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Doctors in the line of fire
Published in Ahram Online on 24 - 03 - 2020

Is it easy to call a doctor these days and find him or her available?
Their telephones are always busy, and their WhatsApp groups are often full. Friends and relatives are very often inquiring either about symptoms like those of the Covid-19 or questioning the notes shared on social media related to the pandemic.
“At this point, all our resources have been mobilised to fight the pandemic. As doctors we are practising anything that can help,” Dr Tarek Sharawi told Al-Ahram Weekly.
Sharawi is president of the International Society of Glaucoma Surgeons and believes that although the situation differs from one country to another, all physicians feel that they are responsible in facing the pandemic.
He said that the last global pandemic that was almost at the same level of danger was the Spanish Flu pandemic in 1920 that left millions of people dead. “At that time medical equipment was not as developed as now, but neither was the spread of the pandemic as quick as it has been now,” he said.
Doctors are on the front line in the war against Covid-19 to save the largest number of patients, and their efforts depend on the facilities of each country and the number of doctors.
Based in Switzerland, Sharawi said that at the university hospital, they have closed the Opthalmology Department and redirected nursing staff to work in intensive care.
The pandemic “has changed the lives of doctors beyond recognition,” he said. “People who have been practising a certain specialty for many years like myself as an ophthalmologist are now being mobilised to do other medical jobs such as intensive care and general emergency or even help out with administrative matters,” Sharawi told the Weekly.
Besides adjustments to routines, the pandemic has also brought enormous stress. A physician who preferred to remain anonymous told the Weekly that “the main stress that many Egyptian doctors feel is the fear of carrying the disease to their loves ones.” She said that doctors especially in intensive care units are exposed to patients in critical condition. Some of them later suffer from diseases related to stress.
But “Egyptian doctors have proved that they are responsible and are doing their best regardless of the conditions that many of them work in,” she added.
Many Egyptian doctors seek positions abroad, leading to a shortage in the number of locally available doctors. According to the World Health Organisation (WHO), there are 2.2 doctors for every 1,000 citizens in Egypt, whereas the WHO advises the minimum should be 3.4.
However, the doctor who spoke to the Weekly said that “when the pandemic hit Egypt, I witnessed many of those who were preparing to work abroad being willing to offer medical services in Egypt without any pressure from senior doctors.”
Protection against the virus is crucial for physicians, stressed Ashraf Salah, who has been a physician for 25 years.
“The number of physicians who can put in a tracheostomy tube is low. They are precious, so we need to protect them or we will end up by asking dentists to do it,” he said.
People should understand that doctors are working in very difficult conditions, and they should help them rather than make their lives more difficult. When people rushed to hoard alcohol-based disinfectants and surgical hand disinfectants and gloves, some doctors could not find any to protect themselves, he said.
He mentioned that one of his patients had offered him a bottle of alcohol, and when Salah refused, the patient insisted that he should take it as he had 100 more at home.
The anonymous doctor agreed with Salah, adding that the situation in government hospitals was better than in private ones regarding the stock of gloves, masks, and sterilisation materials, although she feared that in the coming days the number of patients may increase.
“Our main target now at the government and educational hospitals is to increase the number of these items,” she said.
Many charity initiatives have taken place to buy hygienic materials for hospitals, and infection-control courses are being held for all medical specialties to train them on how to protect patients and doctors.
Some doctors have also taken the initiative to help patients with other diseases through social media to keep them from coming to hospitals unless absolutely necessary. Through a WhatsApp group “Stay home and ask your doctor”, patients can ask medical questions, easing the pressure on hospitals preventing further infections.
In the midst of all this, physicians are paid a LE19 infection allowance per month, which is a little over $1, complained physician Sherif Abdel-Fattah, an assistant professor of radiation oncology at the National Cancer Institute.
“This is very little in comparison with the efforts and the atmosphere that doctors work in,” he said, adding that when the crisis is over he hopes compensations will be reconsidered.

*A version of this article appears in print in the 26 March, 2020 edition of Al-Ahram Weekly

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