a premium that most can’t afford.

Of course there is no way I can ever imagine subjecting my husband, myself, or my children to this atrocious level of care if we were ever in need of it. As far as I’m concerned, as much as I want to spend the rest of my life in Egypt- I will not do it unless we are financially capable of securing the best medical care for ourselves should it ever be needed. I am always praying that Egypt will become a better country than it is, and that these sorts of deplorable conditions will be improved drastically very soon.

 

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