Doctors began their planned strike to pressure the government into meeting their demands, reports Reem Leila Doctors started their strike on 1 October as was agreed on 21 September during a meeting of the Doctors Syndicate general-secretary with syndicate branches across Egypt. The strike excluded emergency and ICU units, kidney dialysis and incubators. During the strike, doctors will work only on Thursdays to monitor patients in critical condition. "Patients will also be able to pick up their medication on Thursdays," Ehab Taher, treasurer of the Doctors Syndicate, said. "We faxed hospitals asking them to hang up signs informing patients who are scheduled to collect their medication during the strike with the possibility of picking it up every Thursday instead of every day." The general committee organising the strike warned hospitals across the country to inform patients of the importance of obtaining their medication. Thousands of doctors in Egypt's 387 public hospitals and 1,192 rural hospitals are on strike, causing a severe shortage in medical services provided to patients. However, the strike excluded all hospitals affiliated to universities, the Armed Forces and police. Two weeks ago, President Mohamed Mursi met representatives of the Doctors Syndicate to discuss their demands. The president agreed on implementing the doctors' cadre system starting the fiscal year of July 2013 but that was all. Doctors are demanding a minimum wage for medical practitioners of LE3,000 per month instead of the current LE200. They also want security guards inside hospitals, especially emergency rooms which have been witnessing violent attacks in the wake of last year's revolution which resulted in a security lapse. The healthcare budget should, doctors say, also be increased to 15 per cent of the country's general budget instead of the current five per cent. They also want the government to immediately implement the doctors' cadre system with what they say should be a proper scheme for promotions. Egypt currently spends an estimated LE11.5 billion on medical care, roughly 4.7 per cent of gross domestic product. The international average is 7.4 per cent of GDP. Grants are mainly channelled into the governmental sector, with about 70 per cent going to the Ministry of Health and Population (MHP) and the rest to university hospitals, teaching hospitals, NGOs and private clinics. Funds are also raised from employers who use social insurance. Taher believes "the ultimate goal is an efficient, affordable and accessible medical care system that does not discriminate between people geographically, socially or otherwise." According to Taher, access to global communications and commerce is raising local expectations of better health care. Several human rights organisations have defended the doctors, arguing it is the only way to secure a proper career for them. Among these is Al-Nadeem Centre for the Rehabilitation of Victims of Violence and the Association for Health and Environmental Development (AHED). They have issued a statement which focussed on the doctors' right in striking and using it as a legitimate means to accomplish their goals. Former presidential candidate and current head of the Arab Doctors Union, Abdel-Moneim Abul-Fotouh, announced his full support for the strike. "Safeguarding hospitals, increasing the health budget as well as providing doctors with better financial incentives are legitimate rights of all doctors and not unreasonable demands," said Abul-Fotouh on his personal twitter account. Dr Ahmed Tarek, on strike, believes that doctors should not spend their lives worrying about how to continue the month with the salary the Health Ministry pays them. "I am married with three children. I have been working for four years and all what I'm paid is LE345 along with LE555 in bonuses every three months. This amount is not sufficient to cover all my needs as well as my family," complained Tarek. Another doctor on strike, Mustafa Othman, complained about working conditions. "Most of the time we are working in difficult conditions and in unsafe hospitals. We previously tried several ways to get our demands met but nothing credible up until now has been done," said Othman. Officials at the MHP are denying any shortage in medical services provided to patients at the ministry's public hospitals. "We did not receive any complaints until now, however, we do not know what will happen during the coming days," Deputy Health Minister Abdel-Hamid Abaza said. "The ministry is backing the doctors' legitimate demands in improving their overall situation as long as they do not harm patients or any health institution," said Abaza. The Cabinet has established a committee to explore increasing funding for the Health Ministry, he added. According to Abaza, the ministry will closely monitor the situation. "If patients or any of the ministry's hospitals are affected, the ministry will be obliged to take legal action against violators," Abaza added. Amr Kandil, deputy health minister for preventive diseases, agreed with Abaza. Kandil added that Upper Egypt cities were currently suffering from an outbreak of mumps with more than 300 cases in Qena, Luxor, Assiut and Sohag. "If doctors do not provide proper and speedy treatment for those patients, they will definitely be referred to an internal investigation. Mumps is a contagious disease that leads to painful swelling of the salivary glands as well as its inflammation. It could be fatal if not treated quickly and properly," Kandil said.
