Gourna Hospital Crisis.

We have heard this morning, from a friend of ours who works in the Gourna Central Hospital on the West Bank, that the ICU has been shut down and that the children’s ICU will be shut within three days, leaving all of the women who are waiting for caesarean sections without any post-natal care. The doctor who was doing the deliveries had a nasty shock when he found that he would have no access to the ICU and that all of the nurses/doctors who normally work in the unit have been signed off for ‘holidays’; holidays which they still get paid for no matter how long they don’t work for.  Many of these ‘expecting’ women have no money so this was their only hope for having a safe delivery. The doctor in question was furious that no-one would allow him access to the unit but he decided that he could not do the deliveries without the unit so now the women are in a terrible position. The appointment book was ‘full’ for women having caesareans and they now have to go to a private clinic and pay over 1000LE for their op, money which they do not have. There are no longer any doctors to work in the ICU so they shut them down.

Not only that but they also had two dental rooms, kitted out with expensive dental chairs, such as the ones we use in the UK and Ireland. Well, in his wisdom, the manager of the hospital, decided to shut one room and turn it into a check up room, unfortunately the chair, complete with its wires, was in his way.4810816-i1 So he cut them off and cleared the room, leaving a completely useless, expensive dental chair, which had been donated to the hospital, in the process.

The manager of the Hospital, a Mr. Mustafa Hafni Labib apparently trained as a Doctor specialising in urinary infections, but has had no training in the management of a large hospital or in any management at all. The doctors who are paid to work there also run their own private clinics outside, where they get paid a lot more for equally lousy work. They don’t bother to turn up for work in the hospital but still get paid for it. They ring up and ask him to sign in for them and then don’t bother to come in, or they get him to sign them off for holidays, where they then go and work in their clinics, charging an arm and a leg for the privilege of being treated there.

No-one understands why this doctor/manager is suddenly changing everything and closing things down and many suspect that he is an MB supporter, or perhaps that they were contributing to the care of the hospital!

Twice my husband has had to rush into this hospital for emergency care. The first time he nearly cut the top of his thumb off while working in the Sugar cane field. He was taken, bleeding profusely, to the hospital for stitches but he was told that there was no-one there who could do it for him and therefore he would have to pay to go to the Hospital on the East Bank. They would of course charge for this! They also did not have any supplies with which to sew his thumb with! He decided not to bother and to manage it himself.

Whenever you have a procedure here, either in the hospital or the private clinics, you have to buy all of your medical supplies yourself. That includes drips, syringes, pain-relief, bandages, cotton-wool etc. EVERYTHING. All of the things a hospital would normally have in their dispensary you are required to purchase. The doctor gives you a list, which you take to the pharmacy attached to the Hospital/clinic and there you buy it. Often the list contains stuff you don’t actually need but that the doctor gets to keep.Then you have to pay extra for the doctor and, if you have to stay in for treatment, you also have to pay for the room. It is a massive con!

The pharmacy where you have to buy all of these supplies and medicines make a commission on everything you buy too. Doctors will only send you to their approved pharmacies because they are in a commission-based relationship with them.  I am often shocked at the amount of medicine a patient is required to buy, even if they only have a cold! All of it is about money for the doctor and money for the pharmacy, but no-one gives a damn about the people, and the fact that they are poor! If you are lucky enough to have a caring pharmacist, which we are, then he will often change the medication to a cheaper version so that the very poor person can actually afford it. Often even our pharmacist cannot understand why a certain medication is prescribed and will often refuse to give it out. He is a very knowledgeable and caring man and has never been wrong yet, plus his wife is a doctor so she usually helps him with his work. 

On the second occasion, when Omar had to go to the hospital, he tore his scrotum on a hook on his donkey cart and needed stitches. Once again he was taken to the hospital only to be told, by the doctors’ that it was too serious even for them and they didn’t want to be responsible for his not being able to have children in the future. The doctors were shocked when they saw the tear, which was quite big, but the testes themselves were undamaged. My husband was left reassuring THEM that it was all OK…really! So they sent him home without doing anything. Thankfully, our friend in the hospital called another friend who does the post-caesarean sewing-up, who promptly came around with his little black bag and sewed up the tear. Although he is a nurse he does a better job than any of the doctors here; and he doesn’t charge a fortune. He let me watch what he was doing so I was able to take the stitches out myself when they had healed up enough. Its amazing what you learn to do here as a result of terrible medical care.

A few months ago wahmedscalp2013-05-20 13.14.43 (2)e took Omar’s nephew to the skin specialist doctor, who has a clinic across the road from the hospital. 10 year old Ahmed had developed bald patches on his scalp. To my untrained eye it looked like either a fungal infection or alopecia.When we got in to see the doctor he was very nervous when I said what I thought about it. He had a book of scalp photos with different types of skin problems and said that it was unlikely to be alopecia as ‘what did a 10 year old have to be stressed about’?  Was he kidding? Did he have the slightest clue to how stressful this child’s life was? No! He said it was ‘probably’ a fungal infection and he prescribed over 100LE for creams! That’s like prescribing £100 worth of skin cream for a fungal infection in the West! The doctor had no clue what it was. He also said that if the creams did not clear it up then he would have to have steroid injections in his scalp. WHAAAAAT??? That would cost 150LE! But, for everyone else in the family’s sake we bought the cream which didn’t work! So his father brought him back to the doctor who gave him steroid injections in his scalp and guess what happened? That’s right…absolutely nothing! 

The doctor seemed to know nothing about what might have caused this so I went online and did some research! I thought that perhaps he had picked up the infection from the animals, as he is always with them. I grew up in the country and I was familiar with infections like this. They were a fact of life. I figured they were ringworm of the scalp as the other kids also had ringworm, both on their scalp and on their skin. As it turns out that is exactly what it was. A cousin of Omar’s is also a pharmacist so he went and asked him and he gave him ringworm cream for 7LE and it is now clearing up!!! Ringworm is such a common fungal infection here that I was completely gobsmacked that the doctor never thought to ask whether we had animals or not!  I don’t even think it is ignorance in many of these cases but greed which motivates such bad medical care. They are not interested in people, just money!

And this is why we have such a bad situation in the hospital. I just wish I had the money to set up a functioning hospital and training facility to care for people properly, without doctors stealing every last penny from them. I feel such a sense of hopelessness here sometimes when I experience such bad care in filthy clinics and wish I could set up maternity training and basic healthcare for the people here. Maybe one day it can be achieved…

In the next few  blogs I will describe some of these private clinics, which these doctors own, to show you just how they work and then you can judge for yourselves…

6 responses to “Gourna Hospital Crisis.

  1. Pharmacies have fixed prices on drugs set by the government. That you suggest that doctors are making a commission off drugs is utterly ridiculous. The profit margin is simply way too small for that to happen.

    • Do you live here on the West Bank? You obviously don’t know much about things work here for Locals. Most of them are illiterate and most are sold medicines that they do not need. But I am interested more in the fact that you chose to comment on that fact rather than on the rest of the blog and the isues which exist here. There are two doctor’s ‘surgeries’ around the corner from us…well…there were two. Somebody builds a block of flats and then rents out the building as clinics for Doctor’s. A pharmacy is usually set up on the ground floor to sell the drugs which the doctor prescribes. One of the buildings is now completely empty because the pharmacist himself was busy ripping off both patients and doctors and so they all moved to a pharmacy which did not. It was giving them a bad reputation and and they could no longer afford the rent. But they still over prescribe. The pharmacy still makes a lot of money on unnecessary medication. Thankfully our local pharmacy tells patients if it disagrees with a prescription. They all know their customers. They will also give a cheaper version of a necessary drug to poorer customers. It is very hard to find A) a reliable and honest doctor who actually knows what they are doing and B) a doctor who is not on the make. Once found however, they are like gold dust! And our local pharmacy is pretty good too.

  2. I too live in a city that seems more rural than modern, El Mansoura. I struggle constantly finding decent medical/dental care. When I do, the costs are the same as in the USA where I lived all my life.
    The main reason I found your blog is because of your crochet links, but have thoroughly enjoyed your blogging.
    May Allah always bless you and your loved ones.
    Be strong, stay strong, and always remember you have the “foreigner” card up your sleeve to play when needed. LOL

    • Hi Maryan, I’ve never been to El Mansoura but it has been coming into mind a lot in the past few months! I think the reason it is so annoying is because people here cannot afford the medical care and they are prescribed things they do not need. My sister-in-law was told that she had had a heart attack! (She was anaemic!). She went home to bed with a bag of medicine for her heart and was convinced that she was now going to die! She is in her mid-twenties! My husband had been told the same on a prior visit! I honestly do not know how these ‘doctors’ get their certificate!!! It’s a money racket, nothing more. There are so few good doctors here. Then when someone does actually have a heart attack they don’t recognise it! It’s nuts!
      But I’m glad you enjoy the blog! I spend a lot of time crocheting and knitting! Very little else to do here unfortunately! But it keeps me sane!

  3. I am a healthcare facility planner that has visited, worked and lived in Egypt on and off since 2004. Through my work and my personal relationships with the many Egyptians I have had the pleasure to become colleagues and friends with – I have become very aware of the lack of good clinical family and community based healthcare service facilities in Egypt you describe so well in your blog, especially in the poor rural communities far from Cairo. I would like to chat about this important Egyptian community care and service issue further if you like either vis face book or Skype messaging? Let me know if you are available for this.

    Thanks for sending your own experience and message out for all to read.
    Insha Allah it will bring about the needed care.
    Andrea Hyde

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