Should public hospitals be brought down in favour of parks, esplanades and hotels? Fatemah Farag goes to Alexandria in search of an answer To the east of the Bibliotheca Alexandrina stands an ugly but important building. Unlike the many modern grotesque structures that have come to mar Alexandria's skyline, this one has a noble cause: the Shatby Hospital. Shatby is comprised of the Alexandria University Children's Hospital, built in the early 1970s, and the Shatby Maternity and Gynecology Educational Hospital, built in the mid-1950s. "This is a tertiary centre," explains Dr Ahmed Musilhi who has worked for seven years at Shatby Maternity and Gynecology Hospital. "We receive critical cases from both primary and secondary hospitals and we are the only hospital of its kind serving the governorates of Alexandria, Beheira, Matrouh and Kafr El-Sheikh," Musilhi added, estimating that in the maternity section alone -- 450 beds -- doctors save 15 to 30 lives a week. "We conduct life- saving procedures and in our line of work the time factor is crucial," Musilhi said. But for some the hospital is an eyesore. They want it torn down. "The idea is to bring down the hospital and replace it with a park, perhaps a five-star hotel and underground parking," said Mostafa Mekki, consultant engineer for the Bibliotheca Alexandrina. "This is important to create tourism associated with the library and to service all sorts of cultural events." Mekki points to the original plans of the library grounds, approved in 1993, which included a green space with mini-trees in the place of Shatby Hospital. "Like any place in Europe," he boasts. Proponents of bringing down the hospital, along with four apartment buildings west of the library, argue that the offending buildings "kill" the view. In July 1999 as the final stages of construction of the Bibliotheca were in progress, arguments for the removal of the hospital gained momentum, spurring a public outcry. In 2000 part of the hospital was demolished. "It all happened like in a dream. On a Thursday night plain-clothes policemen came into the ward and started carrying beds outside with the patients still on them. They were followed by workers who pulled out the windows and then a couple of bulldozers which reduced the building to rubble by early Friday morning," recounts one of the doctors at Shatby who preferred anonymity. Today, in place of the three stories and 50-bed building, there is a small park. Dr Mufid Shehab, former minister of higher education, announced recently in parliament that a specialised committee had issued a report finding the Shatby Hospital buildings on the verge of collapse. In the wake of the 1992 earthquake, the Children's Hospital was shut down for several months until the necessary renovations took place. Today, doctors who spoke to Al-Ahram Weekly say they never saw a committee come in to assess the premises. "I have yet to see a copy of such a report," Omar El-Sebakhy, head of the Alexandria-based Association of the Advocates of Human Rights (AAHR), said. "And I doubt that such a report exists." He added, "It has been suggested that the ground water underneath the hospital is problematic but there are few buildings in Alexandria, and Cairo for that matter, that do not suffer from the same problem." And while Mekki says that if it was up to him he would pull down the hospital as soon as possible, he would not go as far as to say that the building was near collapse. He put it this way: "the building is coming near the end of its shelf life." But he does recount the "incident of the mice" to validate the opinion that the Shatby premises are not suitable. "When part of the building was brought down in 2000, hundreds, if not thousands of mice, ran to the Bibliotheca and embedded themselves into the roof which was still being built. They started eating through our insulation. I would think that kind of a building would be a source of disease," Mekki concluded. Doctors at Shatby are not impressed. "After this happened, the Ministry of Agriculture fumigated the building so thoroughly that not only did not one mouse survive; at one point we feared for the life of our patients. I fail to see how the presence of some mice is good enough reason to pull down a whole hospital," said Musilhi. To date there are no written orders to bring the hospital down. Those in the know, however, claim the decision has been taken already and rumours are rife in the coastal city. It appears that the plan is to transfer the Maternity Hospital to Al-Mowasah Hospital and the Children's Hospital to a children's hospital currently being built in Rushdi. "A hospital like Shatby can't be brought down in one go," explains El-Sebakhy. "Public opinion is being prepared for the move." The plight of another hospital in Alexandria, Al- Mowasah, is telling. Built in the late 1930s and run by the Ministry of Health, the hospital employs some 170 doctors and is crucial to the care of cancer and kidney failure patients. It also services holders of health insurance throughout Alexandria governorate. "In 1999, Presidential Decree No 479 was issued upgrading Al- Mowasah, a project which cost around LE28 million," detailed El-Sebakhy. "Then in 2004, Presidential Decree No 166 stipulated that Al- Mowasah be transferred to Alexandria University, that the university take over all equipment currently at Al-Mowasah and that all doctors at the hospital be transferred to other facilities run by the Ministry of Health." AAHR has filed legal action against the latter decree arguing that it provides the necessary legal loophole to bring the Shatby Hospital down. Musilhi agrees. "Why else should we be responsible for making an inventory for Al-Mowasah?" he asks. The result of such a move, argues Dr Mohamed Abul-Ghar, professor of Obstetrics and Gynecology at Qasr Al-Aini Educational Hospital in Cairo, is that Alexandria will "lose both a great educational hospital [Shatby] as well as its largest health insurance facility [Al-Mowasah] which is not suited for educational purposes". Further, Musilhi highlights the devil in the details. "For example, Al-Mowasah has 100 dialysis machines. Each machine services two patients a day; a total of 200 patients a day. Where will these machines go? And how about the senior doctors who do not know where they will be transferred, or the junior doctors [employed for less than 10 years] who are on temporary contracts and who might find themselves out on the street?" Neither is the substitution of Shatby's Children's Hospital any less problematic. While it has been claimed that the new Children's Hospital in Alexandria's Rushdi district was ready to receive patients, a visit made by Al-Ahram Weekly to the site this week revealed an empty concrete structure far from complete. "Construction on Rushdi [hospital] began in 1992 and the target date for completion was 1995. To date it is not ready and will require many more years and a lot more money to become functional," argues El-Sebakhy who went on to point out the obvious: placing a children's hospital so far away from the maternity hospital [a 20-minute drive in good traffic] defeats many purposes of the hospital to begin with. "That alternative hospitals are not ready shows a lack of coordination between the Ministry of Health, the governorate and other authorities," pointed out the Alexandria Liberary's Mekki. "Sometimes the best way to deal with such a situation is to take drastic action and then everyone will scramble to create a solution. If this is not done, alternatives may never come into fruition." El-Sebakhy begs to differ. "We are talking about people's lives. What really worries me is the haste with which such a decision is being taken. What is the rush? We can wait a few years on the garden." Advocates of the demolition of Shatby Hospital, contending that 'man does not live by break alone', suggest that culture is no less important than people's basic needs. "If the arguments of those who say a country like Egypt should not spend its limited resources on such buildings as that of the Bibliotheca Alexandrina were heeded, we would not have the cultural giant that stands today. The same goes for Shatby Hospital," shrugged Mekki. The hospital's Dr Musilhi is dumfounded. "Want to ask any of my patients whether she stops by the library to download some book before she comes to the hospital? I don't think so," said Musilhi. Abul-Ghar points out that the Bibliotheca Alexandrina cannot perform its cultural role properly if it alienates itself from the majority of people. "The removal of Shatby Hospital to beautify the site of the library will create ill-will amongst Alexandrians towards the library. They will consider that it did them harm and created a serious crisis for patients, doctors, professors and medical education in the city. They will consider that the library does not belong to them."
