imagine a town in the desert west of the Nile with a population about 400,000. It’s a dusty sandy sort of place. You dust the top of a table and within an hour it is covered with grey dust again. When the wind is up you can feel it between your teeth. The town looks half finished with patches of desert and skeletons of buildings scattered among the completed ones. There is no real centre to the town, though there are shops and quite a good market. There is nowhere to meet. There are mosques all over town but women don’t go to mosques here. The authorities do not allow the Christians to build a church. There is some money here with big, sometimes polluting factories, big banks and some nice houses and Mercedes cars here and there, but that is not how most of the people live. They live in shoddily built concrete flats and struggle to provide for their families. The town is a centre of the Muslim Brotherhood. ISIS blew up the police station a few weeks ago.
There are three hospitals and several clinics in the town. There is the government hospital, a rusting and grubby concrete pile with a poor reputation for competence. Then there is the spanking new Technical Hospital with a large external mural showing lots of medical machines but not many people. One wonders if one went in through the doors of this hospital whether it would be full of white wurring machines and perhaps if one looked hard one might find a very rich patient somewhere. Then there is the third hospital, slightly out of town and with not many wurring machines but lots of ordinary people.
The Christian minority population run this hospital. Their logic is “They despise us, burn down our churches, kill our women and children, but when they are in trouble they come to us for help” so we must act according to our faith and custom and care for, respect and love them. The patients, mainly from the majority population, are listened to and taken seriously. The doctors at this Hospital earn less than in the other hospitals. This is because a poor person will never be turned away without care because they can’t pay the fee. The people who pay for this are the families of the doctors and nurses of this hospital in reduced salaries. It is also a struggle to find the money for equipment necessary for treating very ill patients.
In a hospital like this it is absolutely necessary that patients are treated by competent as well as caring doctors. In the medical schools of Egypt, you become a doctor by going to lectures, reading books and passing exams without ever meeting a patient. The doctors then go to the posts difficult for the government to fill, often in villages and practice unsupervised for a year.
Sadat City is located in the Menoufia Governorate where Harpur Memorial Hospital is located. 60 miles north of Cairo. Established by former president of Egypt, Anwar Sadat to be a large industrial City
Dr Edwin Martin and his wife Peta are members of EDA and old friends of the diocese of Egypt
After this they go back to hospitals. It is only in the tiny minority of University Hospitals that they will have any supervision or teaching at all. They practice alone without any of the core medical skills training that young doctors receive in the West, Singapore, South Africa etc. This means that they are never taught how to communicate, problem solve, make a proper diagnosis, review management, treat multiple conditions in one person etc etc. They just practice medicine and learn from their mistakes, if they recognise them as mistakes. And of course, the mistakes are ill, disabled or dead patients.
Dr Mike Davies, Dr Jonathan Day, Peta my wife and a nurse and I have agreed with this hospital that we will help them construct and run a three-year core skills course. The directors of this course will all be Egyptian, the majority of the teaching will be done by them, most of it in real time consulting conditions. We will be teaching the teachers how to teach and doing a minority of the training of the young doctors. The young doctors will be responsible for reading around the subjects they have been taught and, as in the West, will have a log book recording what teaching they have received and what they have learned. They will then be responsible for teaching their fellow young doctors what they have learned. The key to all this is an ethical and spiritual issue, that of becoming a servant and stepping down from a position of privilege. Peta and I are too old to teach medicine but we have many friends who can make things happen all over Egypt. We will be in charge of the social and spiritual care of the people in the project and dealing with the organisational problems which will inevitably occur. It helps that the director of this hospital is a respected 62-year-old man who chooses to live with his own junior doctors in a small hospital room without a sitting room or his own bathroom to serve his patients. He works from 7.00am to 9.00pm every day of the week as well as bearing the burden of the administrative work and one worry is that he will burn out.
But, there is a problem in all this. Over the past 13 years we have been doing this sort of work we never take money in with us in a situation like this, so at the end of all this hard work over 3 years the young doctors will still earn less than the other doctors. And they have families to care for. Why should they do it? We could go in and pay the doctors much more and fill the hospital with wonderful machines. That would make it a western plant and in the long run would be unsustainable. We want to encourage the doctors and nurses to work competently within the economic level of their community with the extra ingredient of love. There is no reason at all for the doctors and nurses to do this other than being passionate to improve the lot of poor members of the community. They are hesitating. Please pray over on all this. These isolated hard pressed colleagues work in a prime target for the terrorists and need all the help that they can get. They are some of the heroes of our faith. We are also working towards a nurse training programme which is still in the early planning stage.
Dr Edwin Martin