Administrative abuse against doctors is a systematic practice within the Ministry of Health and causes a high number of Egyptian doctors to resign from government hospitals and migrate outside Egypt. After the Minya doctors’ accident on January 16, the head of the Egyptian Doctors Syndicate, Dr. Hussein Khairy said: “What has happened is a disaster for all of us, and it’s a result of the policies adopted by the health department.” Despite the fact that the media is calling doctors “Egypt’s White Army” who deserve recognition and respect, the Ministry of Health’s officials have not stopped abusing them.

Once the World Health Organisation declared a state of emergency due to the coronavirus on January 27, Egypt sent a plane to return 306 Egyptians from Wuhan, who would then be isolated in Al-Nagela Hospital in Marsa Matrouh for 14 days. Meanwhile, the ministry announced it needed doctors in various specialties and nurses to work in the hospital for 15 days in exchange for pay of up EGP 20,000 ($1,267), but without clarifying the nature of the work.

After the doctors arrived in Matrouh, they were informed that they would deal with the Egyptians returning from China, for early detection of infected cases. Doctors objected to not being informed of the nature of the work before they travelled, as well as not having received any training related to how to deal with corona infections. Ministry officials threatened that they would subject to military trials if they did not complete the task.

Expulsion of doctors From Al-Sheikh Zayed Hospital

On April 4, Cairo University announced its agreement with the Ministry of Health to allocate the Sheikh Zayed Specialist Hospital affiliated to the Ministry for isolation of infected health care workers at Cairo University Hospitals, provided that the hospital is managed by medical staff from Cairo University and not the ministry. It was an exciting agreement, as Cairo University owns several hospitals equipped to deal with corona cases, while the Ministry of Health had not yet allocated a private hospital for its infected medical staff. Al-Sheikh Zayed Hospital serves thousands of people of Duwaika and Manshiyat Nasir, the poorest areas in Cairo, and upon their knowledge of the news of the agreement, the patients admitted at the hospital and their families protested and organised a sit-in inside the hospital.

Ministry leaders went with the security services to the hospital and met with the hospital administration, after which the protesters were told that the agreement had been cancelled, and the hospital wouldn’t be turned into a quarantine. But after midnight the same day, a large security force led by officers of the State Security Agency went to the hospital to evacuate patients. The medical staff, including the intensive care doctors, were expelled and even prevented from taking their personal belongings. The doctors strongly protested against the raid on the hospital and their expulsion at midnight, when there is no transport available at this time due to the curfew.

The evacuation of the hospital has ended and the hospital was handed over the next morning to Cairo University staff, but what happened after that was never to be expected. After only two days, Cairo University medical staff withdrew from the hospital, and the Ministry of Health asked the hospital’s primary staff to return to work, after two days of their humiliating expulsion.

Threats of dismissal

Many doctors wrote on their social media accounts that they received threats that they would be dismissed if they disclosed the number of infected cases in their hospital or in the event that they required PCR tests when one of their colleagues is confirmed to be infected. This is what happened in the National Cancer Institute when one of the nurses was confirmed infected. The doctors and nurses asked to stop working at the institute and that all the people the nurse was in contact with be tested, but the director of the institute rejected their request and insisted they continue to work and threatened them with dismissal. After three days the epidemic had spread, and 26 health care workers were infected.

Only a quarter of the salary

After the Ministry of Health promised the doctors working in quarantine hospitals EGP 20,000 as a reward for their work in the quarantine hospitals for 14 days, they were told that people in direct contact with infected patients will receive EGP 4,900 ($310) and people in indirect contact will receive EGP 2,450 ($155). Officials have also refused to provide places to quarantine medical staff after they have finished working in quarantine hospitals and have only provided them with oral results of their tests, rather than in writing.

Maladministration

Al-Ajimi quarantine hospital director rejected a request submitted by a newly joined doctor to perform a coronavirus PCR test, despite telling her that he had been in contact with an infected case before he came to work in the hospital. The hospital administration left this doctor working and dealing with his colleagues for more than 48 hours before a test confirmed he was infected. Hospital doctors have complained about the housing of new doctors with veteran doctors who were in direct contact with patients, and this caused the infection of a newly joined doctor to the hospital after he dealt with two doctors whose tests came back positive.

New commissioning system

The Ministry of Health announced its implementation of a new system for assigning physicians after the end of their internship. The old system distributed the new grads to primary health care units for a year to work as general practitioners and then be transferred to residencies. However, the ministry decided that the doctors should start their career working as resident doctors for a period of nine months, alternating with three months as general practitioners in the primary health care units. More than 7,000 doctors from the 2020 grads objected and refused to register in this system, and demanded that they be assigned to the old system but the ministry rejected their demand, so the doctors organised a successful strike. No agreement has been reached yet, so the ministry lost more than 7,000 doctors at a time it is facing a severe shortage of doctors. As a consequence of this crisis, the ministry has refused to sign off/release the 2019 graduate doctors from primary health units so that they can start their residency after completing one year of working as general practitioners.